Knee pain is one of the most common complaints seen at The Physiotherapy Place in which running is often a trigger. Everyone reacts differently to pain with some stopping running due to pain or others running through pain, but who is right? Well depending on pain levels the answer often lies somewhere in between!
Different types of pain..
Patients frequently want to know what is causing their pain and whether they can still run. We know that most running injuries are caused by overuse and poor activity management, pain is very subjective so everyone will have a different experience of what they are feeling.
Below we shall explore common areas of knee pain and if there are things we can do to prevent knee pain when running.
Pain at the front of the knee:
This area of the knee is one of the more common painful areas for those seeking treatment and advice in clinic. It is often referred to as ‘anterior knee pain (AKP) ’ and the cause can come from various sources and relates to any pain coming from the front of the knee.
Patellofemoral pain syndrome (PFPS) or ‘runners knee’ accounts for a significant portion of AKP in which the source of pain is found to be the patella or more commonly known as kneecap. This joint is responsible for transferring huge forces generated by jumping, running and bending in which the patella runs within a groove formed by the knee itself. The repeated stress is often associated with malalignment of the kneecap which in turn can start to cause pain around this area.
Another potential source of AKP seen frequently in running populations is the patella tendon which lies just below the kneecap and is the tough band of tissue which attaches the kneecap to the shin. Again like PFPS this area is under a huge amount of stress with the load of running. This type of pain is known as patella tendinopathy or ‘jumpers knee’ and is similar to pain seen in the Achilles tendon in which microscopic degeneration of the tendon causes pain.
Pain at the outside of the knee:
There are several sources of pain which can occur on the outside or lateral part of the knee but in the absence of trauma the main source with runners is the iliotibial band or ITB. Often referred to as ITB syndrome, sharp pain is commonly felt on the outside of the knee with activity. The ITB runs along the outside of the thigh and inserts on the bone at the side of the knee and irritation of the band on the bone that causes pain. Again it is seen as an overuse injury in which running frequency, distance and speed need to be determined to manage this type of pain.
Pain at the inside of the knee:
In clinic we often see pain on the inside of the knee or medial knee. In running there is less change of direction or contact with others which can rule out ligament injuries in the majority of cases. Ligaments are tough fibrous bands of tissue which hold the structure of the bones together to make up a joint. Injuries involving these structures usually require direct external force which can tear or put the ligament under tension and is referred to as a sprain of the area.
Causes of pain on the inside of the knee (and the outside) which can be potentially caused by running (amongst other sports!) is a meniscal injury. A meniscus is seen as the shock absorbing or cushioning structure that sit between the knee joint and are made up of an inside and an outside portion. Pain from this structure can indicate irritation or a possible tear which can be the source of pain.
How to prevent knee pain when running…
We have some typical sources of pain and associated areas but what can we do to minimise symptoms and its effect on function?
1. Warm up and cool down! We have all heard of it and probably done it at some point but how many of us do it regularly? Good examples are spending some time warming up muscles with light activation exercises like squats or heel raises combined with dynamic stretching. Can we do some stretching or mobility when we return from a run which helps with flexibility.
2. One of the biggest mistakes we see in clinic is runners increasing their training load too quickly in a short space of time which usually leads to one thing…pain! Give your body time to adapt to loads placed upon it and listen to you body. With most overuse injuries running with some pain or discomfort is ok but there are limits.
3. Another common issue is running on consecutive days with too little rest. Some recovery days are needed especially if you are experiencing pain, this may include cycling or walking instead of running, stretches or gym work but all with the view of managing load.
4. At The Physiotherapy Place we are advocates of strength training even with runners! We know that resistance training can give us the resilience needed for the rigours of running so heading to the gym may be as beneficial as going for another run.
Can Physio help…
If you have had at least several weeks of pain which you are finding difficult to manage or have not improved then we would recommend having an assessment at The Physiotherapy Place as our team is placed to diagnose and treat your knee condition.
If you are suffering with knee pain of any discomfort we at The Physiotherapy Place are here to help. Book an appointment or FREE phone call consultation with us and let us help you get back to health!