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Knee pain in runners

Tom Jennings exercise knee muscles pain patellofemoral recovery run runner running sports performance strength therapy training

Typically we find that a muscle imbalance causes knee pain or patellofemoral syndrome in runners. An imbalance of hip and leg strength can lead to over-use knee injuries like patellofemoral syndrome. Patellofemoral syndrome is one of the more common knee injuries in runners. It can start as a general ache in the front and or side of the knee after running with little or no swelling, and progress to a sharp pain in the knee while running. The patella or knee-cap is positioned between the femur (thigh bone) and tibia (lower leg bone) and increases the leverage the tendon can exert on the femur by increasing the angle at which it acts (wikipedia).

In our assessment of runners a leg strength imbalance is usually uncovered, and if left alone may lead to compensatory patterns. Usually, the dominant leg is overloaded increasing the forces on the patellofemoral joint causing wear and tear on the knee. By strengthening the weaker leg the load will be dispersed more evenly between the two leg. A simple way to determine which leg is weaker is to perform a step up exercise (see video). Step up slowly on a 6-12 inch platform, and after 15-20 reps you will notice one leg tires more easily, and is less balanced. Commonly, we find that right hand dominant runners have a weaker right leg because the left leg is dominant (think right hand layup in basketball and  jumping off left leg).

After you determine which leg is weaker you can integrate the same step up exercise into your leg strength program to help prevent knee injuries like patellofemoral syndrome. While building strength is the goal, over-loading this with heavy weights can irritate the joint. Start with no weight and progress to a light weight (5-10#). Only use a 6-12 inch step, anything higher is unnecessary, and add more reps and sets on the weaker leg.

Note: This is a prevention exercise. If you feel pain in the knee with a step up you may already be experiencing patellofemoral syndrome. Do not perform the step up if you experience pain. 


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