- January 23, 2017
- Get the Spring back in your Step! Have you got Runner’s Knee?
Get the Spring back in your Step!
Have you got Runner’s Knee?
Runners knee tends to affect runners, walkers and cyclists. It is a repetitive strain injury and it tends to effect just one knee. There are two main types of injury , Iliotibial band syndrome (ITB) and patella femoral pain syndrome (PT) (also called patella tendonitis)
In this article I will cover ITB Syndrome
Ilio tibial band syndrome –
This is a very common running injury. The ilio tibial band is a band of tough connective tissue running from the hip to the outside of the knee. It helps to stabilise and give spring to the knee joint.
Pain develops on the side of the knee, it can be ¾ down the outside of the thigh, all the way along the side of the knee or sometimes at front of the knee just below the knee cap.
The pain can be a sharp or a dull ache with a numb feeling on the outside of the leg when exercising. It is caused by the tendon rubbing against the bone on movement. In some cases there may be micro tears and thickening which would be visible on an MRI scan . X-rays will show nothing.
Other symptoms of ITB pain-
- Pain behind the knee cap, outside of the thigh
- Pain on bending the knee or sitting for long periods
- Pain going downstairs or hills
- Running causes pain
Causes of ITT-
- Worn out shoes.
- Running up hill or banked surfaces.
- Track workouts in the same direction.
- Too much running
- Pelvic imbalance/ lower back pain.
- Foot problems (Pes Planus).
- Weak quadriceps muscles.
- Misalignment of bones from previous trauma.
If the symptoms have developed within 48 hours using ice on the sore area, resting and taking anti-inflammatories will help. If the symptoms do not settle down after a week or so then osteopathy is the answer.
We will look for the cause, not just the symptoms. In most cases the lower back or the pelvis is the problem.
Commonly the patient will have some mild pain or stiffness in this area. We use gentle soft tissue and manipulative techniques to release the pelvis and soft tissue massage on the ITT and quadriceps muscles.
After a couple of sessions the runner is not only running again but, running more freely and efficiency. Patients tend to feel as if they have a spring in their step again!
This kind of treatment is also useful for walkers and older folk who feel that they are struggling to walk as far or as fast as they used to.
Call us now to book your appointment,
You could also do an ITB stretch by following this link
PATELLA FEMORAL PAIN SYNDROME-
Patellofemoral pain syndrome (PFPS), also known as runner’s knee, is the most common of all kinds of knee pain, causing pain around and under the kneecap. Almost anyone can get it, but it particularly affects runners, cyclists and hikers, and also office workers or anyone else who sits for a living.
The stress of running can cause Irritation where the knee cap (patella) rests on the thigh bone. Pain can be sharp, dull or chronic. It may sometime disappear whilst running especially on the short runs, but only for the symptoms to return after running.
What are the symptoms of patellofemoral pain?
Pain around the knee. The pain is felt at the front of the knee, around or behind the kneecap. Often, the exact site of the pain cannot be pinpointed; instead the pain is felt vaguely at the front of the knee.
The pain comes and goes. It is typically worse when going up or down stairs or with certain sports. Also, it may be brought on by sitting still for long periods. For example, after going to the cinema or a long drive.
In many cases, patellofemoral pain syndrome is caused by vigorous physical activities that put repeated stress on the knee —such as jogging, squatting, and climbing stairs. It can also be caused by a sudden change in physical activity. This change can be in the frequency of activity—such as increasing the number of days you exercise each week. It can also be in the duration or intensity of activity—such as running longer distances.
Other factors that may contribute to patellofemoral pain include:
- Use of improper sports training techniques or equipment
- Changes in footwear or playing surface
- Patellar Misalignment
Patellofemoral pain syndrome can also be caused by abnormal tracking of the kneecap in the trochlear groove. In this condition, the patella is pushed out to one side of the groove when the knee is bent. This abnormality may cause increased pressure between the back of the patella and the trochlea, irritating soft tissues. In some cases here we may see micro tears of the very distal part of the Patella tendon. X rays will show nothing of the patella tendon, but may show worn patella grooves. MRI may show thickening of the patella tendon and is not really necessary.
Factors that contribute to poor tracking of the kneecap include:
Problems with the alignment of the legs between the hips and the ankles. Problems in alignment may result in a kneecap that shifts too far toward the outside or inside of the leg, or one that rides too high in the trochlear groove—a condition called patella alta.
Muscular imbalances or weaknesses, especially in the quadriceps muscles at the front of the thigh from possible pelvic imbalance. When the knee bends and straightens, the quadriceps muscles and quadriceps tendon help to keep the kneecap within the trochlear groove. Weak or imbalanced quadriceps can cause poor tracking of the kneecap within the groove.
- There may be a grating or grinding feeling or noise when the knee moves. This is called crepitus.
- Sometimes there is fullness or swelling around the patella.
Pinpointing a single cause of runner’s knee is difficult. It could be a biomechanical problem—the patella may be larger on the outside than it is on the inside, it may sit too high in the femoral groove, or it may dislocate easily. Also, worn cartilage in the knee joint reduces shock absorption, high-arched feet provide less cushioning, and flat feet or knees that turn in or out excessively can pull the patella sideways.
Just the repetitive force of a normal running stride alone can be enough to provoke an attack.
As for ITT, see above. In most cases like the ITT the pelvis and the lower back is the main cause here. It causes the quadriceps muscle to shorten which then causes patella tracking malfunction. Doing strengthening exercises is not the answer here until the pelvis and lower back are straightened out first, with lots of soft tissue stretching to the quadriceps. This treatment alone can cure your knee symptoms quickly.
At the first sign of knee pain, cut back your mileage. The sooner you lessen the knee’s workload, the faster healing begins. Avoid knee-bending activities, uneven surfaces, and downward stairs and slopes until the pain subsides. As you rebuild mileage, use a smaller stride on hills. Consider orthotics if new shoes don’t fix the problem. Give Exeter Osteopaths a call on 01392 428141 or BOOK ONLINE if the pain persists, to rule out another condition, our helpful team will be more than happy to get you back on track.