Patellofemoral Pain syndrome is commonly known as Runner’s Knee. The pain occurs under and around the patella (kneecap), which is worsened with activity, particularly going up and down steep hills or stairs. The pain can occur after prolonged sitting, especially when their is excess stress on the knee joint. When the knee joint bends, there is increased pressure on the patella. Abnormal stress or pull from one muscle group, over-rotation of the leg, an abnormal angle at the hip, excess load or force on the knee can all cause uneven contact between the patella and the knee joint, resulting in repetitive irritation of the undersurface of the patella.
The condition is called runner’s knee because it is a common problem in runners due to the repetitive stress on the knee joint. But, certain mechanical factors contribute to it’s development. One problem is over-pronation. Over-pronation is the excess “rolling in” motion of the foot that tends to result in arch collapse. When the foot rolls in, the tibia (shin bone) rotates internally, causing the patella to also rotate in. This disrupts the alignment of the patella and the knee joint, causing repetitive irritation and resulting in pain.
If one of the contributing factors is over-pronation, a pair of orthotics can help reduce or eliminate the abnormal motion, decreasing the excess stress on the patellofemoral complex.
Strengthening and stretching are both an important part of decreasing the chance of injury. Quadriceps strengthening can help stabilize the patella. From a seated position, lean back and support yourself with your elbow and one leg extended, with the other leg flexed at the knee, as shown below. First flex your quadriceps and hold your leg straight out for 30 seconds and then relax for 10 seconds, repeat this 10 times. Then, raise your leg 6 inches off the floor and hold it in the air for 10 second. Lower your leg as slow as possible over 10 seconds and place on the floor. Rest for 30 seconds. Repeat this 10 times and switch legs.
An iliotibial band is also a helpful stretch. From a seated position, start with your right leg bent and your left leg straight. Place your right leg over your left leg and then twist your body, looking over your right shoulder. Place your left elbow along your right thigh and your hand on the ground. Hold the stretch for 30 seconds, taking a deep breath and exhaling slowly during the stretch. Then relax and repeat 10 times and switch sides. Do not stretch through pain.
Additional tips to help prevent runner’s knee:
- Maintain a healthy body weight. Extra weight on the body places more stress on the knees. More on weight loss.
- Warm up and then stretch before aerobic activity, especially running.
- Slowly increase the intensity of your workout. Add in hills gradually to avoid overstressing the knees.
- Purchase quality, supportive shoes with adequate shock absorption. More on choosing shoes.
- Use orthotics to control abnormal motion, if necessary. More on pronation. More on orthotics.
- Run on an even and fairly soft surfaces, as uneven surfaces can worsen the problem. More on injuries in runners.
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