Apex Clinic: Treat and Beat ‘Runners Knee’


Treat and Beat ‘Runner’s Knee’ 

Runners get a lot of flack, especially from non-runners, who believe that we are quite literally running our knees into the ground with every step we take.  This just isn’t true. ‘Runner’s knee’, otherwise known as patellofemoral pain syndrome (PFPS) or anterior knee pain, doesn’t have to stop you in your tracks.  At Apex Clinic, we have found that 99% of runners that come to us with patellofemoral pain can be cured if the correct treatment regime is applied.

What is ‘runner’s knee’, patellofemoral pain syndrome (PFPS) or anterior knee pain?  PFPS accounts for roughly 20 per cent of all running injuries.  Symptoms include pain in and around the knee cap region, predominantly affecting the front and front/ inside area of the knee.  The pain experienced is non-specific, more like a dull ache, and in some cases will be accompanied by a crunching or grating sound from the front of the knee.

PFPS is often aggravated by running up or downhill or by walking up and downstairs.  Kneeling for long periods of time and prolonged sitting can also cause a flare up of symptoms.  Unfortunately for many longer distance runners, PFPS often strikes as mileage increases (especially if you are running above 30 miles per week).

Causes of ‘runner’s knee’:

The knee cap (or patella) sits in a little groove in your thigh bone.  When all is working as it should, the knee cap slides easily up and down this groove as you bend and straighten your knee.  However, when the outside or lateral structure s, holding the knee cap in place become too tight and the inside structures become too weak then an imbalance or ‘maltracking’ occurs.  It’s a bit like pitching a tent; if the guidelines on one side have too much tension, then the tent won’t sit straight.  This means the tent will be unsteady, drifting towards the side where the guidelines are tightest.

Treat it and beat it:

The good news is, if treated properly, ‘runner’s knee’ can be cleared.  Depending on the patient, following an initial assessment of their injury, treatments for PFPS are as follows:

1) Manual stretches: a physio progressively stretches the outside knee structures to allow the kneecap to relocate back to its correct position in the centre of the groove.

2) Taping: in severe cases, a physio will show their patient how to tape the kneecap in order to pull it back to the centre until the imbalance has corrected.

3) Specific home strengthening exercises: 2 to 3 strengthening exercises are given to be completed daily at home with the purpose of strengthening the inside knee muscles (VMO), allowing them to pull the kneecap inwards and back into position.  These exercises must be done with a biofeedback machine in place.

4) Specific home stretching exercises:  A regime of stretching exercises may also be given after muscle length testing to help improve flexibility of any tight leg muscles.

5) Foot biomechanics: Having flat feet often goes hand-in-hand with ‘runner’s knee’ or PFPS.  A physio needs to assess the biomechanics of the feet (how they move) to establish whether insoles or orthoses are appropriate.

Biofeedback machine: the secret weapon for successful rehabilitation:

At Apex Clinic we could not achieve our high success rate of clearing this pain without a biofeedback machine.   All too often, knee rehab is doomed to complete failure when patients do their home exercise programmes without properly engaging the relevant muscles required to ‘fix’ the problem.  The biofeedback machine works by passing electrodes over the patient’s weak inside knee muscles, beeping and lighting up when the correct muscles are ‘activated’.  This really helps patients understand how it feels when they activate the specific muscles needed to successfully strengthen the knee muscles.

Get back on track:

The good news for runners is that in most cases ‘runner’s knee’ doesn’t have to disrupt your training.  Proper diagnosis and treatment will help you treat and beat ‘runner’s knee’ and get your kneecap and running regime back on track!