Running into problems: Runner's knee
Updated: Apr 19
"Running will ruin your knees," a phrase I'm sure we have all heard. Despite what your well-meaning but potentially ill-informed neighbours, co-workers, and relatives may have told you, there's no evidence that regular running damages knees.
What is runners knee?
Runners knee is widely defined as "diffuse anterior knee pain, usually with activities such as squatting, running, stair ascent and descent". When it comes to injury management it is important to understand that injuries have multiple different names. The names for runner's knee include, Patellofemoral pain syndrome, chondromalacia patella, anterior knee pain, and anterolateral knee pain. The important thing is that we can recognize the pain pattern and understand the mechanics on why the pain comes about.
What structures are affected?
It is believed the areas affected in runner's knee are the patellofemoral joint and the articular cartilage. This is the joint between the back of the knee cap and the front of the lower thigh bone. People with this condition will often describe this pain as being "behind the knee cap". Articular cartilage covers the bone and allows the bones to glide over each other with minimal friction.
In movement, the joint experiences compressive load with activities like running, going up and down stairs, and getting out of a chair. With poor management of running distances or excessive load, the cartilage under the knee cap can become inflamed, causing pain.
Did you know? Recreational Runners are less likely to develop arthritis in their knees compared to nonrunners.
Those are the facts. If anything, long-term studies have found that runners have less incidence of knee osteoarthritis. One study that followed runners and nonrunners for 18 years found that, while 20% of the runners developed arthritis during that time, 32% of the nonrunners did as well.
There are some simple ways to keep your knees happy.
1) Get stronger
There's increasing support that many people with runner's knee have a few common biomechanical problems. These include weak hips and glutes, which give way to instability further down the legs; weak quadriceps, which can make it difficult for the kneecap to track properly; and tight hamstrings, which can increase impact to the knees. A strengthening and conditioning program can go a long way to preventing runner's knee.
2) Maintain appropriate body weight
Extra weight places tremendous strain on your knees. Each additional kilo of body mass puts four extra kilos of stress on the knee. Running's long-term effect on keeping weight lower is thought to be a key reason why, runners might have less incidence of knee arthritis.
Runner's knee is a very common occurrence for the running enthusiast. Like many injuries affecting any athlete, there is not one clear cut solution. Consult your local physio for an individually tailored solution to fit you. Once your symptoms settle, do not forget the long-term planning for prevention of recurrence as this is often overlooked and should be a priority.
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