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Writer's pictureDr. W Zach Smith

Anterior Knee Pain And Running

Anterior knee pain is a common complaint among runners, and it can be caused by a variety of factors. In this blog post, we'll explore some of the most common causes of anterior knee pain in runners, as well as some tips for managing and preventing this condition.




PatelloFemoral Pain Syndrome

One of the most common causes of anterior knee pain in runners is patellofemoral pain syndrome (PFPS). This condition occurs when the patella (knee cap) rubs against the femur (thigh bone) in an unnatural way, leading to pain and inflammation. PFPS is often caused by a misalignment of the patella, which can be caused by a number of factors, including muscle imbalances, improper running technique, and overuse.




IT Band

Syndrome

Another common cause of anterior knee pain in runners is the IT band.


band syndrome. The iliotibial band (IT band) is a band of tissue that runs along the outside of the thigh and knee. When the IT band becomes tight and inflamed, it can cause pain and discomfort in the knee. This condition is often caused by overuse, but it can also be caused by muscle imbalances or poor running technique.


IT Band Syndrome is a debilitating condition that affects the lateral part of the leg. Symptoms can include pain and tightness along the outside of the knee, hip, or thigh, as well as swelling and difficulty with moving the affected limb. People may feel a grinding sensation when walking or running, have trouble with weight bearing activities such as climbing stairs, experience decreased performance in sports or physical activity due to the pain, and their knee may be prone to buckling when pushing off with the foot.


Other Pathologies That Cause Knee Pain

Anterior knee pain can also be caused by a number of other conditions, including arthritis, tendonitis, and bursitis. These conditions can be caused by a variety of factors, including injury, overuse, and age. Knee tendonitis, also known as patellar tendonitis, is a common condition characterized by pain and tenderness at the base of the kneecap. Pain may be mild at first but can worsen over time. Other symptoms include swelling, stiffness, difficulty jumping, running or walking, and pain when bending or straightening the knee. In severe cases, there may be pain even during rest.

To manage and prevent anterior knee pain, it's important to address the underlying causes of the condition. This may include correcting muscle imbalances, improving your running technique, and reducing your overall mileage. It's also important to stay active and engage in regular strength training exercises to help improve the strength and stability of your knees.


Strategies To Reduce Knee Pain While Running


When it comes to physical therapy, strengthening the hip is one of our top priorities. Proper alignment of the leg is essential and weak hip muscles can lead to too much strain on the knee. Our physical therapists typically start with targeted exercises in order to increase strength and stability in the hip region. Glute bridges, donkey kicks, side-lying clamshells, fire hydrants and hip abduction exercises are some of the most popular methods we use in the early stages of rehabilitation. Each exercise is designed to target specific muscle groups around the hip that help improve mobility, reduce pain and regain confidence while walking or running. These exercises not only stabilize the leg alignment but also strengthen surrounding muscles which further helps reduce any discomfort or instability that could be causing problems down the line.


5 Common Hip Strength Exercises

  1. Glute bridges: Lie on your back with feet flat on the floor and knees bent, then press through your heels to lift hips off the ground creating a straight line from shoulder blades to knees. Return to start position after 3-5 seconds for one repetition, doing 10-20 reps in each set.

  2. Donkey kicks: Begin on all fours with hands and knees shoulder width apart, then flex foot so toes are pointing up as you squeeze glutes and kick that same leg up behind you. Hold this pose for 3-5 seconds before slowly lowering it back down for one rep, performing about 10 repetitions in each set.

  3. Side plank clamshells: Start by lying on one side propped up on elbow with legs bent at a 45-60 degree angle (knees stacked one above other). Lift the hips off the floor and keep the knee and foot down. Squeeze glutes while slowly opening top knee away from bottom knee (as if opening an oyster shell).

  4. Fire hydrants: Starting position is similar to donkey kicks where you’re on all fours but with arms extended out in front of body instead of hands planted firmly into floor – then lift same leg up towards side while squeezing buttocks tight throughout exercise, hold for 3-5 seconds before slowly lowering it back down for one rep & repeat about 10 times per set.

  5. Hip abduction: Begin by lying face down propped up onto elbows or forearms but legs should be straight out at hip level, then raise top leg as high as comfortable without arching lower back at any point throughout exercise & holding this position.


Stretching and Foam Rolling


Another way to manage and prevent anterior knee pain is through stretching and foam rolling. Stretching can help to loosen tight muscles and improve flexibility, while foam rolling can help to release tension and reduce inflammation. Additionally, using a knee brace or compression sleeve can help to provide additional support and stability to the knee.


Our physical therapists also utilize manual therapy such as massage, cupping, and instrument assisted soft tissue mobilization to help improve muscle mobility and reduce pain.



Running Technique and Gait Pattern

In addition to addressing underlying conditions such as muscle imbalances and overuse, proper running technique is also crucial in preventing and managing anterior knee pain. One important aspect of running technique is maintaining proper form while running. This includes keeping your head up and shoulders back, landing on the mid-foot or forefoot, and avoiding over-striding or landing on the heel. It's also important to engage your core and maintain a steady, even pace while running.


Foot Strike

An important aspect of running technique is proper foot strike. A proper foot strike is when the foot lands directly beneath the center of gravity. When the foot lands in front of the body, it can create a braking force that can lead to knee pain. Foot strike is a hotly debated topic in the running community. Some experts believe that forefoot strike is optimal. Some think that mid-foot is optimal. If you are going to change your running gait, you should consult an expert in biomechanics.

Proper foot wear is also important for preventing knee pain. Wearing shoes that are worn out, don't fit well, or don't provide adequate support can lead to knee pain. Make sure that your shoes are in good condition and that they fit properly. It's also a good idea to replace your running shoes every 300-500 miles, or when the tread starts to wear down. Lastly, it's important to gradually increase your mileage and intensity when starting a new running program or training for a race. This will help to prevent overuse injuries and allow your body to adapt to the increased demands of running.

In summary, proper running technique is crucial in preventing and managing anterior knee pain. This includes maintaining proper form, engaging the core and maintaining a steady pace, proper foot strike, proper foot wear, and gradually increasing mileage and intensity. By paying attention to these details, you can help to reduce your risk of knee pain and improve your overall running experience. Anterior knee pain is a common complaint among runners, and it can be caused by a variety of factors, including patellofemoral pain syndrome (PFPS), IT band syndrome, arthritis, tendonitis, and bursitis. To manage and prevent this condition, it's important to address the underlying causes and engage in regular stretching, foam rolling, and strength training exercises. If you are having pain in the knee while running reach out to us. We have expert physical therapists that are skilled with evaluation and treatment of running injuries.




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