As the days are getting lighter, one of the things I notice is more runners out in the mornings and evenings. Race season is fast approaching with people upping their mileage in order to get their legs and bodies prepared for race day. I often see a number of people in the clinic at this time of year who are training for the Edinburgh marathon, and this year has been no exception.
Of the various aches and niggles that are common in runners, runners knee is one of the most common and can also be one of the most debilitating. Runners knee is the layman term for Patellofemoral Pain Syndrome, a condition that causes pain in the front of the knee due to irritation of the underside of the kneecap.
The kneecap (patella) is a bone that is embedded in the quadriceps muscles, the large muscle at the front of the thigh. It is a very mobile bone that slides up and down the lower end of the thigh bone when we bend and straighten our knee. Because a huge amount of force goes through this joint, the patella has a very thick layer of cartilage on the underside to protect the bone from being damaged - in fact this is the thickest layer of cartilage in the body. In normal circumstances the patella slides centrally up and down the thigh bone, distributing the force evenly throughout the surface of the cartilage. However if the leg mechanics change and the patella is caused to move off centre, this is when problems can develop due to too much pressure being applied to one side of the kneecap, leading to irritation and pain.
The type of pain that is felt with runners knee is usually quite a sharp pain in the front of the knee, sometimes spreading to the inside or outside. It is commonly a problem in runners because of the increased force going through the knee with running, but can also be felt when walking and in particular when going up and down stairs. In most cases, the pain will subside with rest but if there is more severe irritation then it can be sore at rest and there will be some swelling around the knee.
In order to effectively treat runners knee, two things need to be done. Firstly the inflammation must be settled and this is achieved with rest, stretching, and treatments such as ultrasound. Secondly the reason that the knee cap is sliding off-centre must be identified and addressed otherwise as soon as you go back to doing the activity that caused the runners knee, the pain will just come back. This will be different for everyone and a thorough assessment of the whole leg including the hip and the foot needs to be done to identify if there is a weakness or a tightness somewhere that is forcing the kneecap off centre. Once this has been addressed and the kneecap is back sliding up and down in its normal fashion, then training should be recommenced.
Runners knee is just one of the knee conditions we specialise in treating at The Physiotherapy Place. For more information, you can download our free e-book on knee pain here or if you would prefer to speak with an expert physiotherapist about your specific case, get in touch to arrange a FREE 15 minute telephone consultation.