Running the Extra Mile: Overcoming Runner's Knee with Physical Therapy

Running the Extra Mile: Overcoming Runner's Knee with Physical Therapy

Do you have knee pain when running?

Is it like clockwork everytime you go to increase your volume your knee flares up?

Do you constantly find yourself changing your shoes every six months? Calling up your chiro or massage therapist to help you work out the kinks? Popping ibuprofen/advil just to take the edge off?

What if we told you- you have the tools you need to overcome your knee pain.

What if we told you- there is a pain you can run through just as much as there is a pain you shouldn’t run through.

What if we told you that the treatment could be very simple and not require an invasive treatment like surgery

Pain at the end of the day is very subjective. It is not black and white and requires much dissecting. We do our best to qualify it and make it easier to understand for each of our clients. We like to use a stoplight analogy. Green would indicate no pain, so it’s a go!. Yellow would indicate some discomfort but a level which is tolerable so we proceed slowly, with caution, because the light may turn red. Red would be pain that is intolerable so you need to stop.

Knee pain can be caused by many different diagnoses. At the end of the day a diagnosis is just a small piece of the puzzle. 

We find it to be very crucial to look at the whole body when evaluating any type of ache or pain. We will definitely assess the knee because yes that is where the pain is. However, we can’t forget we are human beings who function through multiple systems which are constantly working together to allow us to function. If a joint, muscle, organ, etc in the body isn’t showing up- that just means another body part has to show up twice as much to make up for it. This is the body’s way of protecting itself. It can only function like this for x amount of time. It is a compensation to allow continued function in the short term so you can go on living and completing necessary day to day tasks, but it isn’t sustainable long term. The body will sound that pain alarm when enough is enough.

According to research, approximately 25 percent of running- injuries are attributed to patellofemoral pain syndrome percent of running- injuries are attributed to patellofemoral pain syndromePFPS), or “runner’s knee.” In our experience, the number of women affected by this condition is significantly higher than the number of men due in part to the angle that women’s wider hips create at the knee joint. Runner’s knee has been described as usually like a dull, diffuse ache present in and around the kneecap. It can occur for many reasons, for example- weak hips or an asymmetry in quad strength, which can cause the knee cap to shift out of place as you bend and straighten your leg. These problems ultimately lead to irritation in and around the joint.

To understand the big picture- we must assess walking mechanics barefoot. That way we can see how the foot and ankle are interacting with the ground. This gives us more insight on how things up the chain could be affected, such as the knee and hip. The foot and ankle will become crucial when it comes to strengthening the knee and hip for return to running.

We don’t normally like to sideline people 100% from activity- as we do understand sometimes it can be important to mental health. However, rest is something to consider. We make sure to educate it is just temporary with the goal of returning to increased activity as soon as possible. The rest period could still include walking and light, low impact activity (swimming or biking) instead of running, performed in combination with some mobility exercises to target any deficits

With an activity, like running, it is important to consider the volume of the activity and how the accumulated impact will affect the human body. When walking our foot & ankle must be ready to absorb 1-1.5x our body weight, but with running the foot & ankle must be ready to absorb 3-4x our body weight. Therefore, the calf muscles must be trained appropriately to be able to absorb the force and propel you forward. If they are not then muscles and joints up the chain have to make up for it.

The information the foot and ankle sense when hitting the ground helps the body determine the right response for safe and efficient movement. The foot relies heavily on the vibration it receives from interacting with the ground to produce any movement. Since this information comes from the nerves in the skin on the bottom of the feet, footwear can have a big impact on the ability to accurately perceive impact forces. This is why shoes can have such a big impact on the way we walk, run, and move.

The more cushioning a shoe has, the thicker the sole, or the more rigid it is, the more it will alter the body’s perception of impact forces. Be careful when footwear shopping. If you have questions about what is the best footwear option for you- we can help you at Clash Physical Therapy & Health Services. We aim to advise you to pick a shoe appropriate for your specific body and goals. That way injury risk is low and foot health is high.

When we treat a client who has been diagnosed with Runner’s Knee here at Clash we prioritize foot to core connection. This will create a functional carryover to running gait. Exercise prescription to address this function will be very unique to each client’s specific deficits and goals. Unfortunately, there are no “three best exercises to resolve runner’s knee.” If someone tries to tell you otherwise, please kindly thank them and walk away to seek another opinion. Yes, there is much research to show that working on lower body strengthening, specifically foot, knee, and hip can help resolve knee pain. It’s just not as easy as 1, 2, 3 because each person presents with a unique set of past injuries, experiences, beliefs, and goals. 

Looking to get your knee, foot, or hip assessed to find out if you can improve your running gait?

Want to prevent being sidelined by Runner’s Knee this Spring?

Contact us today!

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