Written By: Super Clinic Physiotherapist, Luke Reynolds.
For runners (whether social or competitive), knee pain is a common complaint seen in clinic. Below are some of the most commonly asked questions we as physiotherapists hear:
What is causing my knee pain when running?Unfortunately, there is not one answer for this question. The biggest thing to remember about knee pain when running is there is no one size fits all. There are also common conditions of the knee, but it is important not to pigeon-hole your symptoms and assume you have the most common condition. Assessment is important to determine what factor is causing your pain. Some common areas to address include lack of strength through the quads or hips, increased tightness, overloading due to lack of structured training program, etc.
How can I alleviate this pain?
Strength training is the most effective way to improve knee pain when running. This will allow your body to adapt to the high level of loading that goes through the knee when running. Particular groups of muscles include the quads, hamstrings, calves and glutes. Strengthening further up the chain (i.e. the glutes) will allow greater stability of the hip to reduce overall load placed on the knee.
Hands on treatment with a physiotherapist may also be effective to loosen tight structures around the hip or knee. This can be used both as a general treatment for pain, or as recovery from a heavy block of training.
Can I continue running or do I stop until the pain goes away?
During periods of high knee pain, it is very important to manage loading. Does this mean you have to stop doing the activity you enjoy? Absolutely not! We will just have to adjust some parameters that give your knee a small break. For example, we may look at adjusting the type of surface you are running on to make it easier for the knees to handle (i.e. from concrete to grass). Some other factors may include reducing the number of kilometres run per week, modifying the intensity of the runs (how fast you go), how many runs you perform per week, etc.
Should I see a physiotherapist or doctor for my knee pain?
The first step is to see a physiotherapist. A physiotherapist will be best equipped to assess what is going on through detailed hands-on and biomechanical assessment. If necessary, hands-on treatment (i.e. mobilisation, massage, etc.) can be performed to leave you feeling good. At this point, specific exercises can be prescribed depending on what is found in the assessment.
If medical intervention is necessary (i.e. medications, referral for specialists, etc.) your physiotherapist will provide you with the necessary correspondence to get this assessed by a GP.
How long until the pain improves?
How long is a piece of string? For most runners, adherence to a strength program will have the knee feeling much improved within a few weeks. However, if the knee pain is coming from a source taking longer to heal, it may take slightly longer. Again, this does not mean you have to stop; it just shows the importance of correct diagnosis and programming.
Can I make lifestyle modifications to reduce this pain whilst running?
Although not applicable in all cases, increased weight can be a substantial factor in knee pain. A balanced diet through correspondence with a dietician may be beneficial to aid this process. Referral to a dietician can be discussed with your physiotherapist.
Diet is not just important for weight management. It is just as important for people looking to recover properly to train at their best. These questions in regards to recovery foods, supplements, vitamins, etc. can all be discussed in clinic. If unable to be answered by your physiotherapist, they will be able to point you in the right direction to get the correct advice.