With the Two Ocean’s coming up this weekend, I thought it would
be appropriate to write about a common condition experienced by runners, namely
patellofemoral pain syndrome (PFPS), or “runner’s knee”.
This condition is usually an overuse injury caused by the
patella (kneecap) not tracking over the knee joint efficiently, resulting in
pain and discomfort in and around the knee. This condition can be caused by
various factors, thus it is important that a thorough assessment is done in
order to establish what is causing the condition before appropriate treatment
and rehabilitation can be done.
Biomechanical causes
The actual structure of the patella and how it glides over
the knee joint and surrounding bones can contribute to PFPS. If the cartilage
(cushion/padding) in the knee joint is worn, this will result in bone rubbing
on bone, causing pain and discomfort. Flat feet cause the knees to collapse
inwards, resulting in malalignment of the knee joint and thus the patella not
gliding efficiently over the joint. Similarly, high arches cause the knees to
fall outwards, resulting in inefficient tracking of the patella over the knee
joint.
Muscular causes
Tight hamstring and calf muscles put strain on the knee
joint, contributing to the development of PFPS. Weak quadriceps muscles contribute
to instability of the knee joint, which can result in inefficient tracking of
the patella, again contributing to PFPS. The patella attaches to the quadriceps
tendon as can be seen below.
Runner’s knee can also be caused simply by the repetitive
jarring force on the knees when running. This condition can, therefore, also be
experienced in other sports involving repetitive bending and jarring on the
knees, such as squash and tennis.
Biomechanical causes can be more difficult to treat, because
if it is a structural problem with the patella itself, then surgery will be
required to correct it. Similarly, if the cartilage is worn away, surgery will
be needed to fix this problem. If, however, it is a problem with the feet –
flat or arched – a podiatrist can be consulted to correct the problem with
orthotics.
Muscular causes are easier to fix – the tight muscles must
be stretched and the weak muscles must be strengthened. But, it is important
that these muscles are identified properly, otherwise the knee pain could be
made worse. It is important to consult a Biokineticist to assess these muscular
imbalances and correct them appropriately.
Runner’s knee can occur in one or both knees and, according
to the British Journal of Sports Medicine, young, recreational runners are most
commonly affected, with women being twice as likely to be affected. This is
because women have wider hips, placing an increased force on the patella due to
the increased angle at the knee joint.
If you think you may have runner’s knee, cut down on your
running, run on softer surfaces where possible, and consult the appropriate
professionals to assist you as soon as possible before the condition becomes
too severe.
To all those running the Two Oceans this weekend, all the best
for a fun and successful run!
Reference
