5 Ways to Stop Knee Pain in Runners

By Ryan Domeyer PT, DPT, CMPT for Athletico

Between 20 to 93 percent of runners suffer from knee pain, making it the most common lower extremity injury.  When knee pain occurs, one of the treatment options is physical therapy. Physical therapists are trained to examine, diagnose and treat knee pain to help patients return to the activities they love.

The majority of knee pain associated with running is not caused by direct trauma butknee-pain rather improper loading. Running requires the ability to absorb the weight of the body when the runner’s foot hits the ground in order to propel the runner forward. Although it might not seem like it, running is actually a complicated skill that most people do not actively practice prior to their recreational run. Knee pain can start during a run, but most commonly is experienced after running longer distances. Research shows the more miles you run the higher risk of sustaining a knee injury. The most common causes of knee pain in runners are iliotibial (IT) band syndrome, chondromalacia patella (runners knee) and patellar tendon pain.

It is common for runners to treat their knee pain with rest and ice and hope it goes away on its own. Although rest can help during the initial stages of knee pain, there are many ways that runners can take load off their knees and prevent future injuries, including the five listed below:

  1. Improve Hip Flexor and Quadriceps Mobility

Americans spend on average 13 hours per day sitting.1 Sitting for long periods of time during school, work or watching TV causes the front of the hip to shorten, which leads to tightness in the hip flexor and quadricep muscles. Stretching or foam rolling are the most efficient ways to improve hip flexor and quadriceps mobility to lessen knee pain. For more information on stretching and foam rolling, read:

Stretching: It’s All in the Hips Part 3

Foam Rolling: 3 Ways to Roll Away Muscle Tension

  1. Improve Hip Strength

Another adverse effect of sitting during the day is the inefficient use of our gluteal muscles. The gluteal muscles are the largest muscles in the body and when trained properly, can lessen the load on the knee. The easiest way to improve strength of the gluteal muscles is with bodyweight exercises including bridges, planks, side planks, bird dogs and hip abduction raises.

  1. Improve Balance

As previously mentioned, running requires the ability to land on one leg repeatedly to propel the body forward. The knee is the middle connection between the ground and the body. A loss in balance can lead to poor force absorption from the ground with each step taken during running.

To test balance, try standing on one leg without using your arms for 30 seconds. If this is difficult, balance can be improved by practicing. To take this balance exercise a step further, try balancing on one leg without holding onto anything with your eyes closed. If balance continues to be a problem, consider scheduling a complimentary injury screening at your nearest Athletico Physical Therapy.

  1. Improve Core Position and Stability

Another way to improve muscle imbalances is to improve core strength and the ability to run with a neutral spine. To do this, begin your run on the right track with a neutral neck aligned over your shoulders, neutral low back without a large backward curve and feet straight forward. Awareness of your low back and core position is important at the start of a run, as it becomes more difficult to maintain as fatigue sets in.

  1. Increase Number of Steps

Running technique is the most significant way to decrease the load on the knee to prevent or improve an injury. A simple way to improve technique is by increasing the number of steps taken. Although it may seem counterintuitive to take more steps, this will prevent a poor foot strike position and set the body in a good position to fall forwardathletico300x250 rather than absorb the force.

If you need help with running technique, request a video gait analysis at Athletico, which provides real-time audio and visual feedback on your running style. This will enable your physical therapist to provide feedback that not only helps improve efficiency, but also helps to prevent injuries.

Click to Schedule a Complimentary Injury Screen

ACL Bracing by DonJoy

HELPING WITH PREVENTION, PROTECTION & HEALING

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DonJoy pioneered the concept of functional knee bracing more than 30 years ago. Our first prototypes were simple neoprene sleeves sewn together in the Carlsbad, Calif. garage of our founders, Philadelphia Eagles Offensive Line Captain Mark Nordquist and local lawyer Ken Reed. Those first braces came from a deep understanding of the need for prevention, protection and healing, and DonJoy has led the profession of performance ever since by studying the body, listening to athletes, consulting physicians and pushing the envelope of innovation.

THE PERCEPTION

The overall perception of knee bracing technology available to most patients today is that “everyday” knee braces can be unsightly, bulky, heavy, minimally effective, restrictive and uncomfortable. These misconceptions combine to produce “brace anxiety” among many patients, often preventing mainstream adoption and compliance of braces that can help prevent injuries, allow people to remain active while healing, and protect the knee from future injury.

THE REALITY

Patients are looking for quick, effective and economic options for maintaining or regaining their life activities; most want to delay expensive, invasive surgeries. While some patients are turning to the use of prescription narcotics (which can lead to addiction) and cortisone shots to manage their pain, these treatment options do not provide stability to the knee.

THE FACTS

Young people between the ages of 15-25 account for half of all ACL injuries.

A person who has torn their ACL has a 15 times greater risk of a second ACL injury during the initial 12 months after ACL reconstruction, and risk of ACL injury to the opposite knee is two times that of the restructured knee.

Many athletes don’t return to sport after ACL reconstruction due to fear of re-injury.

BRACING FOR PREVENTION

Given the physicality of football, it’s easy to understand why collegiate and professional linemen wear braces on both knees. The line of scrimmage is an environment prone to knee injuries, so team doctors, athletic trainers and coaches don’t hesitate to equip their players with bilateral (both knees) custom braces.

As with helmets and shoulder pads, knee braces have become standard equipment to assist in preventing season-ending knee injuries. And the same logic holds true with skiing, snowboarding, soccer, basketball, volleyball, professional rodeo, water sports and others. An ounce of prevention is worth a pound of cure.

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BRACING POST INJURY

Why brace after ACL reconstruction? Clinicians will typically prescribe a functional knee brace after the patient has regained full range of motion—that’s usually between three to five months after surgery. Graft strength of the new ACL is considerably weaker than the native (original) ACL during the first 12 months, so a brace during this early period helps protect it from harmful forces that occur in everyday life or in sport.defiance-300x250

Bracing also elevates a patient’s confidence, allowing them to return to their previous or enhanced level of activity. Just look to athletes including Robert Griffin III, Tiger Woods, Adrian Peterson, Tom Brady, Lindsey Vonn, Matt Ryan and Peyton Manning just to name a few. Another important reason? Peace of mind. A functional knee brace provides not only confidence for the patient, but confidence for the surgeon, knowing that their patient’s knee is protected.

The Role of Hyaluronic Acid Versus Platelet-Rich Plasma in Treating Osteoarthritis

A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intraarticular Biology for the Treatment of Knee Osteoarthritis

By: Brian J. Cole, MD, MBA, Vasili Karas, MD, MS, Kristen Hussey, MS, Kyle Pilz, MMS, PA-C, and Lisa A. Fortier, DVM, PhD, DACVS Investigation performed at the Rush University Medical Center, Chicago, Illinois

Purpose: To compare the clinical and biological effects of an intra-articular injection of PRP with those of an intra-articular injection of HA in patients with mild to moderate knee OA. Interview originally published in the American Journal of Sports Medicine as a February Podcast.

bcmdThe use of plateletrich plasma (PRP) for the treatment of osteoarthritis (OA) has demonstrated mixed clinical outcomes in randomized controlled trials when compared with hyaluronic acid(HA), an accepted nonsurgical treatment for symptomatic OA. Biological analysis of PRP has demonstrated an anti-inflammatory effect on the intra-articular environment.

We found no difference between HA and PRP at any time point in the primary outcome measure: the patient-reported WOMAC pain score. Significant improvements were seen in other patient-reported outcome measures, with results favoring PRP over HA. Preceding a significant difference in subjective outcomes favoring PRP, there was a trend toward a decrease in 2 proinflammatory cytokines, which suggest that the anti-inflammatory properties of PRP may contribute to an improvement of symptoms.

Click here to read the article.

NFL Films Presents: Carson Palmer’s Doner

An incredible story about the woman whose tendon went on to help NFL quarterback Carson Palmer and the amazing bond donation created between these two families!

carsonpalmerdoner

QB Carson Palmer’s ACL Injury in the past resulted in a unique connection with his donor’s family.

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New Study: Seeking Knee Arthritis Patients for Study

USING THEIR OWN BLOOD FOR TREATMENTacp-study

Dr. Brian Cole, Dr. Kathleen Weber and Dr. Adam Yanke are actively seeking patients
with knee arthritis to participate in a clinical trial in which their own blood is used to treat the condition.

The study is designed to investigate the effectiveness of using platelets and growth factors taken from the patient’s blood, called autologous conditioned plasma (ACP), and then injected into the affected area. Possible benefits of ACP may include significant decrease in knee pain and improved knee function and range of motion.

ACP (PRP) Injections for the Treatment of Osteoarthritis of the Knee

ACP (autologous conditioned plasma) is a substance with remarkable healing properties derived from blood and used to treat injuries and arthritis. ACP contains a concentrate of growth factors and platelets which signal a reparative process when injected into damaged tissue.

A small quantity of blood is required for the procedure which is drawn into a specialized double syringe system and then spun in a centrifuge machine until plasma rich in platelets and growth factors is isolated. This plasma is then drawn out and injected into the affected joint to promote healing.

The entire procedure takes about 30 minutes to perform. You may receive three treatments a week apart. ACP is a new treatment currently being researched. Your doctor will explain the procedure and the risks involved before obtaining your consent.

You are eligible if you:

  • Are between the ages of 18 and 70
  • Have had continued knee pain for the past 6 weeks
  • Have been diagnosed with osteoarthritis (grade II or III)

Those interested in the clinical trial should call: 312-912-4701 or
email: kavita.ahuja@rushortho.com.


The orthopedic specialists at Midwest Orthopaedics at Rush are involved in numerous clinical studies to test the effectiveness and safety of new therapies and treatment, as well as to expand scientific and medical knowledge. If you are interested in one of our clinical studies, please use the contact information provided for the individual trial to get more information.

Rotator Cuff Stem Cell Clinical TrialMORGif-180x150-link

Cartilage Restoration Clinical Trial

Back on Course after Spine Surgery Clinical Trial

Knee Osteoarthritis Clinical Trial