Runners knee or Anterior Knee Pain
What are the symptoms of runners knee?
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Runners knee is characterized by pain under the knee cap and around
the front of the knee.
The knee does not lock or give way, but sufferers may lack confidence in
the joint. Anything where the leg is bending and straightening can be
painful, particularly when weight bearing.
Commonly activities that exacerbate pain include going up and down
stairs, running down hill, leg extensions at the gym, or the flick of the
legs when doing breaststroke, also sitting for a prolonged time with the
knees bent, for example in a cinema or on an aeroplane.
Who does runners knee primarily affect?
Runners knee can affect anyone but it is most common amongst teenagers and
young adults, particularly those who do a lot of sports.
It is more common amongst women then men, because the differences in pelvic
shape makes the angle at the knee (this is called the Q angle) greater
increasing the outward pull on the patella.
What causes runners knee?
To understand this you need to know a bit of very basic anatomy:
The patella (kneecap) has a pyramidal shape, so the top side under the skin is
flat, and the underside has a ridge. This ridge fits in a groove in the femur (thigh
bone). Every time you bend and straighten your knee the patella slides up and
down the groove.
You can imagine therefore that if the patella is out of alignment eventually pain
can occur.
Common things that can cause misalignment include:
– Tightness in the ilio tibial band: a band of fibre that runs from the outside
of the hip to the outside if the knee cap. The ilio tibial band frequently
becomes tight in middle distance runners. When tight it pulls the patella
outwards and out of alignment.
– Imbalance of the quadriceps: the quadriceps muscle on the front of the
thigh is made up of four parts. Most forms of training strengthens the
outer part more than the inner part, thus the patella is pulled out of
alignment
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Tight calf muscles: if the calf muscles are tight the foot has to pronate
further to gain the same movement when running or walking – this
causes an increase in rotation at the lower leg leading to patella
malalignment
Tight hamstrings: if the hamstrings are tight when running or walking the
knee is not fully straightened, this means the foot has to roll into
pronation causing malalignment at the patella
Weakness in gluteus medius: One of the muscles that make up the
buttock, it is frequently underactive in runners. If the gluteus medius is
not working well enough the upper leg rotates inwards again causing
patella malalignment.
It often feels like the knee cap is grinding and clicking – this is called
crepitus.
Knee pain relief
Physiotherapy is the best treatment for runners knee. Exercises will stretch tight
muscles and strengthen underactive ones.
Check the age and condition of your running shoes. Runners knee is the most
commonly reported injury in runners, and will be exacerbated by overpronation
(excessive inward roll of the foot on landing).
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