Peanut butter and jelly.  Woody and Buzz Lightyear. Batman and Robin. Minnie and Mickey Mouse. Running and knee pain?  Wait a minute.  One of these pairs does not belong.  Of all the duos listed above, running and knee pain doesn’t have to be your reality.  

As a fellow runner I have experienced bouts of knee pain in my day, but also I’ve enjoyed many miles without the dreaded “runner’s knee” symptoms.  We understand you’re logging your miles, training hard and pushing your limits. We want you to know that running and knee pain problems do not have to go hand in hand like many runners incorrectly believe. In this blog you will learn about what “Runner’s Knee” is, some common reasons why these symptoms occur, and 3 actionable strategies and exercises to try out for yourself to take control of your health and where to go to get you back to running pain free.

Today we are talking about Runner’s Knee or Patellofemoral Joint Pain.  So, what is it?  The patellofemoral joint is where your patella (kneecap) and femur (thigh bone) meet at the front of your knee.

Common Symptoms Occur:

• When exercising
• When bending the knee, such as when climbing the stairs, jumping, or squatting
• After sitting for an extended time with the knee bent, such as while watching a movie or after sitting at their work desk. 

Most runners describe their symptoms as temporary soreness or dull achiness usually next day soreness - but can occur during - and the symptoms are generally at the front of the knee but can be hard to localize and pinpoint. 

Why does it happen?

Although there isn’t a pinpoint reason for Runner’s Knee to occur, there are a few common factors that can contribute to developing these symptoms.  

Poor Movement Patterns

As we run our body’s position can impact the load our joints experience with our exercise.  There are certain positions that can put the knee at a greater load and a technique that tends to overload the knee joint specifically is overstriding and excessive heel strike. 

Rapid Training Volume Increase

Have you recently increased your mileage or frequency of your runs? This may be contributing to your symptoms without appropriate foundational mileage.  Take a look at your mileage tracker to take an audit of your miles the past two weeks. Have you significantly increased your distance or overall miles for the week?  More hills?  All of this information can provide data to determine your best next step for addressing your symptoms.

Treatment & 3 Strategies:

When runners develop overuse or nagging injuries we must identify the main reason for the symptoms to start working on such as:

• Training Volume
• Movement Pattern
• Muscle or joint stiffness?
• Muscle weakness or asymmetries?
• Running Technique?

 Taking a comprehensive approach and looking at the big picture of your training and lifestyle outside of your training will help you and identify a starting point.  If you’re not familiar with or unsure of where to begin, please reach out to a trusted physical therapist to get you on a personalized plan to take action today!

 Avoid Complete Rest

Acute injuries rest is important to an extent, but for anterior knee pain that has occurred for longer than a few weeks or years we must address these symptoms. Identify potential causes and how to make changes. We want to train our knee to adapt and tolerate the load. 

 Quicken Cadence

 Increase cadence to 170-18o steps per minute (spm).  Be aware that by increasing your cadence doesn’t mean you need to quicken your pace. This change in cadence allows the load to move away from the knee joint and allow your muscles and tendons take on the load which our bodies are designed for.

Build up strength to tolerate load 

Initially if your knee is feeling aggravated completing some stretches for your quadriceps muscle may benefit for some relief. But a large portion of long term symptom management and relief that can be overlooked is building up the strength to tolerate the load and running. 

Strengthening build up the joint to tolerate running. Try the exercises below for the next week and see if you have relief in symptoms.  If you’ve had your knee pain for a long time, the recovery process will take longer, but remember we all have to start somewhere.

Straight Leg Raise Lift Over

Decline Squat Holds 

 Start with both heels elevated on a plate or ramp(not shown in video). Push your knees forward  into a half squat hold for 45-60 seconds. Repeat five times. Then go about your day. You can perform one set of these five times per day. Expect your pain to rise 2-3 points (out of 10) during these exercises and settle back down afterward. 

Single Leg Decline Squat Hold 

If regular squats don’t feel challenging enough, you can do these exercises standing on one leg. Sink into a single leg half squat on a decline for 45-60 seconds. Repeat 5 times. Perform them five times per day. Expect your pain to rise 2-3 points (out of 10) during these exercises and settle back down afterward. Heel elevated on a plate or ramp(not shown in video)

Single Leg Banded Hip Abduction 

Runner’s knee can be something of the past for you. With these strategies as a starting point you can begin to see potentially where you're overloading or making a training error that may be leading you down the road with knee pain.

Don’t just sit back and let your symptoms limit your training. We encourage you to take action to resolve your symptoms and begin your journey toward restoring movement, function, and reducing symptoms of pain. If you are looking for further guidance or one on one exercise programming, please contact us to learn more about what our performance specialists at Inside Out Strength and Performance can do to help you reach your goals and live strong and confident in the life you live.

Most people don’t know how to stay healthy and fit without getting hurt. At Inside Out Strength and Performance we provide a clear plan to get you in the best shape of your life, without getting injured, so that you can be active and confident that you’ll feel your best for years to come.

We help North County San Diego’s active adults and runners dealing with pain or injury get back to living a pain-free, strong, and confident life.

We are the Strength Docs who help active adults and runners live a strong, confident, and pain-free life. Fill out our contact form here to get a clear plan and get started.