Kelly’s Experience with Runner’s KneeKelly is 31 and and last summer she decided it was finally time to get fit, start leading a healthier lifestyle and feel great. She joined the gym and for the first time in years, began running.
She did the right thing and started off slow with her running, gradually increasing her pace over the weeks. Unfortunately, as she kept running she started to develop a niggle in her right knee. The niggle progressed to a general ache and eventually starting limiting her running and activities and even some daily activities like walking up the stairs.
Kelly felt frustrated and demotivated. The pain stopping her from achieving her goals and her willingness to exercise decreased. This is when Kelly decided to come in to see us at The Podiatrist in Toowoomba.
Kelly’s symptoms included an achy pain around her kneecap, particularly at the front and back of it. The pain worsened when she tried exercising or running, and when she used the stairs in her home.
Before seeing us, Kelly tried:
- Taping her knee
- Icing her knee
- Taking anti-inflammatories
- Resting and avoiding running
While that helped reduce her symptoms while she wasn’t active, the ache in her knee would resume when she started running or went to the gym.
Clinical Assessment We ran through a comprehensive biomechanical assessment with Kelly which included:
- Muscle strength testing
- Range of motion at all the joints of the foot, ankle, knee and hip
- Gait (walking) assessment with shoes and without, on the ground and on the treadmill
- Gait analysis of Kelly’s lower limbs as she runs using our Zebris cutting edge computerised gait analysis with force and pressure analysis
- Foot posture analysis
- Footwear assessment
- Palpation around the knee and its structures
Diagnosis: Patellofemoral Pain Syndrome (Runner’s Knee) Our clinical assessment revealed that Kelly was suffering from Patellofemoral Pain Syndrome - otherwise known as Runner’s Knee. This is when pain presents at the kneecap, especially behind it, as is often thought to be related to damage to and irritation of the cartilage where the kneecap meets the thigh bone.
The cause of her knee pain was an interesting one. It surprised Kelly, though it’s not uncommon if you have a good understanding of lower limb biomechanics. It was actually Kelly’s feet that played the major role in the development of her knee pain.
Her right foot was excessively pronated (flat), even more so than her left. We could see on the Zebris Gait Analysis that this was causing an internal rotation (twisting) force through the knee. This, combined with an imbalance in the thigh muscles that were constantly trying to counter the twisting, resulted in a malaligned patella (kneecap) which was rubbing on the surrounding bone and over time, resulting in the pain and aches.
Simple, Easy and Effective In order to eliminate Kelly’s pain and symptoms long-term, we needed to address the cause and the contributing factors. We did this through 3 primary ways:
- Orthotics - We used orthotics to reduce the pronation through her feet, thereby reducing the twisting of the leg and malalignment of the knee. We used our in-house Orthema Orthotic Manufacturing System to create the orthotics from a 3D model of her foot and the results of her biomechanical analysis.
- Footwear - We recommended that Kelly replace her worn, neutral joggers with supportive joggers that have some in-built anti-pronatory control
- Strengthening and stretching - We went through a series of strengthening and stretching exercises with Kelly to help address the imbalance and strengthen her muscles to get them working with her body efficiently