What is Runner’s Knee, and How a Physical Therapist Can Help

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Patellofemoral pain, which is commonly referred to as “runner’s knee”, is caused by inflammation and irritation at the joint between the knee (more specifically, the femur) and the kneecap (also known as the patella).

Hence the name, patellofemoral pain indicating pain at the joint between the patella and the femur. 

While the patella may seem like a small, minor bone in the body it actually plays a huge role in our movement. The patellofemoral joint is responsible for absorbing up to 20 times our body weight during things like jumping, running, etc. The patella sits in a perfect little groove in the femur and as you bend and straighten your knee, the patella moves up and down that groove. 

Problems arise typically when the patella is no longer tracking smoothly within its groove – maybe some muscles are too tight and pulling it too much or other muscles are too weak and not pulling enough. Starting something new and doing too much too soon can also create pain at the patellofemoral joint because it’s not used to absorbing all that extra force. 

Those with patellofemoral pain generally report pain underneath the kneecap that is made worse with activity (especially running, jumping, stairs, squatting) or sitting with your knee bent for too long and gets better with rest. It is more common in females than males thanks to our wider hips. 

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So what can we do about that? Here are some simple exercises to try. 

1. Stretch

The IT band is a big fascia band that runs along the outside of your thigh, from your hip down to the side of your knee. It has a few fibers that attach over onto the patella and can pull your patella too far out to the side. While the actual fascia doesn’t stretch too much, we can stretch all the muscles that attach to it which are the hamstrings, quadriceps and glutes. Try these stretches! In general, try to hold for 30 seconds and do each side twice.

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2. Strengthen Your Glutes

Your glute muscles play a big role in keeping your knee steady. If your knee tends to turn in (go knock knee) when you do things like run, jump, squat then this can also throw your patella off course. Try these glute exercises! As a general rule, do one side until you get a nice muscle burn and then switch sides. Do each side twice. 

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3. Strengthen Your Quads

Your quadriceps are 4 big muscles on the front of your thigh that join together to form a common tendon that runs on top of the patella and attaches at the bottom of your knee, on the tibia. Having strong quads plays a big role in helping absorb forces so the patellofemoral joint doesn’t have to do it all. Here are some exercises to strengthen your quads. Again, go until fatigue and try to do each side twice.

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4. Work on Your Technique

One of the most important things you can do is to look at your running, jumping or squatting technique. Do the activity in a mirror or even better, take a video of yourself doing it (bonus points for a slow motion video!) Watch yourself as you land on one leg while running, land on both feet while jumping or drop down into your squat. Does your knee tend to point in toward your big toe (like the first picture)? Really try to see if you can press your knee out – think point your knee toward your second or third toe (like the second picture!). Then try to do that while you’re running, squatting, jumping, etc. This will help your patella stay track smoothly within its pathway.

Ongoing pain that doesn’t resolve with these exercises is a reason to seek out assistance from your women’s health physical therapist. If you’re unsure, reach out to us! We would be happy to provide some guidance or answer any further questions! 

Source:  https://www.apta.org/patient-care/evidence-based-practice-resources/clinical-summaries/patellofemoral-pain

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