Knee pain in runners and active people

Do you get pain in and around the kneecap when you walk, jog, go up or down stairs, or even after prolonged sitting or kneeling? It may have started as just a bit of an ache around the knee after a long walk or perhaps running down My Lofty one day? Perhaps one of your active kids started to complain of knee pain after sports training one day.

Maybe you’ve looked online and come up with terms like ‘runners knee’ ‘jumpers knee’ or the like?

Pain in and around the knee cap commonly referred to as Patella femoral pain syndrome (PFPS) and it is one of the most common injuries experienced by recreational runners.

A bit of Anatomy 

The kneecap sits at the front of the knee joint. The medical name is the ‘patella’ and it acts as a dynamic lever (think back to year 10 physics) for the thigh muscles (Quadriceps) during activity.

The Patella enables the transfer of force from the thigh to the lower leg and foot. Because it is a dynamic system, the forces acting at the knee joint will change depending on the angle of the knee, the ankle and the hip at any given point in time. The forces will also change depending on the rate at which they are applied.

In the past it was thought that it was the patella moving abnormally on the thighbone was the primary problem. As a result our main treatment for this condition was to tape and strengthen ‘just’ the knee muscles.

We now recognize that because most symptoms occur in weight-bearing (standing), it is the thigh bone (femur) moving inwards or outwards underneath the patella that is more important. Flat feet may cause too much movement of the shin bone (Tibia) under the patella. However before we go blaming our flat feet for everything, high arched/ rigid feet can be just as problematic!


Who is at risk?

Like all injuries it comes down to too much load – stress on the body. Making the body work beyond it’s current ability. You can read more about training loads here . Examples of what that looks like;

  • Started running in the past 3 months and have increased the distance too quickly.
  • Recent history or running down hill
  • Adolescent doing too many impact activities every week.
  • Incorrect technique in the gym – especially with squats and lunges.
  • Recovering from a hip or back injury and returned too quickly to sport.
  • Poor footwear choices with activities.
  • Excessive stair climbing recently

As with hip injuries, women tend to be more prone to PFPS which is likely due to the anatomy and general decreased control through the hip and pelvic area. You can read more about hip problems with women here.

What should you do?

First and foremost you need to be assessed by a Vital Core physio.

We will determine what you want to be able to do, you goals. We will also look at all the other factors that may have contributed to the onset of the pain including you training loads (what you have been doing recently). Pain is always the last symptom to present of a problem – there are usually many other underlying factors causing it.

From there your Vital Core physio will look at you. What you can do and what you can’t. They’ll test your knee but also your ankle, hip, pelvis and back. They’ll look at the muscles directly around the knee but also those of the hip and ankle as well as the other side of your body. They need to get to the bottom of the why!

Once your physio has worked out what is going on they will explain it to you so that you understand. Together you and your physio will make a plan to get you back to 100%. They will address all those factors under the surface that have lead to this pain.

This plan will take time and will be progressive and dynamic. You will feel in control and confident about your rehabilitation.

Treatment will often include a combination of;

  • Massage
  • Joint mobilisation
  • Hip and leg strengthening exercises.
  • Stretching and mobility exercises
  • Technique/running/jumping advice
  • Training load management plan
  • Taping to alleviate pain in the short term
  • Arch supports
  • Foam roller training
  • Spiky ball training
  • General exercise advice – including recommendations into one of our classes.

Don’t let knee pain stop you from doing what you love. Please come see us at Vital Core and we can help you achieve your goals.