A Cure for Runner’s Knee?

I’ve always been intrigued by conditions that are “linked” to an activity such as Golfer’s Elbow, Tennis Elbow, and Runner’s Knee. I think those conditions are giving way too little credit to the body (and way too much credit to the activity) in terms of what it is capable of doing.  Your body is designed to run, jump, climb, skip and crawl, not to mention a myriad of other motions and movements.  I believe by blaming the activity we are conveniently creating a scape goat that lets our body get out of doing something it was designed to do.

My point here is that I don’t think the activities are to blame.  And IF they are, then that means we have to assume a few things.

First, if the activity is to blame, wouldn’t that mean that everyone who does that activity should have the exact same symptoms? I run, but don’t have Runner’s Knee, so why do you have it?

Second, if the activities are to blame, then shouldn’t the symptoms be equal on both sides? I’m going to guess that your Runner’s Knee is only impacting one knee or worse in one knee than the other.  So, if you have Runner’s Knee only in your right knee, are you running one-legged?

I’m kidding, of course, but hopefully it at least gets you thinking that there might be another answer as to WHY you have it.  Remember, the “why” is the most important part.

I found a blog post the other day from a massage therapist here in town, Chris Radar (UPDATE: I had a link to Chris’ blog post, but for some reason, the post has been taken down). In full disclosure, I haven’t been to see Chris, but I’ve heard great things about him as a massage therapist.  Also, after reading his post I asked his permission to respond through a posting of my own.  So, Chris, THANK YOU.

His post offer a TON of great info about Runner’s Knee (Patellafemoral Pain Syndrome), what it is, and how to treat it.  My goal here is to offer some suggestions about curing your Runner’s Knee.  I specifically used the term “cure”, because I believe curing and treating are two very different things, and I believe we can’t continue to “treat” the symptom.  I’m going to highlight some of Chris’ points and hopefully shed some light on this condition from an Egoscue perspective.

What Causes Patellofemoral Pain Syndrome?

While the exact cause of patellofemoral pain isn’t known, it’s believed that the way the patella tracks along the groove of the femur can lead to irritation of the cartilage on the underside of the patella.

I 100% agree that the way the patella tracks is key to the pain, but the bigger question is, “What is causing the patella to track incorrectly?”  The answer? Most likely, we are dealing with a dysfunctional pelvic and femur position that won’t let the patella track correctly. Of course, I can’t say with 100% certainty without seeing the client and his or her load joint (shoulders, hips, knees, and ankles) positioning, but based on my experience, I can say with almost 100% certainty that the Runner’s Knee pain is actually a hip issue at its root.

What Can You Do About Patellofemoral Pain Syndrome?

Rest is one of the first treatment steps to reduce the pain and severity of patellofemoral pain and runner’s knee. Reduce your mileage or turn to non-impact exercise, such as swimming.

I agree that rest will help with the inflammation, but we have to remember that resting the joint isn’t going to change the cause. The underlying dysfunction is still there. All you’ve done by resting it is reduced movement, and we are designed to MOVE! If you’re told to “reduce your mileage”, isn’t that another way of saying the activity is to blame? If the right knee hurts and it’s because of your mileage, then that begs the question: How far was your left knee running?

I think swimming is a good idea, but again, what are we doing to treat the cause of the pain? We are simply eliminating gravity for a short period of time. Upon getting out of the pool, the body is met with the same amount of gravity as it was previously.

Hip Strengthening for Patellofemoral Pain Syndrome

The latest information about patellofemoral pain syndrome points the focus on strengthening the hips to get the kneecap to track correctly.

I think strength work is a great idea, and ultimately will be a huge component to staying pain free. But, I believe we first need to straighten, and then strengthen. Take a look at this picture:

What if this client is suffering from Runner’s Knee and we suggest strengthening his hips?  I agree that we have to get him structurally stronger but not before we get him more structurally sound.  If we strengthen him in this position we are building a Ferrari on a bent frame!  We have to straighten and then strengthen.

Footwear and Patellofemoral Pain Syndrome

The footwear you choose, can also be an important factor in recovering from PPS. High quality shoes should be replaced every 300 to 500 miles for a runner. Shoe breakdown can result in more knee pain. Orthotics and arch supports may also be advised.

I specifically want to address the orthotics and arch supports. I believe the arch is an engineering miracle. Actually, the best engineer to ever walk the planet created it, and I can’t argue with Him! I believe that by wearing orthotics we are actually making our arches weaker, when you’ve been told that you need them to strengthen your arches.

Think about this: What happens when you break your leg? You get a cast put on your leg to help stabilize your leg and let the bone heal. What has happened to the muscles around the leg when you get the cast off six weeks later? They have atrophied. The same thing happens with your orthotics. They act as a “cast” and actually make the muscles of the foot and arch weaker over time. Instead of getting stronger, you are in fact, creating the opposite effect.  You have to let your foot move, and I think the less shoe, the better, if you’re suffering from knee pain. If you haven’t seen Vibram FiveFingers, you need to check them out. Also, you can read all my posts on Vibram FiveFingers HERE.

So there you have it.  If you’re suffering from acute pain due to Runner’s Knee (or any other “activity-related” pain or injury) do what you have to do to get the immediate inflammation to go away–ice, rest, brace, etc.  But, remember there is a cause and your body is trying to alert you that something isn’t right.  Find the cause and you’ll find your CURE.  Here are some e-cises to get you started.

Let’s hear it!  Have you suffered from an activity-related injury or pain?  Share you story in the comments section.  Do you have a success story to share?  Don’t be shy.  Your story could change someone’s life!