Q : Chronic knee pain has made it difficult for me to run. Any suggestions to minimize the pain?
A : Runner’s knee (a.k.a. anterior knee pain, patello-femoral pain syndrome, patellalgia or chondromalacia) is an unfortunate, yet very common overuse injury seen among runners. Runner’s knee typically involves an abnormal tracking of the patella (kneecap) in the groove of your femur (thighbone).
There are several potential problem areas to consider if you have runner’s knee:
1. Shoes, feet and arches
If you have (a) a flat foot, (b) worn out or improper shoes, or (c ) feet that tend to roll in, then your kneecap will tend to track to the outside of your knee, putting excessive friction on it and causing pain. If this is your problem, get new shoes and/or some arch supports from a reputable running store.
2. Tight muscles
Running involves the muscles on the back of your body, from the huge Iliopsoas muscle of your lower back to the hamstrings on the back of your thighs to the calf muscles in your lower legs. Runners typically stretch their legs, but commonly forget to stretch the Iliopsoas of the back, the Soleus of the calf, and the Iliotibial band. If your stretching program does not help resolve your knee pain, you may want to visit a sports medicine professional.
3. The core
The core refers to the center of the body and includes the abdominal muscles, the upper and lower back muscles (traps and lats) and the muscles of the buttocks (the glutes). And underdeveloped core can lead to abnormal tilting of the pelvis, which can cause abnormal alignment of the leg and knee cap, producing knee pain. It is a fairly unique feature of our practice that we focus on the core. We feel that attaching a stretched and strengthened leg to a feeble core is just patching over the real problem and will not lead to a permanent solution.
4. Weak, inhibited inner knee muscles
Runners tend to get too tight on one side of the body and too weak on the other side. The oblique portion of the Vastus Medialis muscle of the distal thigh and the anterior Tibial muscle on the front of your shin are commonly neglected. These will need to be strengthened to minimize the pain of runner’s knee.
5. The brain
Runners are tough and can put up with a lot. No pain, no gain means no brain! Remember to listen to your body and enjoy a lifetime of this truly wonderful sport.
Steven M. Lubera, D.O. & Mark E. McKeigue, D.O.
The Center for Sports and Family Medicine