What is Runner's Knee? Is it similar to Patella Femoral Syndrome? What should I be doing (or not doing) in creating a program for these conditions?
"Runner’s Knee" is a layman’s term for patellofemoral syndrome. Even though this is the catch-all term for associated knee pain while running, it is rarely an isolated event within the knee. Considering the anatomy of the entire kinetic chain, the knee is "caught in the middle" between the hip and foot, each of which can be dysfunctional and contributing to the pain symptoms at the knee. For example, if the foot is not able to eccentrically decelerate pronation, then over-pronation occurs. This over-pronation at the foot/ankle complex causes obligatory internal rotation of the tibia, which increases abnormal forces at the knee. Hip dysfunction can also cause knee symptoms. An increased anterior tilt (tight hip flexors) will increase femoral adduction and internal rotation, again increasing abnormal forces at the knee. In most cases, both scenarios exist contributing to knee pain in running.
So, how do you train your clients with this pain pattern? Through strengthening and flexibility exercises. Address the gastroc/soleus complex, hamstrings (lateral), adductors, piriformis, psoas and quadriceps through flexibility. Remember that flexibility occurs on a continuum. One "style" of flexibility might not fully address the individual muscle’s needs. Try to strengthen the lower leg complex in a unilateral (single-leg) position, focusing on the alignment of the knee over the 2nd toe. From that position, virtually any upper/lower extremity strengthening exercise will simultaneously be training functional flexibility, strength, endurance and balance.
For more information regarding the different styles of flexibility, strength and balance exercises, check out the Exercise Library.