Running into Runner’s Knee? The Science Behind Injury, Prevention and Treatment

Discovering the science behind the injury and how to prevent and treat PFPS.

Many of our online followers have been asking us about patellofemoral pain syndrome (PFPS), more commonly known as runner’s knee.  What is it?  What exercises can prevent it?  What exercises can treat it?  With the abundance of conflicting information on the internet, finding answers to these questions can feel like a wild goose chase. We called on Juan Nieto, Polestar educator and co-founder/master trainer of Runity, to shed some light on the science behind runner’s knee and what you can do to prevent and treat it. Among runners, lower extremity injuries are very common– up to 79.3% of runners will experience these injuries, about half of which occur in the knee (Van Gent et al., 2007).  Patellofemoral pain syndrome, also called anterior knee pain syndrome or runner’s knee, describes an overuse disorder that occurs in the patellofemoral region and results in pain behind or around the anterior knee.  The causes of PFPS can vary widely due to the complex interactions between intrinsic anatomic and external training factors (Collado et al., 2010).  In other words, runner’s knee describes the symptoms of a painful knee injury, not the cause of the injury.  The cause is subjective and depends on the runner’s anatomy, strategy, and training. Searching the internet to find specific exercises for your runner’s knee will produce a mixed bag of results due to the subjective nature of the injury.  Depending on whether your injury is associated with vastus medialis/vastus lateralis imbalance, hamstring tightness, or iliotibial tract tightness, the best exercises to treat it will vary.   What can you do to prevent runner’s knee?  According to Juan, there’s no standard set of exercises to prevent the injury since it depends on the person and their movement strategy.  When choosing exercises, it’s important to pick exercises that bring relief and do not flare up pain.  The only true method of prevention is to make sure that the tissue capacity of the runner is bigger than the workload.  In other words, the runner has to be fit enough to run the distance they want to run and allow the appropriate resting periods in between to let the tissues recover.  Additionally, technique retraining could reduce the amount of ground reaction forces that the runner is receiving, meaning they can run the same volume but reduce the workload for the tissues. If you already have runner’s knee, what can you do to treat it?  Again, there’s no magic routine to treat the condition because causes vary.  The best thing you can do is see a movement specialist who can conduct a proper assessment and use sound clinical reasoning to design an exercise plan, test it out, and modify it as necessary to settle on a final selection of exercises that create gradual, positive adaptation (strengthening) without irritation.  If you have runner’s knee, it’s important to remember to avoid irritative exercises and to try to resist running too much too soon.  Most importantly, KEEP MOVING!  Movement heals and having positive movement experiences throughout the body will quicken the healing process for your injury. Want to learn more about efficient, pain-free running?

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