Runners Knee 
Spring time is well and truly here, the weather is sunny and the days are longer, time to swap the sofa for the running shoes, its Marathon training season! Some of us are a glutton for punishment and partake in several marathons a year, but for most of us this may be only our first or second go. Whatever marathon experience you have, we all must be aware of the potential for injury that such a challenging training programme can pose. And as the name would suggest, the most common one to look out for is ‘Runner’s knee’.

Runner’s knee, or patellofemoral pain syndrome, is caused by friction or irritation under the knee cap leading to pain behind or around the knee cap itself. The most common cause of this irritation is imbalance in the quadriceps muscles, causing the knee cap to bind tightly to a groove in the thigh bone (femur) as it glides across it during extension of the knee joint.  

Sports like running and cycling tend to overdevelop the quadriceps and a muscle on the outside of the thigh (the iliotibial band) which can lead to the knee cap being pulled more towards that side, known as ‘maltracking’. This is worsened if there is also weakness on the other side of the quadriceps.  

Women are at higher risk of developing this condition due to the angulations of the hips and knees, teenagers and young people are also at high risk as are athletes of any level. Another cause of runner’s knee is over-pronation whilst running which puts rotational stresses through the knee. This is a common occurrence and can be related to technique, body type or footwear.

For example, if you are naturally very flexible, the arch of your foot will tend to drop naturally as you run, a good running shoe with strong medial arch support or an insole will help to counteract this. It is always recommended that before starting marathon training you invest in a good pair of running shoes. Many shops will offer an assessment of your running technique in order to recommend the right shoe for you.

If you do start to experience pain or discomfort whilst running, stop, walk for a few minutes, stretch your legs, then resume.  If you still experience the same pain, rest, ice and elevate the knee.  You can still do cross training such as swimming but it is best to avoid high impact activities until the pain subsides.  If the pain is particularly bad, speak to your doctor about taking some non-steroidal anti-inflammatories. Remember, anti-inflammatory gels can be just as effective.

Lastly, to avoid the problem recurring, the cause ultimately needs to be addressed. Strengthening exercises for the inside of the knee are generally recommended to rebalance the quadriceps, these can take a couple of weeks to give noticeable results so be patient!