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Runner’s Knee Pain

3 Tips to help your with Runners Knee Pain

I’m Victoria, certified run coach, licensed physical therapist, triathlete, and runner. Here at Ironhorse Physical Therapy and Pilates, we treat quite a few runners and triathletes. So I thought I’d share a few tips with you to help you get out of knee pain and back to running the pace and disatnce that makes you happy! Before I do that, let me ask you this question:

Is this YOU? Or someone you know?

  • Started having pain in knee or other  ____ body part weeks/months/years ago. It hurts just walking stairs now too.
  • Decided to rest it and skip a few days of running
  • Tried running again a few days later but still hurt so took a whole week off this time (it must be better by now right?!)
  • Nope, the pains still there (Damn it!)
  • Starts googling all the stretches and foam rolling exercises for knee pain or runner’s knee
  • Knee feels better so you keep rolling and stretching and resting (not running)
  • Let’s try this again….goes for a run and pain starts back again UGH
  • Is feeling really frustrated and may have to pull out of ____race you signed up for
  • Repeats vicious cycle of pain/not running/rolling/stretching etc for a while longer until you decide that this is madness. The definition of insanity is to keep doing the same thing over and over and expecting a different result.

If this is YOU, it’s ok, no judgement cuz guess what? This is like every runner I’ve ever had the privilege of working with!

Read on for 3 tips on runners knee pain and a patient story that maybe you can relate to:

Tip 1: REST is NOT a viable solution to your running problems or in fact, any other injury!

If your goal is to get back to Running or working out , you need more than just rest (or stretching ).

Now, you may initially need to rest the area that hurts. You want the inflammation to settle down. But that shouldn’t take more than 3-7 days. Did you know that your body starts to decondition and lose muscle strength and aerobic capacity in as little as 1 week? There are some injuries like a stress fracture for example that may necessitate prolonged rest from running.  But generally, most muscle and tendon injuries do NOT benefit from prolonged rest > 5-7 days.

If you rest too long, the muscles or tendons all over your body (not just where it hurts) get weaker. So the next time you run, the pain will likely come on even sooner. For example, your knee used to hurt 3 miles into your run but now it’s starting at just 1 mile into the run. Not good, trending in the wrong direction 

Tip #2: Get a proper assessment with someone who will really look at you as a whole person, rather than just your knee

90% of the time, when I treat a runner with knee pain, it’s not about the knee. The knee is known as a slave joint. It doesn’t have any control of its own, and it really just follows what the foot and ankle does, and what the hip and pelvis does. So if you’re having knee pain and you just treat the knee, 9 times out of 10 you will NOT have complete resolution of your symptoms. Case in point, I’ve got a patient right now who went to 4 weeks of physio PT at another clinic and got all kinds of treatment for his knee, Graston, ice and stem. They also cupped the muscles around his knee. He’s been foam rolling his quads like crazy, stretching. And 4 weeks later, he runs, knee pain is exactly the same. There’s nothing wrong with those treatments. In fact, you need to treat the symptoms and runners generally feel better temporarily with massage, cupping etc.  But if you just treat the symptoms , and not the root cause, then runners knee pain will just keep coming back and never really go away.

So when he came in to see us, we took a closer look at him, we looked a little bit further than the knee. And it turned out that he really had very poor core control, very poor control of his spine. He had a back problem like 10 years ago and his back no longer hurt so he just sort of ignored it. And btw he’s someone, for example, that that very common running cue to “run tall” would not work, because he literally doesn’t have the postural control or flexibility or mobility to run tall. You can’t out-coach something that the person inherently doesn’t have access to in their body. He literally did not have that as a movement option. So what we did was worked on his spine. And that improved his hip control, which then helped his knee pain. So he’s a classic example of, “If you just treat where it hurts, you’re gonna get incomplete resolution of your symptoms and may not get any relief whatsoever.”

Here’s a video of a different patient with a similar issue . She didn’t have back problems but she had a baby ~ 1 year ago and hadn’t restored all her core and pelvic floor strength. That was the root cause of her knee pain!

Tip #3: Get a Run Gait Analysis by a certified Run Coach or Physical Therapist

If your PT or chiropractor, doctor etc. doesn’t watch you run, you should find another practitioner who is skilled at watching runners run. You run form can reveal some things that you may not realize is contributing to your runners knee. The picture below shows “hip drop” on the Left side which was contributing to her runners knee pain. Can you see how her hips go crooked when she’s standing on her Left leg? The good news is that she worked on it with me and she was able to run pain free again!

running gait analysis

Do you know what your run cadence is? That’s the # of steps you take in 1 minute. A 5% increase in your run cadence can decrease the stress on your knee by 20% . This is the kinda stuff I teach in my Bulletproof Runner Workshops. You can find out more by going here: Run Pain Free

I hope this blog post on runners knee has been helpful to you and that you’re on your way to running pain free! If you need additional help, feel free to reach out for a free consultation. You can request it by going here: Yes I want help 

Happy Running!