Runner’s Knee

Patellofemoral pain syndrome (PFPS), or ‘runner’s knee’, is the irritation of the cartilage on the underside of the patella (kneecap).  About 40% of running injuries are knee injuries. PFPS typically flares up during or after long runs, after extended periods of sitting, or while descending hills and stairs.

Who’s at risk?

Anyone with biomechanical factors that put extra load on the knee is vulnerable to PFPS. Risk factors include over- pronation (excessive inward foot rolling) and weak quads, hips, or glutes.

Can you run through it?

Yes, but taking extra rest days and reducing your mileage is necessary.

Run every other day and only as far as you can go without pain. Some runners find that uphill running is less painful, so simulate hills on a treadmill. Uphill running has the added value of working your glutes. Strong gluteal muscles help control hip and thigh movement, preventing the knees from turning inwards.

Running downhill, which can exacerbate pain. Bicycling may speed your recovery by strengthening the quads. Elliptical training and swimming are other knee-friendly activities.

Rehab it.

Strengthen weak hip and glute muscles with lateral side steps:

• Place a loop of resistance band just above your ankles or your knees.
• Separate your feet and bend your knees, lowering down into a slightly crouched position.
• While staying in this position, walk sideways 10 to 15 steps, keeping your feet straight and your upper body still.
• Then reverse directions.
• Keep your feet separated to maintain band tension.
• When this becomes easy, try doing this on your toes with your heels off the ground.

If there’s a problem in the way your kneecap tracks, athletic tape may reduce pain. Post-run icing also provides relief in the early stages of this injury. Heat works best once the injury is healing and no longer in an acute stage.

Prevent a relapse.

Shorten your stride length and landing with the knee slightly bent, which can take up to 30% load off the joint. Count the number of steps you take per minute and increase by 5 to 10% per minute. Keep your knee tracking correctly by strengthening your knee’s support muscles like quads and glutes with exercises like lateral side steps and squats. It’s also important to stretch your hip flexors.

Elite Treatment

Marathon silver medalist Meb Keflezighi was building up for the 2010 Boston Marathon last year when he slipped on ice and tweaked his knee. He took two weeks off, ran only every other day for the next two weeks, and then decided not to run a half-marathon in March. The strategy worked: He was the second American at Boston in April, running a 2:09.

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