The knee is the most common joint injury in runners. Did you know that your amazing knees must handle a force between 3 - 5 times your body weight as you run? Research shows that 80% of running injuries are due to a joint, bone, or tissue that is placed under more load than it is used to.
Runners knee is a general term most commonly characterized as vague pain around the front of the knee. This pain can be hard to pinpoint because it is not caused by one specific structure. If you were to take an x-ray or an MRI of the knee you would see a structurally intact and “normal” knee. Runner’s knee is a biomechanical problem. A change in biomechanics happens when some muscles become less active, when some muscles become too tight, or joints lose controllable range of motion. This change leads to a different force being placed on a joint and often leading to discomfort with use.
Symptoms of Runner’s Knee may include
Pain when transitioning from sit to stand
Pain with squatting
Pain with running hills or negotiating stairs
Pain with speed work
Far and away, the most commonly caused by a recent increase in running volume, an increase in speed work, or an increase in vertical feet. Too much too quickly too fast.
Commonly, the athlete does not increase their self care routine or their strength work to match their new increase in running.
Test yourself
Use this glute strength test to see if your glute strength is adequate for pain free running. Is your strength even side to side?
Let’s Fix it
The first thing we need to do is decrease the inflammation and pain levels. This means a temporary reduction in training load to a level you can tolerate. Using modalities such as rock taping, trigger point dry needling, active release technique, graston technique, and deep tissue massage therapy in our Boulder office can provide you with immediate pain relief. Another quick fix to reduce pain while running could be to simply increase cadence by 5-10% to reduce the load on the knee joint. The “optimal” cadence is somewhere around 180 steps per minute. This should be done gradually and with caution due to the increased load it will place on the ankles. If you have a history of ankle pathology, it is imperative you discuss this strategy with a professional prior to incorporating into your running. However, if you simply go back to running once the inflammation is gone without addressing the biomechanical issues - you can expect a swift return of pain.
For lasting long term results, you need to implement a strength training program.
We know that you want to get back to pain free running ASAP. You want to get back to pushing the limits of running. The proper solution is to add in some easy strength work.
Strength training is not the most sexy treatment because it takes 6-12 weeks to fully strengthen muscles. It has been proven in many scientific studies to be the most effective treatment for injury prevention in runners.
What does a strength plan entail?
At Boulder Sports Chiropractic, our Physical Therapist will first perform a thorough physical exam to pinpoint your weaknesses and unravel your compensations. We then build a plan starting with a rehab approach to activate specific muscles before progressing into a performance phase of training to build strength towards running performance.
A typical program would start with hip dominant exercises such as a bridge variation, or single leg banded lateral toe taps. We then progress to more knee dominant exercises to increase load capacity of the knee with exercises like Goblet box squat or the rear foot elevated split squat. Finally progressing to power based plyometric drills if appropriate.
Are you struggling with runner’s knee type symptoms? Start by addressing the compensatory tissue tightness with foam rolling like this:
Then add in a glute activation exercise before your runs such as this: SL banded lateral toe taps
This is a simple intervention that may help to decrease symptoms. If you are struggling with runner’s knee pain in Boulder, schedule an appointment today to get pain relief today and a strength training regimen that will not only get rid of your pain, but will help you run faster and more efficiently for your next race.
At Boulder Sports Chiropractic, our team offers Chiropractic, Physical Therapy, Massage Therapy, Strength Training, and Nutrition Coaching. If you are an injured athlete, we can help! Schedule an appointment today by phone or email.