Knee pain when running is very common. Patellofemoral Pain (PFP), often known as Runner’s Knee, refers to pain that originates from the joint between the kneecap (patella) and the end of the thigh bone (femur). As the knee bends and straightens, the patella tracks along a grove in the femur. With dysfunction, the patella may no longer track smoothly in the groove, typically causing pain and loss of function.
A combination of both intrinsic and extrinsic factors can influence the likelihood of a runner experiencing PFP. Intrinsic factors affecting the knee typically include muscle imbalances and biomechanical alterations and can include:
- Deficits in strength of glutes, quadriceps or core musculature, which can all impact the positioning of the knee and kneecap during running, as well as loads and forces felt at the joint.
- Loss of motor control at the hip and pelvis due to poor muscle control.
- Poor stability of the foot or ankle, such as increased pronation (rolling in) of the foot.
- Tight structures, particularly those down the outer side of the knee and thigh, which may contribute to pulling the kneecap outwards.
A physiotherapist can assess you, identifying any intrinsic factors that may be contributing to your symptoms. They will be able to design you an appropriate exercise program to combat any muscle imbalances and may prescribe some orthotics or trial some taping. Hands-on manual therapy can also be very beneficial to release tight musculature, and your physiotherapist may use techniques such as massage, cupping or dry needling.
Your physiotherapist can also provide guidance with managing and extrinsic factors that may be impacting your knee pain. These can include:
- Sudden and voluminous increases in mileage
- The introduction of hills or speed work
- Changes to footwear or terrain
Your physiotherapist may also recommend that you undergo a running assessment which will allow them to provide you with any tips or drills to modify your running appropriately, helping you to achieve your running goals and run pain free.