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Running is one of the most efficient, effective, and convenient forms of exercise that can be performed anywhere, at any time! Saving money on a gym membership, taking in the beauty of your surrounding city or neighborhood, there are so many benefits to the activity. The thought of it is simple. Put on some shoes, lace them up, and get after it. Simple right? Not exactly. That wonderful “running high” you feel can quickly turn into a nagging pain or injury that can leave you in an uncomfortable state where that moment of striding down your favorite route turns into a frustrating and painful walk back to your home. In fact, Runner’s Knee is one of the most common injuries that can be a nuisance to get rid of. In this article, we will cover runner’s knee causes and treatment, modifiable risk factors related to this condition, and evidence-based strategies including runner’s knee exercises to effectively get you back to running and feeling better than ever.

 

What is Runner’s Knee?

Running is one of the most common forms of exercise, with over 40 million people in just the United States alone running regularly! Yes, it has been known as a great form of exercise that can maintain great health, but it also can lead to injury, as up to half of runner’s per year report injuries (1). Runner’s Knee is a common knee injury that is used to describe a plethora of conditions that lead to pain around the front of the knee. Although it is called runner’s knee, there are other activities that can lead to this clinical condition, such as walking, cycling, or jumping activities. For the scope of this article, we will specifically be covering how running can contribute to knee pain. Common treatments for runner’s knee includes rest, medications, or injections, which may assist in alleviating symptoms; however, these interventions often do not address the underlying origin of the issue, potentially resulting in poor outcomes (2). On the contrary, taking a more active approach to recovery with exercise and proactively educating yourself as an individual will help promote a better prognosis.

Two of the more common conditions that are often related to runner’s knee include Iliotibial Band Friction Syndrome (ITBFS) and patellofemoral pain syndrome (PFPS). In the next portion of this article, we will break down what each of these conditions are, how they can contribute to runner’s knee, and evidence-based treatments for optimal management.

 

A lot of people think that you can just grab a pair of shoes and start running, which can be true. However, failure to prepare may set you up for failure. “You don’t run to get fit, you have to be fit to run.” Without proper training, education, and an understanding of healthy running hygiene habits, issues may arise that can keep you from running. The Running [P]Rehab Program will teach you the best cross-training routine for runners and education to help you maintain optimal running health. Learn more HERE

 

Iliotibial Band Friction Syndrome (ITBFS)

 

ITBFS is a common knee injury that is due to inflammation of the distal portion of the iliotibial band, which results in pain that occurs around the outside portion of the knee (2). The repetitive bending and straightening of the knee with daily activities such as walking or running can lead to potential irritation of certain portions of the IT band that eventually can lead to injury. To better conceptualize this, it helps to visualize exactly where the iliotibial band is situated within the human body.

The iliotibial band is a thick band of fascia that originates on the iliac tubercle, blends into the fascia lata just above the mid-thigh, runs alongside the lateral femoral epicondyle and patella, and then inserts on Gerdy’s tubercle just below the lateral tibial plateau. What is unique about the iliotibial band is the type of tissue that it is. As previously reviewed in our tissue healing article, there are 4 main types of tissue in the human body: epithelial, connective, nervous, and muscle. The iliotibial band is a type of connective tissue; however, its properties are different than tissue such as muscle, tendon, or ligaments.

In contrast to tissues such as muscles, tendons, and ligaments, the iliotibial band itself does NOT perform actual contractions within the human body! This is a very important concept to understand when one is conceptualizing the anatomical and physiological properties of the IT band. Furthermore, when one is overcoming an IT band origin of pain, the underlying origin of the source of pain may not be the IT band itself, but the muscular attachments that connect to the IT band!

 

The muscles that attach to the IT band which you can see above include the vastus lateralis (one of your quadriceps muscles), tensor fascia lata (TFL), gluteus maximus, and biceps femoris (one of your hamstring muscles). If these muscles are tight and/or weak, they can create more tension on the iliotibial band, ultimately leading to pain. This is one of the key aspects to evaluate as a clinician when deciphering what exactly is the underlying cause behind runner’s knee.

 

 Patellofemoral Pain Syndrome

 

In addition to ITBFS, Patellofemoral Pain Syndrome (PFPS) is one of the most common knee injuries that affects many athletes, including runners (3). To give you a proper framework regarding basic anatomy, the patellofemoral joint consists of the patella (knee cap), articulating with the femur (thigh) bone, which is situated on the front of your knee. As you bend and straighten your knee, the knee cap will slide back and forth within the patellofemoral groove. The way that the knee cap normally moves is similar to a C shape, starting slightly towards the outside of the front portion of the knee, then moving more towards the middle aspect of the knee, and eventually back towards the outside portion of the knee. We use this joint constantly with daily activities, such as negotiating stairs, squatting, walking, and of course, running! To learn more about the biomechanics of the patellofemoral joint, read this excellent article by London from the International Journal of Sports Physical Therapy (4).

 

https://theprehabguys.com/runners-knee-causes-and-treatment/