Runner's knee treatment plan
Several factors can cause runner’s knee. The treatment plan in the app takes all of these into account. Here’s how it works.
Research-based treatment plan
While runner’s knee pain is usually felt around your kneecap, the cause is often further away. Research shows that weak core, hip, and thigh muscles and a lack of coordination and control may be prominent factors in the condition.
Therefore, it’s not surprising that the most successful runner’s knee treatment plans include exercises addressing all these areas.
The Exakt Health app provides a holistic treatment plan
- The app guides you safely from when your knee first becomes painful to your full return to sport.
- The runner’s knee treatment plan contains evidence-based exercises with clear guidance on reps, sets, and frequency.
- The app adapts the program according to your feedback and specific needs.
- It implements a walk/run program for a safe return to running.
- It also includes a maintenance program for injury prevention.
The app teaches you about runner's knee
Understanding what caused your runner’s knee, how healing occurs, and when it’s necessary to see a doctor helps you plan your recovery better and prevent re-injury.
The patellofemoral joint is the area between your kneecap and the two bones of your leg that lie beneath it. When it’s injured, a typical pain pattern develops over the front of your knee and around your kneecap. This painful condition is known as runner’s knee or patellofemoral pain syndrome.
- The pain is located over the front of the knee and is usually difficult to locate. You can feel the pain above, to the side, or below the kneecap.
- Walking down stairs or hills is often more painful than walking up.
- Deep squats or kneeling may hurt.
- There may be a slight puffiness or swelling around the kneecap, but not always.
- Your knee may click occasionally click or clunk as you move it from flexion to extension.
- You may notice a grinding sensation under the kneecap.
- Sitting with your knee in a flexed position for a prolonged period can make it hurt.
- Your knee is very painful, swollen, red, or hot to touch, indicating an inflammatory condition not covered by the app.
- You experience pain at night that keeps you awake or interrupts your sleep.
- You feel pins and needles or tingling in your leg that might indicate a nerve injury and require different treatment.
- Your symptoms get worse.
- Your injury takes longer to heal than expected (see healing timeframes in the following section).
- There is a sudden increase in (high-impact) activities such as downhill running, squats, jumping, or running long distances.
- Weakness in your core and hip muscles can cause your knee to turn in more when you run. In turn, this can strain your patellofemoral joint.
- If your foot rolls in (over-pronates) too much, it can cause your knee to turn in excessively and strain it. Usually, this results from weak ankle muscles or wearing unsupportive shoes.
- Weak quadriceps (front thigh) muscles may also contribute to it.
Treatment
- First, you have to reduce the pain and allow the joint to settle by reducing aggravating activities and using ice when necessary.
- Then, you have to slowly strengthen all the muscles in your core and legs while training optimal movement patterns.
- Finally, you can ease back into running while focusing on good running form.
Healing times
- You’ve heavily overloaded the joint with an extreme sporting activity,
- or you’ve neglected it for a while and trained through the pain.
Prevention
- Continue regular strength training for your core, hip, and quad muscles.
- Do regular balance and proprioception exercises.
- Avoid increasing your running intensity or volume too quickly.
The runner's knee treatment plan consists of 6 stages
Your workout intensities must increase as your injury heals, so you regain your full strength by the end of the program. The app ensures this process happens safely and effectively by setting clear goals for you at each stage.
This stage’s main aim is to settle your knee pain while maintaining your quadriceps (quads) muscle strength and start working on your legs’ general strength and control.
Quad strength workout
When you have knee pain, your quad(thigh) muscles can often switch off (become a bit less active), making it feel even worse. The app suggests exercises that activate your quads in positions that don’t strain your knee during this stage.
Core and leg strength
If you have good strength and control in these areas, your knee will take less strain. The app chooses exercises during this stage that work all the relevant muscles in positions that do not affect your knee.
Balance
Balance exercises are brilliant at developing the control you have over your body, and it helps to improve your movement patterns. Poor movement patterns can lead to the knee turning in more than it should, causing strain on the kneecap. The app takes you through progressively more challenging balancing exercises as your knee heals.
Flexibility exercises
Some of the most common stretches used by runners can place a lot of force on the kneecap, making the pain worse. So initially, the app chooses exercises that avoid straining your knee. Then, as you heal, it finally adapts these to return to a more normal routine.
Activities to avoid
Avoid:
- Sitting on bent knees (this position compresses the kneecap and can increase your pain)
- Kneeling
- Walking down steep hills
- Running
- Hopping
When to progress
You can progress to the next stage when you can do the knee workouts the app sets you without pain.
Workouts
The main aim of this stage is to develop optimal movement patterns while strengthening your core and leg muscles.
The app will introduce exercises that load the kneecap more than in the previous stage, but these loads will still be relatively low.
Top tip: To benefit most from these exercises, you should focus on doing them in a slow and controlled way.
Activities to avoid
- Deep squatting
- Kneeling
- Walking down steep hills
- Running
- Jumping
When to progress
You can progress to the next stage when:
- You can walk for 30 minutes at a leisurely pace,
- and complete the leg strength workouts without pain.
Workouts
The app will adjust your training plan to help you work through greater ranges of motion. It will also suggest that you slowly increase your weight load, gradually helping your kneecap adapt to the compression forces experienced in your daily activities and sport.
Your balancing and core exercises will become more challenging to optimize your strength and control.
Activities to avoid
- Kneeling
- Running
- Hopping or jumping
When to progress
You can progress to the next stage when:
- You can walk at a brisk pace for 30 minutes,
- and complete the leg strength workouts without pain.
Workouts
During this stage, you will develop dynamic control in your legs and ensure good movement patterns while running. The app helps with this by introducing exercises like lunges that require you to control your leg while stepping.
Run/Walk program
A run/walk program is an excellent tool to help you ease back into running. Use the short running intervals to focus on your form and how your legs move.
Activities to avoid
- Running downhill
- Jumping and hopping
- Deep kneeling
When to progress
You can progress to the next stage when:
- You can jog pain-free for 20 minutes,
- and complete the leg strength workouts without pain.
The focus is now on regaining your previous running endurance. Be careful not to increase your running volumes too quickly. It’s best to stick to the 10% rule and only increase it by 10% per week.
Workouts
Your strength workouts will now reduce in frequency, preventing your legs from overworking as you build your running volume. Continuing your strength workouts will help maintain what you’ve built in the previous stages.
Activities to avoid
Avoid high-intensity running like tempos, sprints, or hill sessions.
When to progress
You can progress to the next stage when you’re able to run your normal weekly running volume at your regular easy running pace pain-free.
You can now introduce more high-intensity training sessions that include downhill running.
You have completed your rehab program when you are back to running your normal running volumes, including high-intensity sessions, at your normal speed. Remember, always allow enough recovery time after more strenuous sessions.
Recover faster. Now.
Download the App now and start the recovery with your tailored treatment plan. Adjusted to your specific needs.
References
- Brukner, P., Khan, K., & Brukner, P. (2018). Brukner & Khan’s clinical sports medicine. Sydney: McGraw-Hill.
- Collins, N. J., et al. (2018). “2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017.” Br J Sports Med 52(18): 1170-1178.
- Crossley KM. Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? Br J Sports Med. 2014 Mar;48(6):409-10. doi: 10.1136/bjsports-2014-093445. PMID: 24569144.
- Lack, S., et al. (2018). “How to manage patellofemoral pain – Understanding the multifactorial nature and treatment options.” Physical Therapy in Sport 32: 155-166.
- Neal, B. S. (2019). The influence of lower limb biomechanics on the development, persistence and management of patellofemoral pain in recreational runners, Queen Mary University of London.
