Pattellofemoral Pain Syndrome (Runner's Knee) - Causes and Solutions

Runner’s Knee - Overuse and Alignment are the Causes

Runner’s knee (Pattellofemoral Pain Syndrome, PFPS) is one of the most common running injuries. Thousands of runners experience it annually. Many non-runners do as well. Symptoms include a dull aching pain at and behind the kneecap, which often becomes more intense after a period of rest. Pain experienced by this common overuse injury can be magnified by walking up and down steps and hills or on uneven surfaces. It is more common in recreational runners than elite runners, and twice as prevalent in women than men. It can last a few weeks or bother you for years.

The main causes of runner's knee are:

• Overuse - Too much stress on the knee can trigger runner's knee, particularly if there is a sudden change in activity levels. The problem is caused by misalignment of parts of the knee joint.
• Imbalance – The misalignment of the knee joint can by caused by imbalance. There are two types of imbalance.
• Muscle Imbalance - When the muscles on the front of your leg are not as strong as the muscles in the rear, the stronger muscles pull your knee out of alignment and cause inflammation and pain.
• Functional Imbalance - This occurs when the biomechanics of your foot and ankle are flawed and the rest of your leg (and hips) suffer as a result. Correcting the biomechanics of the foot and ankle with insoles or orthotics can have a positive effect.

Treatment includes alleviating the symptoms and addressing the cause.

Runner's knee symptoms are most effectively treated with:

• Rest - Decrease the physical activity that taxed the knee joint.
• Ice - Apply ice to your knee to decrease the inflammation and pain.
• Compression - Support the knee with lightly-wrapped ace bandage.
• Elevation - Rest with your knee above your heart to help ease the pain.

Address the causes of runner’s knee to create a long-term solution:

• Overuse - Rest and decreased activity will help with a long-term cure.
• Muscular Imbalance - A physical therapist can suggest exercises that balance the strength in the muscles surrounding the knee joint. Stretching also minimizes the uneven pull of the muscles.
• Functional Imbalance - If foot biomechanics is a cause or partial cause of your knee pain, insoles or orthotics with strong arch support will help. They prevent the inward rotation of the knee that results from overpronation of the foot. Look for insoles that have a firm plastic or carbon fiber structure. Soft foam insoles do not provide the necessary support.

Recently there has been a waterfall of research published about orthotic insoles. The research shows a clear trend. Orthotic insoles can assist with alignment injuries and help prevent and treat runner's knee.

If you’re looking at orthotic insoles to help heal an injury, here are a few tips:

• Use orthotic insoles like a tool - Even though you picked the most comfortable orthotic insole, don’t overdo it! If you stick that insole in your shoe and run a marathon the next day, you’re at risk of injuring yourself again. Ease yourself into your new orthotic insoles. Wear them for a few hours to start, increasing the time gradually as your body adapts to a greater level of support.
• One size does not fit all -  Though your best friend might rave about her new insoles, you need to find the pair that will fit your feet and needs. Feet and bodies are different; one-size-fits-all solutions rarely work.

A chart showing some of the better functional insoles is available on the Tread Labs site. We’d like to think that our wide array of sizing and 30-day fit guarantee offers a superior experience for people with runner’s knee. But maybe one of our competitors’ products fits you best. Whatever you choose, we hope that you’re able to walk and run pain free and enjoy the level of activity that you desire. If we can be of any assistance, please give us a call at (781) 435-0662.