[00:00:00] You just finished couch to 5K amazing, or your first half, or even full marathon. You’re finally calling yourself a runner. Now. Your knee is extra mad at you for doing all that stair suck. Sitting sucks, running and walking. Horrendous and terrible, and no amount of YouTube rehab videos is helping you.
[00:00:17] Here’s what’s actually going on with your runner’s knee and how to fix it before it gets worse. In this episode, I’ll be going over what runner’s knee actually is. Spoiler. It’s not just one thing. The exact treatment plan, a physio, a physical therapist, will give to you what to do and not do in your first seven days.
[00:00:32] And if you stick around in the middle and actual free download to fix your runner’s knee and base training plan to get back to proper fitness is available for you. And the long game approach to stay pain free as a runner, I’ll be joined for all the science backed stuff by Sam Shearman. Pro running physiotherapist here at Sydney, Australia and founder of 10 Weeks to Strength running app.
[00:00:51] I’m Daren D Lake Sub three hour marathon, a 10 hour Ironman finisher, run coach, and human Guinea pig of the last 30 years trying to figure out how to get 1% better each day and tell all the self-coach runners of the world out there how to do it. Let’s get into the episode. We have Sarah, who is a 3-year-old woman who has recently started running after being relatively.
[00:01:16] Sedentary. So she’s been sitting around not doing anything. She’s completed a couch two, 5K program. Everyone loves that and is now running three to four times per week, but has been experiencing pain in her knee. Specifically, she reports pain around the kneecap, especially when going up or down stairs or when sitting for long periods with her knees bent.
[00:01:34] So with our framework. That I’ve described. What would you diagnose her with? This sounds like patella femoral pain syndrome, also known as runner’s knee. All right, and what would be the immediate treatment? Oh, I see lots of these actually. And I always wanna reassure the, um, the athlete or the patient like this is okay, this is normal.
[00:01:53] These things can happen with running particularly more so with novice runners considering it’s her first injury. A lot of it is education on how to balance. Running training. She’s just finished the couch to 5K program, which is I think is fantastic, um, to have that gradual increase in time and kilometers.
[00:02:10] But I do see once they finish that program and they start, they get, you know, really confident and start running, you know, five Ks, four times a week, and it’s still rapidly loading up the structures in her knee. And that’s what’s led to this presentation. So a bit of education with the first session.
[00:02:24] Secondly, I don’t recommend anti-inflammatories for all injuries, but this one would do well with a bit of ibuprofen. So I’d recommend ibuprofen twice a day, five days or so, and that’s, I prefer ibuprofen over other anti-inflammatories ’cause it’s better for your tendons. Then would look at doing a bit of quads release work, simply because when the knee’s in pain, quads don’t fire as well.
[00:02:46] We just wanna get a bit of release work through there. Then we can start looking at strength. Now my go-to exercise for presentation. Oh, hold on. Yeah, sorry. So, uh, that was immediate treatment. So she came in for that first visit? Yes. Yeah. Uh, and now would you do strength even in that first visit?
[00:02:59] Absolutely. Yeah. Oh, okay. Alright, cool. Yeah. So what we’d do with her is we’d get the ball rolling with strength. I’d likely get her doing a wall Sit. Wall sits are a nice way to get some quads activation without actually stressing the knee joint. You just need to make sure the person has the feet. Far enough in front of their body.
[00:03:14] So when they sit down into the squat, they’re not compressing their knee joint ’cause we already know it’s inflamed. Um, that’s usually the, sorry, that’s usually the first place where I’d start, get them to have the ibuprofen. Unfortunately no running this week. The pain is, is too high. And then. In the week’s time, we could see if it’s settled down and whether or not we can get her doing some run, walk, run stuff.
[00:03:34] Again, I don’t like to hold, uh, runners or patients back from running too long because then we just see a further decrease in their load tolerance and it gets harder for them to reenter the train they’ve been doing. But the pain’s gotta be at an acceptable level. Not sure how to fit this into your actual training.
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[00:04:05] Check the QR code right here, the link below, or link in your show notes of your podcast players app if you’re listening. Back to the episode. Alright, so what would ongoing treatment and strength training program be for, for this, uh, for Sarah? So, the best evidence with patellofemoral pain strength syndrome is strengthening the quadriceps as well as the hip glute medias.
[00:04:26] So hip stabilizers. So a lot of her pro uh, her training will be around that. You usually start with something less functional, and then you want to then progress into function. So you may start off with sideline leg rays with a band to start getting some work through the glute medias. And also, again.
[00:04:43] Your wall squats, split stance, wall squats, eventually moving into exercises such as the Bulgarian split squat because it’s targeting both our key muscles, the quads and the glutes, which we talked about in, uh, possibly the episode before this. Yeah. Or after this. And we’ll have videos and stuff on that.
[00:04:58] Keep going. Um, as she progresses, and this is once her pain’s more an acceptable level, and I say acceptable being less than a five, outta 10, it’s responding well in that 24 hours after running. We then look at, you know, continuing to, IM. You know, prove that the kilometers that she’s doing, I probably would’ve reentered her somewhere in the couch to 5K program.
[00:05:18] You know, you could always do like three weeks back to, you know, four weeks back, whatever she can comfortably do and continue on with. You could also consider gate retraining. Again, I’d leave this to later on because you don’t wanna throw too much stuff at this novice runner straight away. But once she’s back running, we could look at how many um, steps she’s doing per minute, what her stride looks like, and see if we can take the load off the knee by increasing.
[00:05:40] Correct cadence. Is gate retraining uh, similar to like running form? Yeah, it’s, it’s looking at your running form and what we can do differently to offload certain structures. Got you. Alright, so you’ve already talked about the follow up, the ongoing strength training, immediate uh, training and um, what the diagnosis is.
[00:05:57] Anything else you wanna say that people might not know about runner’s knee? Well, once, uh, in runner’s knee in general? Well, it’s an umbrella term, so it’s not act, it’s considered a clinical pain syndrome. So it’s not one specific structure that we can. Blame for this presentation, but it may be the cartilage is a little bit irritated.
[00:06:13] It may be that, that there’s some joint inflammation, even the neural structures, whether or not they’re a bit sensitive at the moment, but it’s a combination of factors, which leads to this presentation. All right, so it’s not something to freak out about, as you said. No, no, no. And I understand how, again, more novice runners get a bit freaked out with this condition, but it’s just about settling the pain and then getting things stronger again and gradually broel up your running kilometers.
[00:06:38] Yeah. Would, would you say my last kind of, uh, Daren weirdo contrarian question, you don’t see this in the advanced and more experienced and, uh, pro runners. Would you say that more injuries for, uh, elite runners happen below the knee and then more of the, uh, novice runners that happens like above the knee in the hip area?
[00:06:59] Not quite because the most common, uh, condition with all RINOs, but again, particularly more so in novice runners as medial tibial stress syndrome, so that’s shin splints. Oh, so that’s a key one We see a lot of the time that’s lower weight. Yeah. But rhino’s knee, I do see, again, more frequently with novice runners.
[00:07:14] I haven’t gotten any data on it, but just from my clinical observations I see. Yeah. Much more newer runners with this condition. Again, if you’re dealing with runner’s knee right now, click our free download below to get your immediate recovery plan. Plus that base training program and you sign up for my free weekly newsletter.
[00:07:31] But here’s the thing about runner’s knee, it’s really just a symptom of a bigger problem, a weak foundation. And if you had knee pain, it’s a warning sign that you need to do proper strength training, specifically designed for runners. And I’ve created a whole episode breaking down. Why these specific exercises is five of them prevent not just knee pain, but also shin splint, it band issues, Achilles, and other common running injuries.
[00:07:54] Check out the video right here or link below in description or in the show notes of your podcast player app. If you’re listening, peace.