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Runner’s knee is one of the most often self-diagnosed injuries among active people, said Chad McCann, DPT, with 3Dimensional Physical Therapy & Sports Conditioning in Tacoma. And often, the patient may be right.
According to Sports Health (2013), runner’s knee accounts for up to 40 percent of all knee complaints voiced in sports medicine clinics.
Known clinically as patellofemoral pain syndrome (PFPS), runner’s knee is an overuse injury caused when the thigh bone (femur) rubs against the back of the knee cap (patella), irritating and damaging the soft tissues beneath the knee cap.
This leads to a dull, aching pain around the front of the knee.
“It’s an injury that builds up over time, causing pain,” McCann said. “Many put up with the pain until it reaches the point they can’t run anymore.”
The causes are varied, according to McCann. The runner may have cadence issues, for instance, meaning that he/she runs too slowly or there is too much loping in their motion. This causes the foot to hit the ground harder than it would if the runner were running with a faster cadence.
Runner’s knee can also be caused by structural issues which determine the impact at which the foot hits the ground. The body, McCann said, may not be strong enough to correct the movement.
The good news is that both are correctable. According to McCann, 3Dimensional Physical Therapy takes a three-pronged approach to diagnose and treating runner’s knee.
1. Biomechanical Assessment: A physical therapist will always first determine where the runner can and cannot control movement as they are walking. For example, does the foot swing when walking? The physical therapist will also videotape the patient running on a treadmill from three positions: front, sides, and back. With this, they can determine exactly how body mechanics look step by step.
2. Strength Training: Based on what was gleaned through the assessment process, the physical therapist will develop an individualized strength training program to correct any functional weaknesses that may be causing knee pain. This usually involves strengthening the gluteal muscles.
“The stronger the gluts, the less likely you are to have knee pain,” McCann said, “because the gluts keep the legs aligned.”
3. Mechanical Training: “This is teaching people how to run properly,” McCann said, pointing out that mechanical training often focuses on cadence. Most people run at 140 to 150 strikes per minute, but the ideal cadence is closer to 180-foot strikes per minute. With just a 5 percent improvement (or seven strikes), runners can start to see progress.
McCann also works with runners on proper warm-up and stretching before and after runs. Such issues related to running performance, he said, are important to beginners and competitive runners alike.
“[Running] is a sport hobby one can just start on one’s own,” he said. “But issues can and will develop over time. It’s important to address them to decrease pain and prevent injury, and to increase comfort and enjoyment of the activity.”