Knee pain? Try these exercises.

If you are a runner or just an extremely active person, you may have been diagnosed with or even self-diagnosed yourself with runner’s knee. Here are some tips to better understand what Patellofemoral Pain Syndrome (Runner’s Knee) is and the exercises that you can try to relieve tension and increase knee strength, stability, and function. Whether or not you have runner’s knee or knee pain, these exercises are also great for preventive care and can be performed for general knee pain relief and for quadricep, calf, hamstring, and glute strengthening. 

What Is Runner’s Knee (Patellofemoral Pain Syndrome)?

PFPS is known as anterior knee pain that is caused by overuse, maltracking of the patella, patellar instability, dynamic valgus and from tight or weak surrounding muscle attachments that put stress on the patellofemoral joint. To break it down for you, patellar instability is when your patellar does not align correctly to your femur. Dynamic valgus is when your knee has a medial shift when an individual is distributing a lot of weight to that particular leg. The root of these causes of PFPS are underlying weaknesses, malalignment of your hips or feet, cartilage breakdown, and weak or unbalanced quadricep muscles. According to Knee Surgery, Sports, Traumatology, Arthroscopy, Patellofemoral Pain Syndrome is also associated with weak hip abductors, vastus medialis/lateralis disbalance (quad muscles), hamstring tightness and iliotibial band tightness.

Stretches to Help With or Prevent Runner’s Knee

Your knee joint undergoes a lot of stress so it may be a good idea to try some of these out if you have knee pain or just feel weak in your lower extremity. Remember to perform all of these exercises pain free, ask your trainers if you have questions, and consult your doctor before trying these out if you have previous medical history related to your knee.

First, before starting any exercises it is very important to keep your quadriceps, hip flexors, and hamstrings loose to relieve any tension it may cause on your knee. Try these stretches.

1. Active Quad Stretch: Standing tall, grab onto the top of your foot.  Rather than bending/pulling hard at the knee joint, apply pressure with your foot into your hand to feel a deeper stretch in the quadriceps. 1x10 3-5 second hold alternating. 

2. Side Lying Hip-Flexor Stretch with Strap: Start by lying on your side with knees bent and legs together. With a stretching strap (dog leash, or a belt could work) loop it around the foot of the top leg. Then, wrap the strap over the top and down the side of your opposite shoulder. Pull the strap and apply the stretch. You will feel this mostly in your anterior hip flexor muscle (top of thigh) as well as your quads. Keep your bottom leg at a 90 degree angle.  2x30 seconds each leg

3. Hamstring Stretch Supine: Start by laying flat on your back. Before you start, actively bring your legs up towards you one at a time, keeping your knee straight and toes pointed toward you. After a few active stretches, strap one foot in and raise it up towards you. Hold in the position where you feel a stretch, no pushing past that point. Try your best to keep your knee locked out.  2x30 seconds each leg

Exercises to Help With or Prevent Runner’s Knee

Once you’ve stretched, you can move on to several different exercises. 

1. Sidelying Clamshells: This hip abductor exercise is performed lying on your side with your knees bent. Place a resistance band around your knees, draw up the top knee while keeping contact of your heels together (toes can come off). Keep the top hip turned in, preventing your back to help you. Do not let your pelvis roll back during the lifting movement. Slowly lower knee down to start position. If you do not have a resistance band, perform more repetitions. 3x10-15 each side

2. Banded Bridges: While lying on your back place a resistance band right above knee. With your knees bent, tighten your lower abdominals, squeeze your butt and raise off the floor creating a "bridge" with your body (no low back extension). Hold for 3 seconds and then lower yourself and repeat. May want to cross arms over chest to prevent the help from your upper body. 3x12 hold for 3 seconds

3. Eccentric Step Downs: First find a step or elevated surface that you are comfortable with. Next, lower your one leg down, tap your heel to the ground, and then explode back up. Feel the contraction throughout the quad that’s balancing on one leg. Maintain balance and core stability. This is one of the only exercises where it is ok for your knee to extend over your toes. Can hold onto weight once this gets easier. 3x10 each leg

4. Straight Leg Raises with External Rotation: While lying flat on your back (supine), bent one knee in and leave the other straight. First, externally rotate the straight leg, bringing your toes away from your body. Next, tighten your quad, keep toes pointed towards you, and raise your leg to the height of your bent knee. Hold in this position for a second and slowly lower down. Try to maintain external rotation. Here, we are focusing on strengthening the vastus medialis of the quadricep. 3x10-15 each leg

5. Lateral Steps with Band: Place band looped around feet, not ankles. This is for better activation in your hip abductor and glute muscles. You are resisting adduction as well as internal rotation of your hip, with the band around your feet. Perform with a slight bend in knees (like a basketball defensive slide) side step. Keep toes pointed forward. Chest up! Perform 10 steps to the left, 10 to the right x4.

These are three stretches and five exercises that work well to maintain flexibility, strength, and stability within the knee joint. However, if you do have knee pain please remember to consult your doctor first before trying these out.