The weather is warming up, and while the cold has not stopped some of you die-hard runners out there, for many of you that means running outside again! With the increase in running frequency and intensity outside (let’s admit it, pushing yourself on the treadmill can be difficult), our clinic begins to see an increased rate of injury in our runners. Patellofemoral pain is defined as pain around the knee cap while performing an activity with a bent knee. Multiple studies cite patellofemoral pain as the top injury in runners, with an average estimate of 20% of recreational runners dealing with it at some point. Today we are going to cover our recommended strategy for reducing your risk of developing patellofemoral pain!
Soft tissue treatments are a great way to start any session, and if you are familiar with our blogs, you know that we are fans of foam rollers. Foam rolling your quads helps to relax the muscle and ensure that our tissues have the ability to hit full extension easily. You can replace a foam roller with any soft tissue tool you prefer such as a massage gun.
Now that we have our quads and knees prepped, we want to reinforce comfort in that fully extended position. Quad sets are a great starting point! Sit down with your legs straight in front of you. Squeeze your quads (the muscles on the front of your thigh) and gently push your knee cap towards the floor at no more than 70% of your maximal force. Hold this contraction for around 5 seconds, relax, and repeat. Placing a towel under your knee may make this exercise more comfortable. Be sure to perform this exercise on both knees!
Now that we have reinforced that fully extended position, we want to incorporate the knee into a more complex movement. A reverse lunge allows us to generally emulate a running position while allowing for greater balance because the working leg is staying in a fixed position. If the reverse lunge becomes too easy, consider progressing to a forward lunge!
This series of exercises is a solid starting point for reducing your risk of developing patellofemoral pain, but it needs to be combined with appropriate programming. Avoid increasing your weekly volume by more than 10% unless under guidance of a coach, and avoid increasing by 15% unless you are an experienced runner under guidance of a coach.
In our office, one of our primary goals while treating runners is to maintain some degree of training as much as reasonably possible. We also take the time to identify the mechanism of injury. The most common issues we see leading to patellofemoral pain are lower leg mechanical issues and programming acquired issues. For mechanical issues, we perform a foot and gait analysis, re-establish any lost range of motion, and go through a rehab protocol to strengthen and stabilize the lower leg. For programming acquired issues, we establish that the training program being followed is sound, confirm that appropriate recovery measures are being taken, and manage pain symptoms to minimize the amount of time lost from running.
If you are dealing with persistent knee pain or planning on getting back into running soon, we can help! Give our office a call or schedule online today!
Patellofemoral pain syndrome (PFPS) describes a painful irritation of the cartilage behind your kneecap. Although anyone may be affected, it is a particularly common running injury. Since it is the result of overuse of the knee in sports that require running and is so common in runners, it is sometimes referred to as "Runner's knee".
PFPS is the most common cause of knee pain in the general population, affecting an estimated 25% of adults. One of the most common causes of PFPS is an imbalance between the muscles that help to guide your kneecap in its V-shaped groove at the end of your thigh bone. Repeatedly flexing and extending a misaligned kneecap leads to pain, swelling, and eventually arthritis. Misalignment of the kneecap (patella) is often secondary to problems in the hip and foot, especially weakness of your gluteal muscles or flat feet. Large increases in the volume of running in too short a period of time also contributes to symptom development.
PFPS produces a dull pain behind the kneecap that is aggravated by prolonged walking, running, squatting, jumping, stair climbing, or arising from a seated position. The pain is often worse when walking downhill or downstairs. Longstanding misalignment can cause damage to the cartilage, which results in popping, grinding, or giving way. Conservative chiropractic care, like the type provided in our office, is generally successful at relieving your symptoms. Initially, it is important for you to minimize activities that provoke your pain, especially running, jumping, and activities that stress you into a "knock-kneed" position. Don't allow your knees to cross in front of your toes when squatting. Some athletes may need to modify their activity to include swimming or bicycling instead of running. At Inside Sports Clinic, we utilize an AlterG Anti-Gravity treadmill to help rehabilitate our patients who need to return to running. The AlterG allows us to control the amount of impact our patients experience, giving the patient the ability to continue running while they recover from their injury.
Performing the home exercises prescribed by our providers consistently is one of the most important things that you can do to help realign the patella, relieve pain and prevent a recurrence. The use of home ice or ice massage applied around your kneecap for 10-15 minutes, several times per day may be helpful in controlling pain. If you or someone you know is dealing with knee pain, call our office at 913-888-4845 to set up an appointment.