Proper Running Form for Runner's Knee (PFPS)

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  • tawandacat Runner's Knee (PFPS)

    • Age 55+
    • Female
    • 145 lbs
    • 5' 7"
    • Binalong Bay, Tasmania
    22
    Sep2016
    • Injury Status Cured
    • Physical activity per week 8+ hours
    • Chronicity 6-18 Months
    • Repeat injury? No

    Treatment Ratings

      Cured
      Barefoot Shoes, Proper Running Form
      Improved
      NSAIDs - Anti Inflammatory drugs, Ice, Strengthening Exercises, Cross training
      Not Improved
      Orthotics
      Worsened
      Supportive Shoes

    I had been running for years in really cushioned shoes (Asics Nimbus) When I was in my 30's I developed a sharp pain in my heels. I fixed this problem with orthotics as it was a quick fix to my problem. I ran with these orthotics in very cushioned shoes for 20 years. Then in my mid 50's I developed runners knee. I couldn't run anymore it hurt too much. So I started bike riding. I found that if I pointed my feet outwards (externally rotating the leg) when I peddled, it didn't hurt my knees. I took this concept back to my running. I read the book "Born to Run" By Christopher McDougall. I discovered that really padded running shoes gives the body a false sense of protection. When the brain doesn't perceive danger it does nothing to protect itself from repetitive actions like running with the knees misaligned as in my case, despite the orthotics. I switched to a mid barefoot shoe and got rid of the orthotics. I found the idea of using my feet and having a better connection to the ground profoundly interesting and helpful. I became very interested in posture and mechanical alignment of the body and how it correlates and affects performance. After reading the book "8 Steps to a Pain-Free Back" by Esther Gokhale. I signed up for the Gokhale Method Foundations Course. This is where I learned to walk a line with my inner heels on that line. This was the deal breaker for me. I found that this movement along with using my feet properly and engaging my glutes externally rotated the leg and aligned my ankles, knees and hips. I am now 58 years old and I am happily running again without any knee issues. Today, I just came back from a barefoot run along the beach. I haven't had knee problems for 2+ years now.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      NSAIDs - Anti Inflammatory drugs, Ice, Rest, Supportive Shoes, Stretching, Strengthening Exercises, Cross training, Proper Running Form

    All there's no magic "cure" for injury prone knees. There are a host of things you can do to make life easier.
    Wear the correct shoes, you already have orthotics which is a great start.
    Have your gait analyzed, again you know you pronate so you can make a conscious effort to adjust your run and gear.
    Don't just run. You could have some sort of strength/flexibility imbalance in your feet, ankles, calves, thighs, back etc. Swim, stretch, cycle, do some yoga, pilates. Becoming a good all round athlete promotes healthier running.
    Don't run hurt. If your knees are crying in agony, don't "man up" and smash them into the concrete. Running is about making small incremental improvements, no one gets to long mileage without building up properly (or if they do, it's a recipe for injury).
    Establish a recovery routine. Ice, compression, elevation, ibuprofen. Even if you're not injured, these can help with post-run fatigue/aches and mean you can do more with quicker recovery between runs.
    Run short, run fast. Not everyone is made to plod 23 miles. Try short speed work, intervals, aim for 20 min 5ks, 6 min miles, there are plenty of challenging short distance goals which will challenge your running. What separates beginners to advanced runners is not their mileage but their abilities at the preferred distance. I have no knee pain since.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Stretching, Strengthening Exercises, Supplements, Proper Running Form, Foam Rolling

    I'm 34, 6'0", 185 lbs, and have run six marathons (and a zillion shorter distances). Our body types are probably similar. I worry a little that most runners in my echelon (I'm a 1:27 half / 3:20 full marathoner) have a different body type and less mass than me. Knee problems have always been an issue. But I do a lot of things to try to mitigate it:
    Static stretching after each run, like 10 minutes worth. I never ever skip this.
    I take glucosamine/chondroitin supplements. They're advertised as helping your cartilage, but their benefits haven't been conclusively proven. I figure at worst they're placebos, at best they're helping my knees stay in the game longer.
    Focus on good running form. For a long time (until the past six months) I was running in very heavy shoes that promote heel striking. I switched to entry-level Newtons and my form has gotten noticeably better, which I think has to be better for my body mechanics generally and my knees specifically.
    Spent decent time at the gym doing leg/core strengthening (along with upper body/other stuff). I used to completely skip this, thinking that the gym worked my upper body and running worked my lower body. That was a dumb thing to think. Hips, knees, and ankles need proper support from the muscles around them.
    Before every run I do the foam roll to loosen up my IT bands on the outsides of my legs. This helps ensure that they don't get tight and end up pulling my kneecap slightly out of alignment.
    Even given all of the above, my Dad (age 68) still likes to remind me of all his old pals who ran lots in their younger years and now have bad knees. I like to think that I'm doing it right and they didn't, that my training plan is better, that I have the benefit of modern shoes that they didn't. But the way I see it: even if I do end up with bad knees, I'd rather have spent my peak years using my body to its fullest rather than sitting on the sidelines preserving myself for retirement.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Supportive Shoes, Stretching, Strengthening Exercises, Proper Running Form

    I would suggest getting a gait analysis done. I went to a doctor who has a running clinic to get this done. He pointed out certain flexibility, strength issues and extreme pronation, that caused my knees to twist a lot when I would strike. He gave me a specific stretching and strengthening program, got me in the correct shoes and insoles (off-the-shelf) and I have not had any knee issues since. And I do about double my old mileage.
    Honestly, I recommend this for every runner I know, to avoid future problems. Best $300 I ever spent. The before and after videos of my gait are astounding.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Physical Therapy, Rest, Supportive Shoes, Strengthening Exercises, Proper Running Form

    I went to physical therapy. I was given some leg-strengthening exercises, and told to change the way I run. Lean forward a bit, and shorten my stride. Also, I stopped wearing these (http://www.saucony.com/en/jazz-original/11843W.html), and bought a proper pair of running shoes.
    After a few weeks off, things worked out.


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  • 06
    Oct2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Supportive Shoes, Strengthening Exercises, Proper Running Form, Foam Rolling

    Im no expert but I have a similar story. I completed my first half marathon and then the following week when I tried to run again my knee was very painful and felt like it was going to give out. I waited another few days and tried again with the same result. I tried a few exercisers from the physio and some foam rolling which I think helped a bit but I still wasn't 100%.
    After reading some stuff online I decided to go and see someone about my running form. Turns out i was heel striking which can apparently lead to higher shock loads on your knees than a mid foot strike.
    He was able to fix my running form immediately. He told me to download a metronome app for my phone, set it to 180 beats per minute, listen to it when running and step at every beat (180 steps per minute). Apparently this is an efficient cadence and also helps to prevent you landing with your foot out in front of you and landing on the heel (you don't have time to move your leg that far comfortably). He also recommended a particular shoe for me.
    Worked wonders for my knee. It works your calves a lot more so you have to ease into it, but once you're running at that 180bpm it feels really comfortable and efficient. After a week or two you get the rhythm ingrained and dont need the metronome any more either.
    Like I said, no expert, just my story ;-)


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  • 22
    Feb2011
    • Injury Status Cured
    • Chronicity 18+ Months

    Treatment Ratings

      Cured
      Proper Running Form
      Not Improved
      Physical Therapy, Orthotics, Strengthening Exercises

    I had runner's knee symptoms in my right knee for three years. I got custom orthotics, went to physical therapy, and did knee strengthening exercises religiously. None of that helped much, though. The knee problem reduced me from marathoning to 20 mpw of easy jogging. If I tried to do anything more ambitious, my knee would start acting up.

    I finally got rid of the knee painby switching from heel striking to forefoot striking. The knee pain disappeared, and I have not had any knee problems since. I'm back up to 60 mpw and thinking about a marathon this fall.

    I know a lot of people don't like to think about changing their form, but it worked for me. It took a few months to adjust to it, but it was well worth it. If nothing else is working for you, it is something to consider.


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  • 16
    Mar2010
    • Injury Status Cured

    Treatment Ratings

      Cured
      Supportive Shoes, Other, Strengthening Exercises, Proper Running Form

    So I used to be a very consistent runner. I never raced, nor really had a desire to, but I used to run between 3 and 5 miles a day, with one day a week off and one long weekend run of ~ 10 miles. I did this for no other reason than I liked running. Well, at one point I hurt my knee on a bad indoor track and was unable to run for a few months. Since, I have tried running on and off for the past couple of years, but I always quit when I start to get stiff knees. However, I finally seem to be making some progress.

    Right now, I'm running around 2-3 miles a day and have gone up to as much as 4. However, I'm TERRIFIED of hurting my knees. I've been reading up on form and shoes and exercises. My knees don't hurt right now, but I'm getting a little bit of stiffness.

    Here's a summary of what I've read: 1) run with shorter, quicker strides; 2) increase distance slowly; 3) slow my pace down from what I'm used to; 4) upper body should be erect; 5) I should be landing on the fleshy part of my foot - about mid-foot; 6) I should strengthen my hips and quads.

    On shoes...yeesh, this is a controversey. I've always sworn by getting shoes from a running store nearby that looks at your feet, watches you run, etc., before fitting you with a pair. I've generally liked the shoes I get. However, I just read Born to Run and now I'm wondering if I should chuck my expensive shoes for something with less padding?!

    I've also been trying to run hills when I'm on the treadmill to avoid too much repetative motion. This all seems to be working.


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  • Anonymous Runner's Knee (PFPS)

    • Age 55+
    • Male
    • 6' 0"
    • Chicago il
    14
    Feb2017
    • Injury Status In Pain
    • Physical activity per week 0-4 hours
    • Chronicity 18+ Months
    • Repeat injury? No

    Treatment Ratings

      Improved
      NSAIDs - Anti Inflammatory drugs
      Not Improved
      Cross training, Proper Running Form

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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Proper Running Form

    I suffered from knee pain, on and off, when I started running in January. Changing my foot strike, so I was landing more on the front of my foot, solved the problem for me. I could feel the strain increase on my calves but they're much stronger than my knees. I'm now running 50K+ a week with no knee pain at all.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Proper Running Form

    Land with a mid-foot strike and try ChiRunning. This is waht heped me.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Stretching, Proper Running Form

    so runner's knee is often ITBS, which is a swelling or inflammation of a band of tissue that runs from your hip, down the side of your leg, and inserts into the bottom of your knee. So, basically get on the foam roller with it on the outside of your leg, somewhere between your knee and hip, and roll up and down. it'll probably hurt. a lot if you've never done it before. google foam rolling or youtube it, for examples. if you find a knot, roll it out. think of it like a pin roller to pizza dough.
    i should also mention, stretching is uber important here too. i've found pigeon pose (from yoga) to be a very effective stretch, but really, anything that stretches the outside of your legs will suffice. I have been free of knee pain since.


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  • 03
    Dec2015
    • Injury Status Cured

    Treatment Ratings

      Cured
      Proper Running Form

    Its all in the form. I hurt my knees sprinting to make into the next block before the traffic light changes on a busy cross-street; and went into an "all out - lions are chasing me" sprint for the last 30 yards.
    Once I slowed down on the other side, I realized my knees hurt like hell, and that in trying to sprint as fast as possible, I was landing on my fully extended front leg, jarring my full weight into the knee.
    Thankfully it was not too bad and pain went away, but if I did not caught myself doing it, I can see myself completly busting my knees in a few months.
    Since that wakeup call, I worked on my form a lot, and had no problems whatsoever.. The key is to never land on fully extended leg, and also when sprinting, to think "pull knees as high as possible", instead of "stride forward as far as possible"... the stride length will take care of itself due to knees being pulled high, and you'll be hitting the ground with your knee already bent a bit and leaning forward, instead of using your straight leg to pole-vau