Common Knee Injuries

​Common knee injuries experienced by runners
 
Generally, people run to gain a positive reward, whether that is to improve wellbeing and achieve a physically active lifestyle or to achieve an ambition of running a Marathon or just simply because they enjoy the space and freedom. If this positive reward is met by frustrating challenges such as pain and injury it can soon become a negative experience. There are times when activities such as running can seem to bring about injury. There is usually an explanation for this and therefore a solution!
Here are some common knee injuries suffered by runners.
 
Patellofemoral pain syndrome (runner’s knee)
 
What is it and what causes it?
This is a common Injury suffered by Runners. It is often termed 'Runner's Knee'. In these circumstances, this type of Knee pain often comes on gradually over time. It can cause swelling in the Knee and generally presents as a dull ache in the Knee or behind the Knee cap. It is aggravated by activities such as walking, running and going up and down stairs.
Common causes of this type of injury in runners are thought to be overuse and misalignment of the knee. There are many reasons for misalignment of the knee and it would be helpful to establish which of these is involved when addressing future prevention strategies.
How to treat it?

• Initially following the R.I.C.E (Rest, ice, compress and elevate) protocol is most beneficial in the first 24-48 hours of an acute flare up.
• Restricting pain eliciting activities such as running, jumping. Consider alternative low impact activities early in recovery such as swimming or cycling.
• Stretching lower limb muscles such as Quadriceps, Hamstrings, Glutes.
• Maintaining full available joint range of movement
• Appropriate strengthening exercises
• NSAIDs (anti-inflammatory drugs) may help manage pain.
• Application of specific taping techniques can off load the patella aiding recovery.
• If it doesn’t settle seek medical advice.

How to prevent it?

• Stretch daily throughout the lower limb, particularly as part of your training recovery programme.
• Establish cause of misalignment of the patella
• Carry out appropriate strength training to address lower limb imbalances.
• Seek advice from professional regarding the possible requirement of insole or footwear support recommendations.

 
Iliotibial band syndrome (ITBS)
 
What is it and what causes it?
Pain is experienced on the outside of the knee, there may be swelling present here. The pain is felt during running, usually coming on after a short while of activity and subsiding once activity has ceased. Often this is seen in longer distance runners and is exacerbated by running downhill and downstairs.
ITBS is generally classed as an overuse injury where the tissue of the Iliotibial band (fascia running down the outside of the leg) is experiencing friction over the femoral condyle (bony surface) underneath.
How to treat it?

• R.I.C.E (Rest, ice, compress and elevate) protocol is most beneficial in the first 24-48 hours of an acute flare up.
• Restricting pain eliciting activities such as running.
• Stretching lower limb muscles such as Quadriceps, Hip flexors, Glutes, ITB.
• Maintaining full available joint range of movement

• Appropriate strengthening exercises
• Use of foam roller or massage ball to conduct myofascial release.

• NSAIDs (anti-inflammatory drugs) may help manage pain.
• Application of specific taping techniques can off load the ITB aiding recovery.
• If it doesn’t settle seek medical advice.

How to prevent it?

• Stretch daily throughout the lower limb, particularly as part of your training recovery programme.
• Introduce appropriate strengthening exercises to support the lower limb alignment.
• Use of foam roller or massage ball to conduct myofascial release.

 
Patella tendonitis
What is it and what causes it?
This is an inflammation of the tendon over the patella. The most commonly experienced site of pain is just below the patella as the tendon joins the Tibia. It is known as another overuse injury causes by repeated impact.
In the early stages of this injury pain may only be felt at the start of a run and ease as the runner warms up. Perhaps becoming stiff once again following the end of the run. If left this may become more symptomatic throughout the whole of the run along with affecting daily living activities such as going up stairs or standing from a seated position.
How to treat it?

• R.I.C.E (Rest, ice, compress and elevate) protocol is most beneficial in the first 24-48 hours of an acute flare up.
• Restricting pain eliciting activities such as running.
• Stretching lower limb muscles such as Quadriceps.
• Maintaining full available joint range of movement.

• Appropriate strengthening exercises, initially these may be static quad strengthening, progressing to eccentric loading after the initial inflammation has settled.
• Use of foam roller or massage ball to conduct myofascial release of the quadriceps.

• NSAIDs (anti-inflammatory drugs) may help manage pain.
• Application of specific taping techniques can off load the patella tendon to aid recovery.
• If it doesn’t settle seek medical advice.

How to prevent it?

• Stretch daily throughout the lower limb, particularly as part of your training recovery programme.
• Ensure a progressive training load programme is carried out allowing for adequate stress and adaptation phases.
• Introduce appropriate strengthening exercises to support the lower limb alignment.
• Use of foam roller or massage ball to conduct myofascial release.

 
Ligament injury
What is it and what causes it?
There are four main ligaments in the knee. Too much stress on these ligaments can cause them to overstretch and even tear. Ligament injuries are often resultant of a specific trauma such as a sudden twist, an awkward landing, an over straightening or a direct impact to the knee.
If damaged the knee will often experience sudden sharp pain and swelling. It will likely be painful to weight bear and there could be a degree of instability.
How to treat it?

• R.I.C.E (Rest, ice, compress and elevate) protocol is most beneficial in the first 24-48 hours of an acute flare up.
• Restricting pain eliciting activities such as running.
• If significantly painful the use of crutches may be beneficial.
• Maintaining full available joint range of movement.

• Appropriate strengthening and balance exercises.

• NSAIDs (anti-inflammatory drugs) may help manage pain.
• Application of specific taping techniques can support the joint.
• If it doesn’t settle seek medical advice.

How to prevent it?

• Be aware of uneven, rough terrain particularly if training under fatigue.
• Introduce balance and proprioception training into a programme to challenge your bodies awareness in space.
• Introduce appropriate strengthening exercises.

In any case if the knee becomes injured with no specific trauma, continuing running on it without any intervention is likely to exacerbate symptoms. If left unresolved the risk is further longer term damage to the knee causing undesired wear and tear.
It can be most helpful to seek advice from a registered Health Care Practitioner to ensure that you have an accurate diagnosis and to ensure an effective treatment plan is prescribed.