In this blog post we will explore what runner’s knee is, why it occurs and, most importantly, how you can prevent and manage it to get back into your running shoes as quickly as possible.
Part 1: What is runner’s knee?
In the existing literature, the term “runner’s knee” is used as an umbrella term for pain conditions that occur in the area around the knee, whether on the front or the outside of the knee.
Pain on the outside of the knee, often referred to as iliotibial band pain syndrome, is a relatively common injury associated with running. This is because the large tendon that runs along the outside of the thigh causes compression of sensitive tissue at the bottom and outer side of the thigh bone.
Pain that occurs around and under the kneecap is called “patellofemoral pain syndrome”. This condition is also not uncommon in connection with running. This condition can also cause symptoms when you sit with a bent knee for a long time. Climbing stairs and jumping are other activities that can provoke pain.
Part 2: What causes runner’s knee?
There are several factors that can contribute to the development of runner’s knee. Overload from large amounts of running, running technique and weak muscles can all play a part. It is most often a problem related to total load. Simply explained:
Too much, too often, too fast and with too little rest.
It is important to note that runner’s knee does not only affect runners, but can also occur in people who take part in activities involving repeated squats, jumping or lifting.
Part 3: How is the diagnosis made?
There are no good clinical tests to establish runner’s knee. So how is the diagnosis made?
A good medical history and the exclusion of other knee injuries, such as meniscus or ligament injury, is important. Furthermore, an assessment of your function should be carried out, including squat and jump tests. Naturally, the area where the pain occurs is also examined. If there is tenderness and pressure pain over certain structures, these are good indicators for the diagnosis.
Diagnostic ultrasound is a simple and effective way of imaging the area. With typical pain on the outside of the knee (iliotibial band pain syndrome), swelling/fluid formation can occur under the tendon where compression of sensitive tissue over the thigh bone occurs. In addition, the tendon tissue can change and become thickened. This is easy to see on ultrasound. Other imaging such as X-ray or MRI is seldom necessary and is expensive. It is not recommended when runner’s knee is suspected. Diagnostic ultrasound can be performed at Behandlerverket’s clinics.
Part 4: Prevention and treatment of runner’s knee
Now that we have understood what runner’s knee is and why it occurs, it is time to take a closer look at how you can prevent and manage the condition.
Here are some useful tips:
- Load management. The most important thing is to change the load on the irritated tissue. It is recommended to maintain a certain amount of activity, but reduce the activity that causes the pain, so that the body can heal itself.
- Strength training. Include regular strength training in your training routine, focusing on exercises for the muscles on the outside of the hip and the large muscle at the front of the thigh. This can be exercises such as side-lying straight leg raises, lunges, step-ups and squats.
Finding the right balance between the two points above is the essence of treating runner’s knee. You must first calm down the symptoms without necessarily becoming completely inactive, and then gradually increase the training volume again in combination with strength training. In addition to this, some studies have shown that proper information to the patient about the diagnosis, taping or customised orthoses can be useful in treatment. There is no good research on treatment with shockwave therapy (rESWT) and other manual treatment techniques, but we know from experience that several people experience improvement from it. However, the two points mentioned above are by far the most important in a course of treatment.
Runner’s knee can be a long-lasting and frustrating injury, so a correct diagnosis and individually tailored load management and treatment are important in order to become pain-free and resume the desired activity and training. Our practitioners have good expertise to help you with this. Get in touch if you need help.
References:
- Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med 2016; 50(14): 839-843.
- Geisler PR. Iliotibial Band Pathology: Synthesizing the Available Evidence for Clinical Progress. J Athl Train. 2020 Dec 22. doi: 10.4085/JAT0548-19. Epub ahead of print. PMID: 33351908.