Knee pain isn’t uncommon in female runners, and can be really frustrating in progressing your training plans. You have most likely heard of terms like runners knee, patellofemoral pain syndrome or ITB syndrome but what are they and what can we do about them?? This blog gives a little more insight into runners knee, what causes it and of course how we can manage it!! Check it out and fire away if you have any questions!
WHAT IS RUNNERS KNEE?
Runners knee is typically characterised by pain around the edges of and under the knee cap and research has shown that as females, we tend to suffer with it more than our male counterparts. While we don’t fully understand the reasons for this, contributing factors can be that we typically we have a wider pelvis, resulting in a greater Q angle (angle between the top of the hips and centre of the knee cap), which can potentially result in the patella being pulled differently. This can result in the patellofemoral joint (joint between the patella and femur-thigh bone) becoming irritated and overworked. The joint can become really sensitive and doesn’t necessarily mean harm. There can be alot of scare mongering out there being told your knee is out of “alignment” and causing “serious damage” but be reassured that it very rarely has serious underlying pathology so it’s important not to fear the worst.
WHAT CAUSES IT?
A variety of issues can result in knee pain. Typically these include:
– Changes in training load: Increased Volume/speed and type (different surfaces, more downhill running is typically aggravating)
– Lack of muscular support or muscular imbalances surrounding the knee and hip resulting in the knee being loaded ineffectively
– Running technique
– Trainers
– Foot type
MANAGEMENT
The important thing to remember is not to panic and be reassured that runners knee is really responsive to treatment approaches. Try these options to see how things settle:
1. LOAD MANAGEMENT: This doesn’t mean don’t run (hooray!), but look at your training week. Has your running volume suddenly gone sky high? Have you introduced more hills, speed or different strength work? Find out what effects your pain. If its over 10 km, drop back to 8km while we’re settling it down. If its hill running that is the issue, leave them for a few weeks, then start with running uphill and walking down. As a rough guide allow the pain to be around 3 out of 10 during running but settles within 24 hours. If it is more severe have a few days of complete rest and ice the knee then build the distance back up slowly. It may be useful to cross train in-between runs while we are settling in down, to minimise the load going through your knees such as swimming or cycling. Also consider different terrains to help manage the stress on your knees, such as grass running.
2. STRENGTH WORK – It is not just about having strong quads! We need a variety of muscles working together to help support your knee and other joints as well, these include the calf, gluteal muscles and hamstrings as well. Look at your squat technique too, double leg then single leg. Does your knee fall inwards? Can you see your toes when you do it or does your shin bone more further over your toes? Both of these overload that knee joint. Do you do this down the stairs too? I have attached some generic rehab exercises to work through (these are not intended to substitute the advice of your specific healthcare provider).
3. RUNNING TECHNIQUE -Your running technique can influence the loads that go through your knees. Evidence has shown that braking with the heel down in front of you, upright postures, long strides and pulling back with the leg, can increase the forces going through your knee by 6-8 times. This is often related to a backward tilt of your pelvis (butt tucked under), weaker glute muscles and a stiff running posture which is often seen in women post-partum. Think about leaning forward and rotating through your trunk (not just your arms) so your body isn’t held stiff or gripping with your abdominals. Try and think about the weight going through your mid foot (opposed to toes or heel) and push through the foot propelling you forwards with a lean rather than pulling back with larger strides. This can be really helpful for those of
you who leak while running too. Other options are to shorter stride length too.
4. TRAINERS – Making sure you have the correct supportive footwear can also assist in managing the loads though your knees. It can be worth investing in an assessment to look at your foot type and the right trainer for you, and make use of your Asics discount!
5. TAPE OPTIONS – There are various taping options available that can help your knee such as that below using kinesio tape. You can use this code RUNF10 for a discount at www.sporttape.co.uk
6. PHYSIO ASSESSMENT– If things don’t settle with the above, it is worth seeking an assessment. We talk you through all of this as well as pelvic floor dysfunction, diastasis healing, training as a woman and more in my online female fitness and rehabilitation progamme www.theglowmethodathome.com. use code GLOW7 for a free 7 day trial
Any questions then please do let me know!!
Jo Perkins
BSc MSc Sport Med
