The Reason why you get knee pain and how to prevent it?

What is the Patellofemoral pain or knee pain?

Do you remember that sharp pain when you are running? Or moments when you cannot make one more step on stairs? That is Patellofemoral or pain behind or around the patella (kneecap), which is usually aggravated by activities that load the patellofemoral joint. Those activities are running, squatting, going up and down the stairs, prolonged sitting, even cycling loads the knee cap.

This pain is usually due to an imbalance between the load applied to the joint and the capacity of the joint to adapt for this load. This happens when you make changes in your daily activities, either you have increased the load or decreased your tissue capacity to adapt or a combination of both. For example, it might be that as a runner you have recently increased the load by increasing the speed and mileage that you are running too quickly while decreasing your tissue capacity by having a few nights of bad sleep and a bit more stress at work. 


In terms of treatment, it is important to understand this condition and knowing how to manage the load appropriately. You can reduce the load by reducing running speed by 30sec/km, avoid downhill running, run more often but for shorter distances. Usually, slight pain is permitted during and up to 1 hour after training.  Rehab protocols focusing on the muscles of the hip, knee, and trunk have also been shown very effective in treating this condition.

As specialist musculoskeletal osteopaths we will be able to assess your running gait and modify it if necessary to decrease the load going through the patellofemoral joint. Minimalist footwear has also been shown to improve running gait. However, changes in footwear must happen gradually over a period of 3-4 months. Kinesiology and sports taping have also shown as helpful in order to reduce the pain.

Quantifying mechanical stress

This is a scale of different activities and how much these will put through the patellofemoral joint. 0/10 is very little load 10/10 is a high load on the patellofemoral joint.

How load affects the body?

This picture is showing how load affects the body. Too much load will lead to pain. Not enough load will lead to no adaptation and you getting weaker. It is important to hit the right level where there is enough load for the tissue to adapt but not too much to create pain.

Our advice is to have minimalist shoes and your running technique will be better. That is the way to help your knee and eliminate knee pain. That it happens gradually so that you get used to the new shoes. It has to happen over a period of 3 months. Otherwise, you might cause other problem like a stress fracture of your foot. Some people though, due to their genetic makeup will not adapt and therefore need support, people with hypermobility inpaticular fit into this category. But with our guidance, we are sure we can help to lead you on a successful path to achieving your health and fitness goals. 

Damian is waiting for you in the new  Kentish Town Clinic. He is an osteopath and runner, so he really understands the issues runners face. We will do everything to help your specific issues and manage this type of condition.

Knee cap pain and how to help yourself?