Have You Ever Experienced Knee Pain when you Run?

​Have you ever experienced the frustration of having to stop exercising because of a niggling pain in your knees?

What causes it and what can you be doing to get pain free faster?

Shane our newest Remedial Massage therapist took a bit of time to explain a condition that our massage therapists see in the clinic quite often called “Runner’s Knee.”

What is it and what causes it? 

'Runner's Knee' is a term that can describe a variety of issues of the knee. It's not specific to running but, to any activity that requires repetitive knee bending. It's given the term runner's knee because of how common it s seen in runners.

The main causes are related to running

• overuse - for example from too much running or building up your kilometres too quickly,
• mechanical compensation - your running technique is not great which causes excessive stress of different parts of your body such as your knees. 
• or direct trauma

The most common symptom is pain around, behind, or in front of the knee that worsens when running, walking up or down stairs or inclined surfaces, squatting or standing up from a seated position. When people come in to get a massage and we assess their knee we sometimes see swelling and can hear cracking when we asked to do exercises such as squats or general range of movement testing. 

What Can You Do? 

Understanding

One of the key components to any condition is working out what is going on in the first place to cause the discomfort. 

• Have you increased your running time or distance quickly? 
• When was the last time your changed your shoes?
• ​Are you doing any self care such as stretching to loosen up muscles that could be tight? 
• Are you warming up and/or warming down when you exercise? 
• When was the last time you had your running style checked? 
• What else are you doing on a day to day basis that could be putting excessive load on your body that is causing you pain when you exercise? 

Assessment
As Remedial Massage Therapists at Just Knead It we approach the treatment of runners systematically by doing a thorough assessment of your range of motion in your lower back, hips, knees and ankles. This allows us to gain understanding of what could be causing/ contributing to your knee pain. 

Some quick tests that you could do at home:

• When you go into a squat - how far can you go down and where do you feel the tightness? If it's not far, if there is pain and/or you can feel that there are definitely some tight spots it could mean that you need to look into the tightness of your leg muscles.

 

• How is your ankle flexibility? If you stand in front of the wall with your hips square to it and bend your knee so you can touch the wall with your knee cap - how many centimetres away from the wall can you get your big toe before your knee can't touch any more? 

 

• Do you already know that your core stability isn't great and could do with some work?! ​

These are all contributing factors that could be causing your discomfort. 

Actions to take to help!

1. Address any swelling

• Use a combination of rest, ice, compression, and elevation to address swelling. Anti-inflammation medications can help (talk with you doctor for your options).

2. Release

• Release tight muscles using stretching and self-massage techniques like foam rolling and trigger balling. My recommendations for treating Runner's Knee would be:

• ​​TFL (Tensor Fascia Lata):
  • ​Releasing this muscle will help with hip extension, decreased tension into the ITB (Iliotibial Band) and glut activation. Getting your gluts driving the movement (walking, running) will allow for better technique and less mechanical issues). Check out our ITB & TFL release exercises on our Lower Body Stretches and Exercises Page​​​

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• Short Adductors:
  Releasing this area on the inner thigh, close to the groin, can also release tension around the outside of your leg. Lay face down with your leg cocked over a foam roller that is parallel with their body, positioning the roller close to the groin. Keep your hips facing the ground and hold for up to 1.30min.
  
  
  
• Quads & Calves:
  Check out our Lower Body Flexibility Page for additional stretching and self-massage techniques for your calves and quads muscles. 

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3. Activate

• Often having muscles in your body that aren't working properly (weakened) can cause you alignment issues and cause you to change the way your body moves effectively. This is particularly the case with running since you are propelling your body forward through gravity. Activating (getting your muscles to 'switch on and work properly) weakened muscles can help to decrease knee pain and the risk of injury.

​What I would recommend: 

• Wall Sit:
  Knee issues can be largely attributed to quad imbalances. Your quads are a large group of 4 muscles. Often the ones on the outside of your knee can become more dominate compared to the ones on your inside of your knee. By getting all 4 muscles firing more effectively you can create more stability around the knee joint and less pain. 
  
  ​​Sit against a solid vertical surface with knees and hips bend a little more than 90 degrees. Push your lower back into the wall and feel how your quads activate. It should feel like your feet want to slide forward. Hold, with your back pressed, for up to 1min. Repeat 2-3 times daily. *If you experience knee pain whilst performing this activity check with a health professional before continuing. 

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• Glut Bridge:
  ​As with the release of the TFL, this activation will improve hip extension.
  
  ​​Lay on your back, knees bent, feet flat, hands on your gluts (if necessary). Squeeze your gluts and use them the drive your hips up to the ceiling/sky. Try not letting the hamstrings dominate the gluts. Hold at the top for 3-5sec and lower back down, keeping the gluts contracted. Aim for 10-15 reps. Repeat 2-3 times.

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4. Integrate:

• Once you have released to tight and activated to weak, you need to get the body working together as a whole. This way the body can be retrained to perform as it should.
  
  
• Stairs: 
  ​Using stairs can be a great way to integrate. Try doing 2 stairs at a time. As you step onto a step, think about the kind of load you felt through your leg when doing the wall sit. Once you feel that load, use it to push up on to the step. You can regress this to stepping on to the step with the front leg, then pushing back to your start position. Refer to pictures. Do this daily and any time you get the chance to use stairs.

Summary:

Attend to inflammation, do not overtrain by doing the same thing like running every day, cross train by doing complimentary exercises like gym training and mobility work, and maintain your body by resting adequately, doing stretching and self-massaging, as well as getting regular remedial  massage treatments (depending on your pain and activity frequency).

​by Shane Asmussen​ 

Learn more about Shane and our great team by visiting our staff profiles! 

Do you currently have knee pain? 
Book in with Shane or one of our other great remedial massage or myotherapists to get your knees assessed, treated and a plan of attack to get back running pain free!

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