Knee Pain
Knee pain makes up 50% of all running injuries and of this 49% is caused by Patellofemoral Pain Syndrome (Runner's Knee).
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The symptoms usually show up as an aching pain in the knee joint in and around the front of the knee and under the patella (kneecap). Walking up and down hills will often make the condition worse as will sitting for long periods of time.
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The pain occurs due to the knee cap rubbing on the femur bone. The incorrect tracking of the patella over the femur may well cause this resulting in the potential irritation (not damage) of the cartilage underneath the patella.
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The incidence of patellofemoral pain is more prevalent in females (62%) as opposed to males (38%) and is more common in new runners due to their propensity to run too much to early.
The major causes are due to running mechanics and training loads. There was a study undertaken in Scandinavia which showed that those who increased their training volume by 30% a week are far more at risk of injury than those who only increase their volume by 10%. To gain the benefits of training you have to increase the load of your training, however, if you load too quickly you can easily break down.
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There are three major running mechanics issues which will contribute to the syndrome, medial collapse of the hips, overstriding and crossover (running with a weaving action of the legs).
Probably the major contributor is medial collapse of the hips (one hip is lower than the other whilst running) and again is far more prevalent in females. It occurs due to an incorrect rotation of the hip leading to the knee not aligning correctly with both the hip and the ankle leading consequently to the patella not tracking properly. Some would advocate the strengthening/stretching of certain muscles to correct this and yes it is a necessary route to help but this needs to be undertaken with gait re-training to make sure that going forward the correct running mechanics are maintained.
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The common patella tracking issue is of an outward nature therefore stretching the Quadriceps and Adductor (groin) muscles will all help. The muscles to strengthen will be the muscles on the outside of the hip (Gluteus Medius) to help the hip rotation problem and muscles on the inside of the knee (Vastus Medialis) to help with the patella alignment.
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So many runners have pains in their knees that they do not get looked at. As we have seen above, these are not likely to go away unless the causes are discovered and the appropriate action taken, both in the short term to relieve the pain and in the long term to avoid the pain returning.