Runner's Knee: Understanding Patellofemoral Pain and How Osteopathy Can Help
If you experience a dull, aching pain around or behind your kneecap during activities like running, squatting, or climbing stairs, you might be familiar with Runner's Knee. Clinically known as Patellofemoral Pain Syndrome (PFPS), this condition is one of the most common complaints among active individuals, affecting not just runners but anyone who places repeated stress on their knees.
Osteopathy offers a comprehensive approach to managing Runner's Knee by looking beyond the knee itself to identify and address the underlying biomechanical imbalances that are causing your pain.
Key Facts About Runner's Knee (Patellofemoral Pain Syndrome)
A Common Complaint: PFPS is the most common running-related injury, but it also frequently affects cyclists, hikers, and people with active occupations.
A Mismatch of Forces: It is primarily a mechanical issue, involving an imbalance in the forces controlling the kneecap (patella) as it tracks through its groove on the thigh bone (femur).
Not Just Cartilage Wear: While pain is felt in the patellofemoral joint, it is distinct from arthritis and involves the soft tissues (tendons, ligaments, and the cartilage underneath the kneecap) becoming irritated.
Common Causes and Risk Factors
Runner's Knee is typically an overuse injury caused by repetitive stress on the patellofemoral joint. Key contributing factors include:
Muscle Imbalances: Weakness in the hip muscles (especially the gluteus medius) and the quadriceps can cause the thigh to rotate inwards, pulling the kneecap out of its optimal alignment.
Poor Biomechanics: Issues with foot posture (such as overpronation – flat feet) or a person's running gait can alter the forces travelling up the leg and affect kneecap tracking.
Overload and Training Errors: A sudden increase in running intensity, duration, or frequency, or consistently running on hard or cambered surfaces, can overload the joint.
Tight Soft Tissues: Tightness in the iliotibial (IT) band, hamstrings, or calf muscles can change the mechanics of the knee and increase pressure behind the kneecap.
Direct Trauma: A fall or direct blow to the kneecap can also initiate the pain cycle.
Common Signs and Symptoms
Dull, Aching Pain: Pain is typically felt behind or around the kneecap.
Activity-Related Pain: Pain that is worse during activities that load the bent knee, such as running, squatting, climbing/descending stairs, or prolonged sitting with bent knees ("theatre sign").
Crepitus: A grinding or clicking sensation under the kneecap when bending and straightening the knee.
Swelling: Mild swelling around the kneecap may sometimes be present.
How Can Osteopathy Help with Runner's Knee?
Osteopathic management of PFPS focuses on correcting the faulty mechanics that are overloading the patellofemoral joint. We assess your entire lower limb and pelvis to find the root cause of the problem.
During your initial consultation, we will:
Take a detailed history of your pain, training habits, footwear, and daily activities.
Perform a physical examination of your knee, assessing alignment, mobility, and strength.
Conduct a functional biomechanical assessment of your posture, gait (how you walk/run), and the mobility of your hips, ankles, and feet.
This whole-body assessment is crucial because the cause of your knee pain may actually originate from your hip or foot.
What Does Osteopathic Treatment Involve?
Using a range of gentle, hands-on techniques, we aim to:
Reduce Pain and Muscle Tension: Soft tissue massage and myofascial release techniques are used to relax tight structures like the IT band, quadriceps, hamstrings, and calves, which can improve kneecap alignment.
Improve Joint Mobility: Gentle mobilisation of the knee, hip, ankle, and even the joints of the foot can restore normal movement and ensure forces are distributed evenly up the leg.
Correct Biomechanical Imbalances: We treat the primary dysfunctions contributing to your pain. This often involves improving hip stability and control by addressing weak gluteal muscles.
Provide Personalised Advice and Rehabilitation: This is a cornerstone of treatment. You will receive guidance on:
Activity Modification: Temporary adjustments to your training to allow tissues to settle, while maintaining fitness with cross-training.
Targeted Exercise Program: A tailored program to strengthen your hip stabilisers and quadriceps, and improve your core control.
Running Analysis and Cueing: Advice on running form and cadence to reduce impact and improve efficiency.
Footwear and Orthotic Considerations: Guidance on appropriate footwear for your foot type and activity.
When to Seek Further Medical Help
It is important to get a correct diagnosis for your knee pain. Please consult your GP for a referral if you experience:
Severe pain that prevents you from bearing weight.
A "popping" or "giving way" sensation in the knee at the time of injury.
Significant or sudden swelling of the knee joint.
Locking or an inability to fully straighten or bend the knee.
Signs of infection, such as fever, redness, or warmth in the knee.
Numbness, tingling, or weakness in the leg or foot.
Your GP can help rule out other conditions like meniscal tears, ligament injuries, or arthritis.
Take the Next Step Towards Pain-Free Running
Runner's Knee can be a frustrating setback, but with the right approach, a full return to activity is highly achievable. Osteopathy provides a safe, effective, and drug-free pathway to not only alleviate your pain but also to address the underlying causes and empower you with the knowledge to run stronger and prevent future injuries.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you get back on track, pain-free.
References
*Barton, C. J., Lack, S., Malliaras, P., & Morrissey, D. (2013). Gluteal muscle activity and patellofemoral pain syndrome: a systematic review. British Journal of Sports Medicine, 47(4), 207-214. [Link: https://bjsm.bmj.com/content/47/4/207]*
*Crossley, K. M., van Middelkoop, M., Barton, C. J., & Culvenor, A. G. (2016). Rethinking patellofemoral pain: prevention, management and long-term consequences. Best Practice & Research Clinical Rheumatology, 30(1), 145-167. [Link: https://www.bprclinrheum.com/article/S1521-6942(15)00132-7/fulltext]*
Australian Institute of Health and Welfare (AIHW). (2020). Musculoskeletal conditions. [Link: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions]
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care. The exercise rehabilitation component is crucial for managing this condition, and adherence to a tailored program is recommended for optimal outcomes.