Strategies to Prevent Runner’s Knee
What is Runner’s Knee?
Runner’s knee is a common term for patella femoral pain syndrome (PFPS) which is a generalised term for pain around the front portion of the knee specifically surrounding the kneecap or behind the kneecap. It usually develops and gradually feels worse with:
Running especially up/down hills
Stairs
Squatting/lunging
Sitting for long periods of time
Why does it happen?
Although runner’s knee is pain in the knee, it is rarely an issue just with the knee but more from structures surrounding. Some common causes are:
Rapid increase in load and mileage
Poor glute strength + stability (poor-single leg control)
Running biomechanics such as overstriding
Poor footwear
Inadequate recovery
Tight muscles
Strategies to prevent
1. Strengthen the glutes
Strong glutes can help with control of the hips and reduce the amount of inward collapse of the knee, preventing too much pressure going through the knee unequally
Exercises to try:
Single leg bridges
Clam shells
Crab walks
2. Improve single leg control
Running is a single leg exercise with a lot of repetition. If you struggle with control on one leg in the gym, it will not translate well to the road
Exercises to try:
Single leg squats
Single leg step downs
Single leg balance drills
3. Progress running gradually
Increasing mileage too fast can lead to breakdown of the body. Try and increase 10% each week.
Consider gradual increases when adding:
Distance
Hills
Speed
Frequency of runs
4. Have your running mechanics looked at
There may be some small technique changes that can be made which can dramatically reduce the load on the knee. I would recommend consulting a professional about what to change and how to change it as changing small things in your running form is not as easy as it sounds!
Consider increasing cadence
Avoid overstriding
Keeping posture tall
Use of the arms
5. Invest in proper running shoes
Your running shoes have a lifespan of about 600km. Having a couple to rotate through will help lengthen their life.
Choose a shoe that matches your preference regarding feel under the foot, fit around the heel and gait type
Would recommend having your feet looked at by a professional so they can recommend what type of shoe is best for your gait
6. Manage recovery well
Your knee adapts to what you recover from, not just how much you train it. Therefore, recovery is equally important.
Sleep well
Have sufficient amounts of protein
Schedule rest days between runs especially long ones
Vary intensity and forms of running such as mixing short runs and interval running
Cool down properly – usually a slow jog/walk w/ active stretching can help
Early warning signs to not ignore
Persistent ache around the knee
Pain with stairs
Pain lingering after running
Swelling/stiffness around the knee
Bottom line
Runner’s knee is rarely about weak knees but more so about load management, strength and single leg control. To reduce your risk, strengthen the hips and thighs, progress running gradually (especially if coming back from injury), improve single leg stability, recover properly and listen to your body. This can dramatically decrease risk of injuring your knee.