4 Runner’s Knee Exercises That Can Help Knee Pain

What is a runner’s knee?

Technically, you don’t have to be a runner to get a runner’s knee, but as the name suggests, the chronic pounding and biomechanical changes that often occur in avid runners lend themselves to the condition.

“Runner’s knee is also called patellofemoral pain syndrome,” explains Steve Yoon, MD, a physical therapist and director of The Regenerative Sports and Joint Clinic at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles and chief team physician for the Los Angeles Clippers. “It refers to pain generated under or around the kneecap.”

In other words, it’s knee pain. But before you start thinking, “Great — running is bad for the knees, of course I shouldn’t be running,” said Dr. Yoon, the pain isn’t necessarily caused by running.

Pain around the kneecap

Runner’s knee pain is more related to misalignment of the kneecap and how it runs over the thigh bone (thigh bone) in activities such as walking, kneeling, or running.

In other words, the pain is a symptom of a biomechanical misalignment that can worsen and worsen when performing specific movements. And of course, because runners tend to put in a lot of miles, if they have this misalignment, they will be prone to experiencing the pain.

(Here’s how to prevent knee pain while running.)

According to a 2019 article published in American GPthe pain is usually related to instability of the kneecap.

And because the kneecap (the patella) is stabilized by multiple structures, including the quadriceps, patellar tendon, vastus medialis obliquus, medial patellofemoral ligament, and more, weaknesses or imbalances in any of these structures can contribute to runner’s knee pain.

An angle formed from the top, outside the hip bone to the center of the kneecap, known as the Q angle, may play a role in a person’s sensitivity to the pain. Since women tend to have wider hips, this angle is usually greater in women.

Most men have Q angles of about 14 degrees, while women tend to have angles of about 17 degrees, according to the same American GP article.

This wider angle in women puts more force on the patella. And while a direct cause-and-effect relationship of increased Q angle to runner’s knee symptoms has not been found, women tend to be more susceptible to the problem, although that can be traced to other possible causes, such as decreased quadriceps strength.

Other factors that have been identified as underlying causes of runner’s knee include foot deformities (which can contribute to gait changes), dynamic valgus (when the knee “pops in” during certain exercises such as squats, jumps, or runs), overuse, or sudden increase in activity, patellar instability and weakness of the quadriceps.

Knee pain when running

If you suddenly experience pain in the front of your kneecap that you associate with specific movements or exercises, the first thing to do is to stop the activity that is causing pain. Then follow your standard home-based pain relief strategies.

“Try ice and over-the-counter anti-inflammatory topical and oral medications,” suggests Dr. Yoon for. “Gentle tissue massage around the kneecap and leg can also help.”

And of course, if the pain doesn’t subside after a few days and you’re still unable to return to your previous activity without worsening the pain, it’s time to see your doctor or physical therapist.

“Further tests may include diagnostic imaging such as X-rays and a biomechanical evaluation to help establish a proper care plan,” says Dr. yoon.

And while following an exercise and therapy routine won’t solve your problem overnight, it can help.

If you hire a physical therapist, they will definitely give you a program of stretching and strengthening exercises that target the entire lower body, as well as the core.

The American GP article suggests following a structured therapy routine that includes exercises performed three times a week for six to eight weeks, at a minimum.

dr. Yoon says this type of rehabilitation can take three to four months to see results.

(Here’s how to avoid pain behind the knee.)

Exercises for Knee Pain

According to a 2015 article published in American GPthere is no single set of exercises that have been found to specifically help the runner’s knee.

That said, prescribing stretching and strengthening exercises is the first line of defense to relieve the pain.

Typically, these exercises focus on building strength in the quads and hips, with additional stretches for the hamstrings, quads, hip abductors, and the iliotibial band complex.

James de Lacey, a professional strength and conditioning coach for the International Rugby Union and Rugby League, points out isometric strengthening exercises that are particularly helpful in the early stages of pain relief.

“Isometric exercise is defined as producing tension without a change in muscle length. It is often thought that isometric exercise involves no movement at all, but there is always some movement, whether you see a change in joint angle or not,” says de Lacey, who is also an exercise and sports science researcher.

“Isometry allows for the remodeling of collagen fibers in the tendon, turning them from a dysfunctional tendon into a healthy, functional tendon. Isometrics also have an analgesic or numbing effect, so doing them before a workout can help reduce pain .

If you’re trying to relieve the pain at home, consider these exercises suggested by the Lacey.

But remember: If the pain persists, make an appointment with your doctor or physical therapist for a more personalized prescription for pain relief.

(Here’s how to get rid of inner knee pain.)

wall sit

The wall sit is a classic isometric exercise that helps develop quadriceps, glutes and core strength.

Courtesy of Laura Williams Bustos, MSEd., ACSM EP-C

How do you do that

Stand with your back against a wall and lean your upper body against it. Step forward with your feet about two feet so that your legs are in a diagonal position to the wall. Place your feet about hip-distance apart, or slightly wider.

Inhale and engage your core, pressing your lower back and shoulders against the wall, maintaining good posture. You may want to put your hands on your hips. Bend your knees and slide your back along the wall, also bending your hips as you squat.

When your knees and hips are at a 90-degree angle, hold the position and tighten your quads and glutes. Check your knees – they should be in line with your toes, not pointing inwards (valgus).

Hold the position for as long as you can with good form and work your way up to 60 seconds. Complete a total of three to five sets.

Isometric split squat in the lower position

An isometric split squat targets the quads and glutes just like the wall sit, but it does this more functionally, isolating each leg individually.

This helps develop side-by-side strength and correct possible side-by-side imbalances (especially important if you tend to experience pain on only one side of the body).

Isometric Split Squat in the Bottom Position

Courtesy of Laura Williams Bustos, MSEd., ACSM EP-C

How do you do that

Stand up straight, your feet about hip-distance apart. Step back with your right foot about two feet and place the ball of your right foot on the floor. Keeping your torso upright and tall (not leaning forward at the hips), inhale and engage your core, and as you exhale, bend both knees and lower yourself about 6 to 12 inches (15 to 30 centimeters).

You don’t want to experience pain, so if you tend to feel pain when you lunge, don’t lower yourself to the point of pain. Rather, lower yourself to where you feel your left quadriceps engage, and check that your left knee is aligned with your left toes (not collapsing inward). Hold the position, breathing slowly, for as long as you can.

Stand back up and switch sides.

Complete a total of three to five sets per side, aiming to work yourself to 60 seconds per set.

(Try these thigh exercises to strengthen your lower body.)

Peterson step up

The Peterson step-up is another exercise designed to improve quadriceps strength from side to side and aid in better tracking of the kneecap. In addition, this move is easy to perform at home without equipment, making it an excellent option for home therapy.

All you need is access to a step or raised surface about 15 to 18 inches above the ground.

Peterson Step Up Exercise

Courtesy of Laura Williams Bustos, MSEd., ACSM EP-C

How do you do that

Stand on the step with your feet together, your right foot on the edge of the step (you lower it to the floor). Engage your core and check for perfect posture, your ears aligned with your shoulders, hips, knees and ankles. Hinge your torso slightly forward from your hips, keeping your torso straight and long.

Move your right foot off the bench and bend your foot so that your toes are pointing up. From here, you’ll bend your left knee, which will lift your left heel off the bench so that your weight is resting on the ball of your left foot, engaging the quads. As you bend your left knee, lower your right leg straight down to the floor.

When your heel taps on the floor, reverse the movement, straighten your left knee and return your left heel to the step.

Complete three sets of 10 to 15 reps per side.

(Here are some hamstring exercises to do at home.)

Inverted Nordic curl

The reverse Nordic curl is another quadriceps strengthening exercise that you can do at home without the need for any equipment.

Reverse Nordic Curl Exercise

Courtesy of Laura Williams Bustos, MSEd., ACSM EP-C

How do you do that

Kneel on a padded mat to protect your knees and control your posture. Your shoulders, hips and knees should be in line. Cross your arms over your chest.

Inhale and activate your core, quads and glutes. Slowly lean back, keeping your torso and thighs completely straight, and carefully control the backward movement. When your body forms a 60-degree angle, use your glutes and quads to pull yourself back to the upright position.

Perform three to five sets of 10 to 15 reps.

Here’s how to deal with indoor cycling knee pain.

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