Runners Knee by Kyle Pepperman-Hackett @Hackett_massage

I want to explain what “Runners Knee” is and what you guys can do at home to treat it.

Clinically, we call this Patella Femoral Pain but you would have heard it has runners knee or jumpers knee. Patellofemoral Pain Syndrome is a common cause of pain around the knee cap, when the knee bends or straightens, the knee cap glides in a special groove on the thigh bone called the “Patellofemoral groove', controlled by the quadriceps (thigh) muscles. However, for several reasons it maybe pulled from this path usually towards the outside of the knee from over use or loading of the lateral quad muscle. This is called Patellofemoral Maltracking and produces abnormal stresses on the under-surface of the patella that can cause knee cap pain.

The knee joint is made up of three bones:

• Femur (thigh bone)
• Tibia (shin bone)
• Patella (kneecap)

The Patella has a Quadriceps tendon that connects the thigh muscles (Quadriceps) to the shin (tibia tubocity). When the knee bends, or straightens, the knee cap normally glides in a special groove on the thigh bone called the Patellofemoral groove.

With Patellofemoral maltracking, abnormal stresses are put on the under-surface of the knee cap that can cause pain. If it is allowed to progress, these stresses can cause over use to the tendon, usually the inside on the knee cap (a condition called Chondromalacia Patella) and femur.

Patellofemoral maltracking is one of the most common causes of knee pain and can be caused by numerous factors:

• Tightness in certain structures. (e.g. calf and hamstring muscles).
• Weakness or incoordination in muscles that should help maintain normal patella tracking.
• Altered hip, knee or foot posture.
• Anatomic variations such as a shallow Patellofemoral groove.
• Weak Gluteal muscle – mainly Glute Med (hip stabiliser)

Patellofemoral Pain Syndrome Signs & Symptoms

The most common symptom of Patellofemoral maltracking is pain at the front of the knee that can occur while ascending or, more often, descending stairs and whilst running. Pain can also result from prolonged sitting and some people may experience instability (this can involve a sensation of insecurity or actual giving way of the knee) or locking of the knee.

Treatment for PFP

There are a few stages of treatment I start with so I can cause positive adaption to the soft tissue, tendons and bones:

Stage One:

Soft tissue (sports massage) work to the Quads and Hamstring – seek a Sports massage therapist who has an understanding of the injury and can treat you with Soft tissue release and Muscle energy technique Start by rehabbing the knee with Gluteal strengthening and activation exercises along with eccentric single leg squats on a 25 degree angle board.

See common exercises:

Eccentric single leg squat:

Gluteal exercise - clam:

Stage two:

Progress the exercise with weights as they become easier with more soft tissue massage to help with the lateral quad tightness.

Stage three:

Writing up a bespoke back to running plan explaining how long the runner can run for and how often. I usually give a 6 week plan and then finally follow up with the progress and as long as they are now pain free, I let them go back to normal training but again explaining to build it up gradually.

When returning to running, try running on the trails or XC routes as this takes some of the load away and start using some other muscles instead of using the same muscles on flat road.