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Knees

Runners Knee recovery- 8 ideas to try today

Runners knee recovery. If you’ve found this post it’s because you are suffering from some knee pain when running or walking. Runners knee is a general term for pain around the kneecap or patella. Symptoms in this region vary widely from being a low-grade annoyance to a complete inability to run. runners knee  treatments

The cause is also somewhat unknown. Some theorize that the pain is due to a misalignment of the knee cap. Misalignment is thought to be due to weak inner thigh muscles and tight outer thigh tissue or IT band.

However we are in the business of looking at runners knee recovery, and have rounded up 10 ideas to try on your recovery journey.

Treatments such as knee braces or taping to change the position of the patella have been used to theoretically minimize the misalignment. These treatments do seem to improve knee function, however, MRIs performed while tape is applied has not shown a change in the alignment of the kneecap. Additionally, the model that the back of the kneecap is the source of the pain is questionable since there are very few, if any pain receptors in this area.

8 ways to help runners knee recovery

  1. butt strenghtening! Yes you heard us right. Research is showing that strengthening of the butt muscles to improve the biomechanics of the entire leg is the most likely way to improve your knee pain. Test yourself by standing on one leg and squatting half way down 5 times. If you can keep your knee centered over your foot while squatting then you have good gluteal function. If your knees wobble or moves inward you should focus on gluteal strengthening.
  2. Stretching. A good stretching regime is is often helpful for runner’s knee. Give extra attention to the hamstrings, calf muscles and quadriceps.
  3. Balance training.  This is an essential component of any knee rehabilitation program. Balance training restores your body’s coordination so that when you run your knee alighment is optimal.
  4. Running form can have a dramatic effect on knee pain, especially if your knees roll in when you run. Improve running form if this is the case.
  5. Try insoles or orthotics (custom foot supports) which may be able to support the foot in a way that reduces strain on the knee.
  6.  A knee brace that has a cut out for the kneecap and a way to adjust pressure on the kneecap can be helpful. Most runners also prefer a cut out region in the back of the brace. Adjust the pull on the kneecap until you find a position that cuts down your pain when you run. You should start by adjusting the brace to pull the kneecap inward, then try inward and upward or inward and downward. I have even had some patients that prefer the brace to pull the kneecap outward. If the brace is going to help, you should notice some improvement immediately. Try not to wear the brace all day. It will probably be more beneficial if it is worn when you are more active.
  7. A physical therapist can perform an evaluation to specifically assess strength, flexibility, balance, etc and design an appropriate program for you. They may also try taping techniques that can provide more specific pressure around the kneecap.
  8. Glucosamine has become popular in the management of knee arthritis. In my experience it can also help for “Runner’s Knee”. The recommended dosage is 1500 mg per day. Currently there are no known side effects and some indication that it may slow cartilage degeneration. *check with your doc.

we hope this advice helps with a swift and lasting runners knee recovery

other posts we think might help:
  • our general advice for recovery is always worth a read here.
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Knees Leg injuries

IT Band – The Injured Runner

IT Band Syndrome or Iliotibial Band Friction Syndrome is a condition that results in pain on the outer side of the knee. The iliotibial band is a thick band of tissue along the outer side of the thigh. It attaches to the Tensor Fascia muscle on the front, outside area of the hip and the gluteus maximus muscle of the butt. As the IT band courses down the side of the leg it covers the boney area on the outside of your knee. Symptoms arise at the spot where the band rubs against the outer side of the knee joint.

Certain body mechanics and muscle imbalances may cause increased friction and result in symptoms. Initially, you will experience the pain only after running a certain distance and the pain will subside after the run. As symptoms progress, walking or going up and down stairs becomes painful and running is quite painful.

Treatments:

  • Recent research conducted on runners at Stanford University has shown promising results. These athletes performed a series of gluteal strengthening exercise. These muscles may help reduce strain on the and allow the area to function more efficiently.
  • Frequent stretching of the ITB and gluteal muscles can improve your symptoms.   Spend at least five to ten minutes twice per day working the area. There are several contortions described as ITB stretches. Try them all until you find a position that stretches the area near the pain.
  • Arch supports or orthotics (custom foot supports) may be able to support the foot in a way that reduces strain on the IT band. If you have a high arch you may benefit from an insole that provides more cushioning.
  • An anti-inflammatory cream could be used to reduce the pain and inflammation. Talk to your doctor about transdermal anti-inflammatories.
  • Deep tissue friction massage is a treatment that some brave (or desperate) runners try. There is actually a study that reported this type of treatment to be ineffective. However, we know runner’s that will tell you it made a difference for them – so you will have to make your own choice on that one.
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Knees Recovery

Jumper Knee – The Injured Runner

Jumper’s knee is also known as patellar tendonitis. It affects the patellar tendon, which is directly below the kneecap (it actually attaches the knee cap to the tibia). This condition is more prevalent with plyometric (jumping sequences) training or sports that require sudden stops or changes of direction. However, I have seen cases where it simply occurs with normal training.

Treatments:

  • In the early stage of this condition frequent stretching of the quadriceps muscle will accelerate healing. Hold the stretch for thirty seconds and repeat three times, perform this routine three times per day.
  • Hamstring and calf stretches may also help reduce strain on the patella tendon.
  • A patellar tendon strap provides a compressive force across the patellar tendon and for some people provides quite a bit of relief. If this is going to work for you, you should notice a distinct improvement while wearing it. Only wear it when doing activities that typically aggravate your symptoms. If you wear it all day long it will become irritating.
  • An anti-inflammatory should be used to reduce the pain and inflammation. Topical anti-inflammatories would be best but would require a visit to your doctor for a prescription.
  • Physical therapists can apply a treatment called iontophoresis, which is the use of an electrical current to apply a steroid medication over the sore spot. Research has shown that this treatment delivers as much steroid (anti-inflammatory) to the tendon as an injection, without a needle. Usually, two to three treatments will improve symptoms substantially.
  • Deep tissue friction massage can also be helpful in stubborn cases.
  • Eccentric quadriceps strengthening has been shown to reverse the structural changes in the patellar tendon if the condition becomes chronic. This exercise is performed with a knee extension resistance machine. The emphasis is on lowering the knee from a straight position, to a bent position. Use both legs to straighten the knee and then lower with the painful one. Repeat for 30 repetitions and gradually increase the weight as your pain improves. This exercise is painful, but if the condition is chronic and not responding to anything else, stick with it for at least three weeks (three times per week) and continue for another six weeks if it helps.
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Knees Uncategorized

Knee Stress Fractures – The Injured Runner

Stress Fractures are a condition where training load has exceeded your body’s ability to maintain bone structure, resulting in partial to complete breakdown of the bone.

Beware of deep aches in the front of the thigh. This tends to be a type of ache where you can’t touch the specific spot that hurts. A firm quick squeeze of the thighbone in the region of the ache with both hands may reproduce the familiar pain and signify a stress fracture.

During the earlier stages of a stress fracture you may be able to run without pain after you are warmed up; however, pain is often increased after the run. As the condition progresses the pain intensifies and often leaves you with a limp.

Whole food provided in the form of milk products with high protein, calcium and vitamin D is the best known nutritional guidance to prevent stress fracture and may speed recovery. 

  • This condition requires more proper rest. Plan on at least 6 weeks of not running. Cycling, swimming or deep-water running are the best cross training options because of the decreased weight bearing. If you are limping when you walk, using crutches until the limp is gone will dramatically speed recovery.
  • Vibration has been shown to accelerate bone healing. You can try using a vibrational massager by placing the massager on the bone a couple of inches away from the sore spot and holding it for 2-4 minutes twice per day.

Considerations: Nutritional or hormonal factors may affect this condition. Consult a sports physician if you feel this is a concern.

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Knees Leg injuries Recovery

Outer Knee Pain Case study- The Injured Runner

David is a 42 year old runner that started feeling pain in the outer part of his right knee. He had run 11 marathons in the previous 2 years without any pain and then began to experience pain in his left knee. He cut back on his running for 2 months tried using a foam roller for his knee pain and then was able to get back into running.  At this point his left knee was fine but he could not run more than 3 miles before he experienced right outer knee / thigh pain. He had tried the foam roller and cutting back again on his running but nothing was working.

When I evaluate a runner I look at: the flexibility of 5 different muscle groups (calves, quads, hamstrings, gluteals and hip flexors); strength of the hip flexors, hip abductors, abdominals, hamstrings, lower back and gluteal muscles; balance; hopping ability: and running gait. David had the typical tight hamstrings and hip flexors but his gluteal muscles were half the flexibility as his left side. He had great abdominal and lower back strength but his gluteal and hip abductor muscles were disproportionally weak on both sides. His balance was horrible and he hopped like a rhinoceros but weighed a slight 150# at 6 ft. tall. His running gait was primarily heel strike but not overly hard and was essentially symmetric.

Usually when a runner has pain on the outer portion of the knee the diagnosis is IT Band syndrome but this was different. None of the tests that we use to diagnosis IT Band problems were positive. So instead of focusing on trying to give David a precise name for his condition we decided to go to work and address the issues discussed above. Specifically, we started with the gluteal flexibility because it was so tight that I was concerned he might be developing arthritis in his hip. Since David could run for 3 miles without hurting I suggested continuing to run but he had to stay in the pain free range.

David went to work on the stretching program for 2 weeks and then came back for a follow up. Luckily, the hip motion or gluteal flexibility was much better. Actually, it was the same as the other side and he had been able to increase to 4 miles 3 times per week.

Our next step in helping David get back to running was to improve the strength in his gluteal muscles. We chose one set of exercises that isolated the gluteal muscles and another set that required the gluteal muscle to work in synergy with the other leg muscles requiring dymamic movements and balance. Since he was doing so well with performing these in my clinic I decided to also advance him to rope jumping so that we could get a bit more spring in his step. David worked on these exercises for 4 weeks and then came in for his follow up.

David had run 13 miles the weekend before seeing me and was elated to be back on track. He told me that he felt transformed, he was running as a whole person – stronger and more balanced than ever.

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Knees stretches

Bent knee calf stretch – The Injured Runner

 Keep your foot pointed straight forward as you slide your knee forward. Maintain your heel on the ground. You should fell stretch in the Achilles tendon or lower calf. Hold for thirty seconds and repeat three times