Runner’s knee is the common term to describe pain on or around the patella (kneecap). It gets its name because of the higher occurrence among people that run. However, it can occur in other sports or activities that repeatedly stress the knee with activities such as gym, walking, jumping and cycling. Managed correctly and early in appearance or better yet in prevention programs, it rarely progresses to chronic conditions. The first step in resolving runner’s knee like any musculoskeletal issue is to assess and find the real cause and contributing factors. In runner’s knee, it’s crucial to rule out the joint and passive stabilizers, the ligaments and cartilage as a source of pain or instability. The second step is to assess muscle length-tension relationships around the knee for muscles such as the gluteals, hamstrings, gastrocnemius, quadriceps, hip flexors and lastly adductors. Like all joints, the knee joint has muscles that provide stability for the knee to function optimally. Finally, the knee joint needs to be assessed under load and with different directions and movements to find any muscular or joint stability weakness.
What can contribute to runner’s knee & why it’s important to get a thorough assessment:
- trauma to the patella
- patella instability
- flat / pronated feet
- weak supporting musculature
- arthritis / Chondromalacia
- Patella bursitis
- baker’s cyst
Once a diagnosis is decided, the goal would be to combat the issue, and it’s contributing factors, some examples of how we treat runner’s knee are:
- Restoring mobility with manual therapies (massage, dry needling, joint mobilizations)
- Strength program to address the deficits
- Kinesiotaping (improve/alter proprioceptive feedback)
- Movement education
- Modification of running program
Muscles respond best to a variety of load types (concentric, eccentric & isometric), with runner’s knee, it is crucial to focus on strength across a broad range of angles and progressive loading schemes. Your specific activity and sport requirements will dictate how much emphasis is placed on each range of motion through the knee. For example, the knee experiences a greater range of motion during a squat compared to running.