With the sun out and the new year starting, running season is well and truly underway. And it’s about this time of year as a physio I start to see an uptick in running injuries, with most of them involving the knee.

So I thought I’d do a little piece on some of the more common knee conditions I see in runners, this post will talk through a few of those and better yet, how to manage them while keeping fit!

PATELLO-FEMORAL PAIN (PFJP)

What is it?

This is probably the most common knee injury I see. PFJP is basically pain and irritation around your patello-femoral joint (go figure!!), this joint is basically the knee cap (patella) and the thigh bone (femur).

PFJP is kind of an umbrella term for most patella pain that comes on without trauma or any other pathology.

It is most commonly a result of overload, so this often happens when people suddenly increase their running loads, change their running surfaces or add in extra strength work. None of these things are bad to do, but they can sometimes upset the knee!!

What does it feel like?

PFJP is often described as a vague or bruised type of pain that can be felt on either side of the knee-cap, it tends to get worse with use, and lingers after exercise. Other triggers tend to be stairs or inclines and squatting.

So how do we manage this then??

The initial treatment for PFJP involves decreasing the aggravating factors, so depending on the severity of symptoms, this can be anything from slightly reducing how often your running, to having a complete rest. More often then not, we can keep you pretty active during this time! Pushing through this kind of pain is not going to cause any physical/long-term damage, but will just annoy something that is already pissed off!

Other treatment involves addressing the causative factors and adding in some targeted strength work. This often includes a lot of single leg work, the benefit of this is it helps reduce injury in the long run, as well as making you a better runner!!

PATELLA - TENDINOPATHY

What is it?

Another classic. This is often referred to as jumper’s knee, but it is most common in runners…….

Anyway, this condition is basically an irritation of our patella tendon, which is the tendon that attaches our knee-cap to our shin bone (tibia). Patella tendinopathy happens as a result of overload, just like PFJP. Essentially, this overload causes the tendon to get angry as it hasn’t had a chance to recover between runs.

 

What does it feel like?

Pain is often felt under the kneecap or top of the shin. Again it feels like a bruised/achey type of pain. This kind of pain typically is bad at the start of exercise, but gets better as we warm-up, then gets shit again at the end of exercise. It often feels tender or bruised on the bottom of our knee cap.

So how do we manage this then??

Similar to PFJP, we aim to reduce the aggravating factors while keeping you as active as possible. This will vary on how angry your knee is. Often too much rest is counter-productive for this condition. Tendons need physical load to get better, so we need to find a happy-medium.

Again we need to strengthen the tendon, but also the lower limb in general. This often begins with isometric exercise, (longer holds of a half range position – so think sustained wall squats etc..). Durations and sets will vary on the individual, but we usually roll with 4-5 sets of 30 seconds on with 30 seconds rest.

There are also a few little tricks we have to keep you moving with this pain as well!

ILIOTIBIAL BAND (ITB) PAIN

What is it?

This is a condition that is often missed or misdiagnosed. It is essentially another overload related condition, that caused pain in the insertion of our ITB. The ITB is a long fibrous piece of tissue, that begins at the hip and inserts into the outer part of our knee, just below the knee-cap.

What does it feel like?

Pain is typically felt on the outer part of the knee, but can also span right up the side of the thigh and into the outer part of the hip. Pain tends to get worse with running and again can have a residual ache following.

So how do we manage this then??

You might be noticing a trend by now, but you guessed it – load management is the key. We want to find the sweet spot between doing too much and doing nothing. We also look at other contributing factors in footwear, biomechanics and strength. There is also a lot of exercises that we can prescribe to increase single leg strength.

So there they are, 3 really common knee injuries that I see in runners. Hopefully this guide has shed some light on those for you. And if this hasn’t been relevant to you, but you know someone who it might help, it would mean the world if you could pass it on!!!

Thanks for reading,

James,