Wednesday, 27 March 2013

Runner's Knee

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!


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