Running  is an inexpensive, favourite pastime activity for many people. Generally, all you need is a pair of running shoes and you are good to go. However, what happens when this activity that you enjoy becomes the issue causing your aches and pains? Your once loved past time activity becomes an activity you avoid. 

This knee pain that I am talking about is located around the kneecap. This pain is difficult to describe at times. However, the pain can be brought on through loading the knee with an extensor mechanism (this is when the knee is being straightened). Examples can include going up or going down stairs, squatting, kneeling, cycling, but more importantly running. The medical name associated with this pain is PatellaFemoral Pain Syndrome or PFPS for short. In this piece of writing I am going to refer to this pain as 'Runners’ knee'.

The Anatomy of the Knee.

The knee is an interesting structure of the lower extremity. It is a hinge joint, meaning that its main movements is bending forwards and backwards. Yes, there is a little bit of play with side to side and rotational movements, but its main job is as mention forwards and backwards. Furthermore, the knee is a stable joint playing an important role in weight bearing movements and there are multiple muscles that act upon the knee.

Runners' Knee.

Runners' knee will hinder your ability to run. It will stop you from training and enjoying your days out on the pavement or trails. Which in reality is crap because I am sure all you want to do is go and blast out some kms, then come home and mobilise (well.. maybe not mobilise but you really should). However, this pain is stopping you from doing what you love. Furthermore, it might be getting  to the point where it is affecting your everyday life and is even present upon resting. Additionally, Runners' knee can be predisposed and maintain by multiple different factors, such as:

1. Issues with your hips

2. Issues with your knees

3. Issues with your ankles

4. Ill-fitting footwear

5. Your running style

6. Muscle not engaging

The list can go on, however, all you want to know is how can I make it better?

What can you do for your runners' knee?

You can show your knee some love by working on the structures that are above and below the knee.

Last week I talked about “The paradox of the TIGHT ITB”. Simply press the "Learn more' button and refresh your knowledge of this structure and what you can do for the ITB. The reason why I suggest this is because the article reasserts the importance of the mobilisation and strengthening.

The couch stretch.

This stretch is a static hold for 2 minutes. It involves you putting the top side of your right foot on top of your couch, then lowering yourself down by bending the left leg. As the left leg descends to the ground, you should notice that you have a 90-degree angle at the ankle, 90- degrees at the knee and 90- degrees at the hip. Your right foot should still be on the couch and your right thigh should be feeling a slight stretch. If you do not feel that slight stretch, try rotating your tailbone around to the front. This adds more intensity into the mix. If you want to challenge yourself more over the next 2 minutes rotate your tailbone for 10 seconds, then relax for 5 seconds, before repeating again.  This is going to allow the anterior chain muscle of the lower extremity to be stretched. Remember to change over and repeat on the other side. 

Work that VMO.

The VMO, the teardrop looking muscle on the inside of the knee, can be mobilised with your lacrosse ball. Place your lacrosse ball into the VMO and flex and extend your knee. This can be intense but a perfect way to mobilise this muscle and unlock its potential. Furthermore, it is important to strengthening the VMO muscle, as it plays an important role in the mechanics of the knee cap.

The strengthening exercise I like to use is a lateral heel drop. You stand on the edge of a weighted plate, tyre, or box and slowly lower yourself down so that your heel of your foot being lowered touches the ground, repeat this exercise on both sides.  For further intensity raise yourself higher on your weighted plates, box or tyre, and slowly lower your heel towards the ground. As you raise yourself higher up on the plates, box, or tyre, you will not be able to touch your heel on the ground so add in a pistol squat within this movement, and let your leg go out in front of you instead of towards the ground. If you don't feel the burn, you are clearly a beast.

Take home message.

Don’t put up with that niggly knee pain