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Runner's Knee

The Cambridge Physiotherapy services available at the betterNow! Healthcare clinic can help you with the affects of Runners Knee, otherwise known as Patellofemoral pain (PFPS) got its nickname because of its prevalence in runners.

 

KNEE

A term I’m sure a lot of you will have heard of is mal tracking which is essentially where the patella (knee cap) is being pulled

essentially out of alignment during movement of the knee.

 

Who it affects?

 

Women:Men = 2:1 (according to the British Journal of Sports Medicine)

 

This increased number in women is partly due to the increased angle between hips and knees. (Women tend to have wider hips, resulting in a greater angling of the thighbone to the knee, which puts the kneecap under more stress.)

 

Symptoms

 

  • Knee cap pain
  • Pain with sitting for long periods
  • Pain to stand
  • Pain down stairs> up stairs.
  • Crepitus (creaking/clicking of knees)

 

Causes

 

Biomechanics- often poor lower limb biomechanics or stiffness in the thoracic/lumbar spine can contribute to PFPS (see diagram 2).

DIAGRAM

 

Muscular Imbalance- often simply related to biomechanics but can simply be as a result of an old injury, postural habits, lack of stretching/strengthening to mention a few. The main muscle imbalance I will see in clinic is hamstring tightness and quads/gluteal weakness (glut med and max) but tightness into calf muscles can also contribute to the PFPS.

If gluteal strength is reduced it will lead to possible overuse of other hip stabilising muscles including Tensor fascia Latae (TFL) which attaches into the Iliotibial band (ITB). The ITB attaches into the side of the knee and if stiff it can increase pressure on structures on the outside of the knee which in turn can alter knee cap movement and alignment and cause symptoms of PFPS.

 

Variation in patella size/shape- the patella may be larger on the outside than it is on the inside, it may sit too high in the femoral groove, or it may dislocate easily.

 

What can help to ease the pain?

 

Correct footwear- after 300 miles or so your trainers will need replacing as they will be worn and will be providing less support than they should.

Stretches for hamstrings and Calf muscles will help to reduce pull on the front of the knee.

Specific quadriceps strengthening exercises will also help to encourage correct patellar alignment.

At the first sign of pain, cut back your mileage. The sooner you lessen the knee's workload, the faster healing begins. Avoid knee-bending activities, downward stairs and slopes until the pain subsides.

PHYSIOTHERAPY- manual therapy and exercise therapy to alter abnormal muscle function will help to correct lower limb and back alignment.

 

Myth

 

Rollering will help reduce tension in my ITB- The main thing to note is that the ITB on its own will not tighten as it is non-contractile so it is essentially thick connective tissue.

With this in mind, rolling your ITB on a foam roller will not help to loosen the ITB. Loosening the correct muscles of the hip will help but you should ask your Physio for direction on this. Manual Therapy will help to loosen the correct areas of tension.

 

If you have any other questions about runner’s knee feel free to give us a call on 01223832808 and I will happily discuss it further.

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Ola is a physio with 20 years experience and has a special interest in musculoskeletal

conditions, sports injuries, biomechanical assessments, orthotics and keeping the elderly fit and independent.

 

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