There’s nothing more frustrating than a running injury knocking you off your training. We spoke to Six Physio’s Rachel Whittaker to find out how to fix it.

What is it?runner knee

Runners hit the ground with anything between five and nine times their body weight on each stride. Over distances from 5km to a 26.2 mile marathon the cumulative effect of those impacts is immense, especially when taking into account the repetition during training and events. For triathletes who run regularly, the main areas of weakness are the knees and ITBs (iliotibial band which extends from the outside of the pelvis, over the hip and knee, inserting just below the knee) from the continual stress of bending your leg on the bike and extension movements of running.

Patello-femoral pain syndrome (PFPS) is also known as runner’s knee and occurs when the stress of running causes an irritation where the kneecap sits on the thigh bone. Common causes of runner’s knee include overuse due to repeated bending and loading to the knee joint, direct trauma such as a fall, misalignment of the kneecap and a muscular imbalance of the thigh muscles which can lead to a disproportionate load on the knee cap.

This last cause is often due to an ITB injury, which in turn could be caused by a mobility issue, strength, control or simple technique fault.

It’s important to see a specialist to work out which of these factors is causing the pain in the first place. Symptoms of runner’s knee may include pain behind or around the kneecap, especially where the thigh bone and knee cap meet, pain when you bend your knee, for example when walking, squatting, kneeling, running or even rising from a chair. It may also be painful when walking downstairs or downhill and it can be common to experience a popping or grinding sensation behind your kneecap.

Fix it

In the initial stages of pain it is important to rest the knee for a few days, with elevation, compression and regular application of ice if your knee is swollen. Taking anti-inflammatory medication may also be required if the pain and swelling is moderate to severe.

Exercises recommended for runner’s knee include using a foam roller to release the ITB, quads, hip flexors and gluteal muscles along with hip flexor and gluteal stretches and strengthening exercises for the gluteal muscles in a non-weight bearing position initially, with progression into standing exercises.

If the pain persists when you return to running after five to 10 days, it is recommended you consult your doctor, an orthopaedic specialist or a physiotherapist for further guidance or treatment. It is also important to remember that a staggering 50 per cent of running injuries are reoccurrences and so prevention is key.

Do not ignore sore spots, for example in the front or outside of your knee, front or inside of your shin, and around your Achilles tendon to prevent injury happening in the first place. Although it can be frustrating, take the time to allow for the soft tissue healing process by resting and icing the area for a day or two.

If this isn’t enough to ease pain continue to rest and try some light rehab. Cross training will help you to maintain fitness plus try foam rolling the areas above and below the sore spot and taping if necessary. A running assessment may also be beneficial to identify any problems with running technique, which may be affecting your biomechanics.

Six Physio is on site at Castle Triathlon events offering post-race massage or visit any of the Six Physio clinics in London and the South East.