The knees engage extensively during any physical activity, be it running, cycling, walking or any other day-to-day movement. Any form of knee pain resulting from such activities can be debilitating, whether it’s acute or chronic. An onset of pain despite following an active fitness regimen can leave one perplexed. However, such pains are a reality and are quite common. If a stinging pain is experienced in the front part of the knee (without any visible inflammation) during running or any physical activity, it could be an indicator of runner’s knee or patellofemoral pain syndrome (PFPS).
What is runner’s knee?
Runner’s knee is a condition characterised by pain around the patella (kneecap) resulting from excessive strain on the knee joint. It is common among runners, cyclists and athletes. However, people who lead sedentary lifestyles are also susceptible to it.
A review article published in the journal Annals of Translational Medicine attributes runner’s knee to the abnormal tracking of the patella in the trochlear groove (groove present at the end of the femur inside which the kneecap moves up and down during flexion), which causes pain in the knee.
Other common knee injuries among runners include IT band syndrome and jumper’s knee. However, they can also occur in cyclists.
Causes of runner’s knee
Overuse of the knee joint is the main cause of runner’s knee. Other than this, any alteration or disruption in the kinetic chain (a concept describing the interrelated groups of body segments, connecting joints and muscles working together to perform movements), mainly due to muscle tightness, can also cause pain.
“Bodyweight is a major factor in case of runner’s knee,” says Joseph. “Other reasons include weakness of the core muscles and tightness of the leg muscles, namely the hamstrings, quadriceps, hip joints and calf muscles. In addition, any biomechanical alteration in the foot, like foot pronation, can also put stress on the knee,” he adds.
Runner’s knee can also occur in inactive people. Sitting or driving for long hours puts pressure on the knee, which in turn can cause knee pain.
Symptoms of runner’s knee
Pain during physical activities involving knee flexion is a classic symptom of runner’s knee. In some cases, a popping noise can also be heard during knee movement.
“Running or any other physical activity is characterised by a lot of dynamic movements made by the knee, which makes them susceptible to injuries,” says MA Joseph, sports physio and head physiotherapist, Medical Trust Hospital, Kochi. “In case of runner’s knee, pain will be the only symptom, and there won’t be any swelling. An individual will feel pain during activities like climbing stairs, running, walking downhill and squatting, among others.”
Treatment
While physiotherapy forms the cornerstone for treating runner’s knee in the long term, painkillers may also play a limited role.
Treatment measures include:
- Loosening or releasing the muscles that have become tight.
- Strengthening of the weak muscles in the leg or hip region.
- Icing the knee at regular intervals to relieve pain.
- Compressing the knee joint using compression sleeves or a bandage. However, they should not be too tight.
How to prevent runner’s knee?
Appropriate warm-up and cool-down routines, strength training and maintaining a proper running form all play an important role in preventing runner’s knee.
“The running form is not optimal in some individuals, where they either run with an improper posture or avoid warm-up and cool-down exercises,” says Mumbai-based running coach and ultramarathoner Preet Parwinder. “Progress in running in terms of distance and speed is a slow process with gradual improvement. However, attempts are made to accomplish too much in less time, which puts additional stress on the knees. So, proper guidance focusing on the basics is essential to avoid knee injuries. If someone is restarting after a break, they should start from the beginning and progress gradually. This applies to running, cycling and any other physical activity,” he adds.
Takeaways
- Overuse of knee joints is the main reason for runner’s knee or patellofemoral pain syndrome (PFPS). Other causes include tight or weak muscles in the legs and hips.
- Biomechanical alterations (like pronation of the foot) or disruptions in the kinetic chain exert additional stress on the knees, eventually resulting in pain.
- Pain during knee flexion is the main symptom of the condition. However, the pain isn’t accompanied by any swelling.
- Runner’s knee can be prevented by performing appropriate warm-up and cool-down exercises, strength training and maintaining a proper running form.
