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Injury #3: Patellofemoral Pain Syndrome (PFPS)
There can be many different causes for knee pain, but one of the biggest culprits is overall faulty mechanics. In the vast majority of cases, we find a significant lack of hip and trunk strength and stability as well as faulty foot mechanics, which cause more stress to be placed on the knee surfaces between the patella (knee cap) and your femur (long leg bone). Generally, runners will feel pain under or around the knee cap with either a sharp or achy sensation during or after running. If these mechanics are not corrected, the cartilage behind the kneecap will eventually wear away, causing even more pain and dysfunction with movement.
=Trunk, hip, and foot strengthening and stabilization activities and ensuring that all of the above have the appropriate mobility are key to decreasing stress on the knee joint. Single-leg activities are great, and there are so many varieties available, starting with balancing on one leg and progressing to single-leg squats and single-leg RDLs. Ensuring your hamstrings, calves, quads, and IT bands are at their proper length and mobility is vital to creating optimal lower extremity mechanics while running.
For a runner with general knee pain, we once again put them through the Runner’s Screening Exam, and as an example, we found limited ankle mobility. We will then treat/improve that ankle mobility, which commonly improves the entire leg movement pattern, thereby decreasing strain on the knee and eliminating that runner’s knee pain. Again, in conjunction with correcting spinal and leg mechanics in our sessions, we provide the runner with a comprehensive home exercise program to prevent future re-injury.
So what if these self-treatments don’t work? If your injury continues to the point where you can’t run without pain or, worse, you’re starting to walk differently because of pain; you may need to seek out the help of a movement professional. Find someone who will perform a comprehensive assessment of all the pieces of this puzzle to determine the cause(s) of your pain. Once you have a baseline, you will be able to begin a targeted and intensive rehabilitation program to eliminate your pain and keep you running.
Who are these health professionals, you ask? Some examples include physical therapists, orthopedic physicians, podiatrists, and athletic trainers. I am biased, of course, but a physical therapist should be at the top of your list, especially one who has a running or competitive athletics background in treating runners.
Also, footwear is a critical component a runner needs to look at if they are having pain when running. A great resource is your local running store, where the employees will be able to determine which shoe is best for you based on your body type, foot type, training regimen, etc. Our friends at Potomac River Running have in-store treadmills where their patrons run for a few minutes to determine which shoe will best fit. These stores are also great resources for finding running clubs, training programs, additional running equipment you may need, and meeting other runners who share your passion for the sport.
Overall, the key point is to use self-treatments when appropriate after incurring a running-related injury, but to know when it is outside of your knowledge and to seek professional help. Make sure the professional you seek out has the most appropriate education/background for your injury, takes the time to get to know you individually, and doesn’t just give you the “typical protocol” they give to everyone else. We are all unique in our anatomy, running mechanics, motivation, and discipline when it comes to running, so find someone who will tailor the treatment to you and, ultimately, a person you trust and enjoy being around.
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