Sunil is an accomplished marathon runner and squash player. If he is not out running long distances every morning, he is usually found in the squash court. He was wanting to break the three-hour barrier in the marathon. He picked up a program from the Internet and started increasing his weekly mileage. Then his right knee started to bother him. As days went by, he started experiencing knee pain while going down the stairs or getting up from a chair. He could not go though his day without his knee bothering him. His running was getting affected as the knee pain would not let him run at his usual pace.

Finding the cause

Sunil consulted a sports doctor who informed him that he had developed runner’s knee pain, also known as Patello-Femoral Pain Syndrome, or PFPS for short. This is an overuse injury where the tissues are overloaded beyond their ability to recover. Tissues, in this case, are the muscles around the knee. Sunil’s doctor also explained that Sunil had to do strength training to injury proof his running. In Sunil’s case, his glutes or the muscles in the butt were very weak. This is not an unusual situation with most runners and other endurance athletes – they only want to run and tend to dislike gym sessions.

The cure – rest, stretch and strengthen

•Easing up on the running or even stopping for a while is the first step. The overused tissues need to be rested for them to recover. If losing fitness is a concern, then alternate means of cardiovascular exercise – rowing, swimming or an elliptical cross trainer can be used.

•Icing is good for reducing pain or any swelling around the knee.

•Strength exercises need to begin as soon as possible. Strengthen the glutes and the quadriceps, the large muscles in front of the thigh.

•Side lying raise – lie on your side, raise the top leg while keeping the hip steady. Do at least three sets of 15-20 repetitions on each side.

Do three sets of side lying raise on each side (Shutterstock)

•Single leg glute bridge – lie on your back, raise your hips up till your knees, hips, shoulders are in a straight line. Take one leg off. Hold for 30-45 seconds on each side. Do three sets on both sides.

•Walk backwards – a functional way for getting terminal knee extension. Walk 20-30 meters backwards as many times as possible in the day.

•Step Downs – Stand on a low stool, keep the affected leg on the stool and step down with the other leg. Touch with the heel and come back up. Push through the ball of the foot which is on the low stool. That is one repetition, do 15 per side for two to three sets.

Do two to three sets of step downs on each side (Shutterstock)

•Use the foam roller on the quadriceps to improve the extensibility of the muscle. (insert image of foam rolling)

Knee pain can be multi-factorial. PFPS is just one of the causes. I shall discuss others in the coming columns. Till then stay healthy, stay pain free.

A strength and conditioning coach for the last 15 years, Kamal Singh, CSCS, specialises in post rehabilitation training and functional training.

From HT Brunch, February 10, 2019

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First Published: Feb 09, 2019 20:36 IST