Runners Knee Stretches
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Runners knee, also know as patellofemoral pain syndrome is a painful condition that affect the knee joint. Pain is felt behind the knee cap as the surface a the back of the knee cap gets irritated. This irritation can be due to overload, such as increasing training volume or intensity at a rate that is too high for your tissues to adapt to. Or it can occur due to biomechanical factors such as weak gluteal muscles or tight quadriceps or iliotibial band. Read more about this condition in our related article: Patellofemoral Pain Syndrome (Runners Knee) and more about managing and treating in: Runners Knee Treatments.
Here we will discuss common questions related to what exercise and sports are ok to do while recovering from runner’s knee.
If it is pain-free to walk, then walking is ok to do. We recommend you take short walks and be aware that the pain might feel worse after the walk. So only gradually increase your distance to avoid irritation. If, however, it is painful to walk it is not advisable to do so. You might find that stretching your quadriceps muscle, or relaxing it by foam rolling, gives you a window of time when you don’t feel pain. In which case, it is a good idea to stretch and foam roll before walking and only walk for a short time. Similarly, if you get pain in the middle of your walk, you should stop and stretch before continuing.
Runner’s knee is caused by repeated bending and straightening of the knee under load, therefore running is a common activity that causes or aggravates it. Often a period of rest from running is necessary to recover as quickly as possible. In mild cases, it might be possible to continue running, but you should consider reducing your frequency, distance and intensity.
Having a running coach or physical therapist who specialises in running, to have a look at your running gait is very helpful as some running styles are more likely to develop this condition, so you can be coached to change your running stype to offload the patellofemoral joint.
Because runner’s knee is a condition often brought on by an increase in training volume, it is common to see it in people training for a marathon. In many of these cases, there isn’t time before the marathon to resolve the issue.
If pain is severe it is not a good idea to run 26.2miles on it, and significant inflammation or damage can occur.
If it is close to the race date, pain is mild, and only after long distances, and if most of the training has been completed without issues, it might be ok to run. It is best to avoid running and aggravation to give as much rest, and time for inflammation to reduce before the event. You might start the marathon feeling undertrained, but at least you are not in pain from the first step.
The elliptical trainer moves the legs in a similar pattern to running but as there is no impact from landing it can me a good alternative to running, if you are unable to run due to patellofemoral pain syndrome. Stretching and foam rolling before and after will help to keep things pain free. If it is still painful after stretching, either during or after using the elliptical then it should be avoided.
Cycling is also a non-impact exercise that can be better than running, if you are experiencing patellofemoral pain, with running. It is still a repetitive bending and staightening action of the leg which might still be aggravating, especially in more severe cases. If you cycle with cleats it can be better to lossen these so that they are easy to clip in and out of the pedal with less force. Other elements that can help are to:
Swimming is a good alternative cardiovascular work out if you cannot run because of your knee pain. With front crawl you can work mainly or completely with your upper body to get a good work out while avoiding any irritation to your knee.
Rowing is a good strengthening exercise for the whole body and is non-impact. It does, however, still bend and straighten the knees under force so needs to be done with caution. It can be an excellent way to strengthen the posterior chain of muscles which include the glutes and hamstrings.
Strength training is often prescribed by physical therapists as an essential part of the recovery of patellofemoral pain syndrome. Common patterns to find in individuals with runner’s knee is tightness of the quadriceps, and weakness in the posterior chain of muscles, which includes the hamstrings and glutes. Therefore, targeted strength training can be very effective for recovery.
The contact of the patella on the femur changes as the knee is bent. The greatest contact of the patella on the femur is between 60-90º of flexion. As the knee is bent, the contact moves further to the top of the patella. Therefore, squatting will increase the pressure on the patella and, depending on the area of the patella surface that is irritated, it may increase the contact on that part. In most cases, squatting is aggravating, but it can be an effective rehab exercise in the latter stages of recovery.
Adding weight to exercises is effective for building strength. The specific movement and the stage of recovery are important to establish if this is a risk of aggravating the injury.
In the early stages, it is likely that weightlifting is not helpful and a risk of causing pain. But in the latter stages of recovery, it can be very useful for strengthening and for the improvement of biomechanics.
HIIT training is often varied in terms of the exercises that are included and the impact involved can be a high load on the patellofemoral joint.
A good rule is to avoid painful movements. However, sometimes symptoms might not be felt during the activity, but only afterwards. To be safe you can try the different exercises from the HIIT sequence, individually to determine if they are aggravating or not.
Yoga is a great exercise to improve flexibility. In many cases of runner’s knee, flexibility is an issue that has contributed to the injury development. Good flexibility can also improve running efficiency and there are some running inefficiencies such as poor hip extension that can contribute to the development of runners knee.
Pilates is an exercise that works on increasing the strength of core muscles. This can help with the control of movements throughout the body and especially with exercise such as running when force is applied to one limb. Poor strength and stability in the core can cause movements such as a pelvis drop which increases the load on the patellofemoral joint.
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.