Runner's Knee Guidelines

Published on 03/5/2014

What is PFPS?

Patellofemoral Pain Syndrome (PFPS), more commonly known as “Runner's Knee,” is identified by a pain underneath the kneecap (patella). The pain can be sharp and sudden or dull and chronic, and it may disappear while you're running, only to return again once resting. While running form issues may be to blame, the actual cause of the injury can usually be traced back to weak quadriceps and/or tight hamstrings. The weak quads are unable to support the patella, causing it to track out of alignment, and inflexible hamstrings can put pressure on the back of the knee.

How do I Identify Runner's Knee?

Patellofemoral pain syndrome can affect one or both knees. PFPS is most common in younger athletes, beginner runners and female runners. Younger athletes and beginner runners tend to have poorer biomechanics, while a female’s anatomy places an added stress at the knee joint. Symptoms of runner's knee include tenderness behind or around the patella, a pain toward the back of the knee, a sense of cracking or a sensation that the knee is giving out.

What are the Causes of Runner’s Knee?

Most of the time, poor biomechanics play a crucial role in Runner’s Knee issues. By landing on the heel in front of the body’s center of mass, a shearing force is placed on the patella, and it is the only thing stopping your body from collapsing. This added stress causes a sharp pain when overused. Another cause may be that the patella is larger on the outside than it is on the inside, it may sit too high in the femoral groove, or it may dislocate easily. Also, worn cartilage in the knee joint reduces shock absorption, high-arched feet provide less cushioning, and flat feet or knees that turn in or out excessively can pull the patella sideways. Some of the muscular causes can include tight hamstring and calf muscles, or weak quadriceps that cause the patella to track out of alignment.

How do I Treat Runner’s Knee?

To help prevent PFPS, it is best to run on softer surfaces, keep mileage increases to less than 10 percent per week and gradually increase hill work into your program. Visit a specialty running shop to make sure you're wearing the proper shoes for your foot type and running gait. Lastly, strengthening your quadriceps and stretching your hamstrings will also improve patellar tracking.

At the first sign of pain, cut back your mileage. Avoid knee-bending activities, canted surfaces, and downward stairs and slopes until the pain subsides. As you rebuild mileage, use a smaller stride on hills. Consider new shoes if strengthening exercises don't fix the problem. See a doctor if the pain persists in order to rule out another condition.

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