Physical Therapy and Wearing a Brace Can Help Treat and Prevent Common Knee Injuries in Runners

By Carl Gargiulo, DPT

Getting regular physical activity is essential for achieving and maintaining good health, and that’s why we encourage all of our patients to get enough exercise every week.  One of the best possible ways to stay active is by running, which requires little more than a good pair of running shoes, some outdoor routes to follow—or a treadmill—and the motivation to get moving.  For these and many of its other attractive qualities, running has become one of the most popular forms of exercise in the U.S.  But unfortunately, common running injuries tend to prevent would-be runners from getting started and may also hold back experienced runners from returning.

Recent statistics estimate that more than 40 million Americans claim to be regular runners.  The reasons for this massive number of people being drawn to running may be different for everyone, but the wide array of health benefits associated with running is likely to be a major factor.  Of the seemingly countless benefits that have been identified by research, running on a regular basis has been found to:

  • Reduce high blood pressure
  • Improve sleeping habits
  • Lower the risk for cardiovascular disease
  • Boost brain performance
  • Improve mood by reducing stress and anxiety
  • Help people better control weight and maintain good overall health

Along with its many benefits, though, running also comes with a moderate risk for injury.  The constant impact of forces on the legs that’s part of running, as well as imbalances in the body like muscle weakness or progressing too aggressively are all factors that can cause an injury, and they may be more common than you think:

  • It’s estimated that up to 79% of runners are injured at least once each year
  • Most injuries are the result of repetitive activity that adds up over time rather than a single traumatic incident
  • Injuries range in seriousness from mild pain to severe issues like ligament tears that can sideline a runner for a long time
  • Though injuries are common for all runners, those that are more experienced generally have fewer injuries since they are more conditioned and can better listen to their bodies

Some may see this as a reason to not get involved in running in the first place, while others who have injured themselves from running fear another injury and stop altogether.  The truth is, most running injuries can be effectively treated conservatively (non-surgically) with physical therapy, rest, and in many cases, a brace.  Below are some of the most common knee injuries for runners—which account for about 40% of all running injuries—how they can be treated, and which braces we recommend to help runners return pain-free:


Runner’s knee (patellofemoral pain syndrome)

Patellofemoral pain syndrome, or chondromalacia patella, typically referred to as runner’s knee, is the most common running injury, accounting for between 16-25% of all running injuries.  The kneecap (patella) is important for absorbing large amounts of force, and is subjected to great impact during running.  When runner’s knee occurs, the patella rubs against the groove of the upper leg bone (femur), which causes a dull pain that’s felt behind or around the patella.  This pain is often aggravated from running, squatting, climbing stairs or sitting, and may also be accompanied by swelling or a “popping” of the patella when bending the knee.

Jumper’s knee (patellar tendinopathy)

Patellar tendinopathy, patellar tendinitis and patellar tendinosis are all used to describe an injury to the same area, so for simplicity’s sake, the term jumper’s knee is often used.  The patellar tendon attaches the bottom of the patella to the top of the shinbone (tibia) and is responsible for absorbing forces from the large quadriceps muscles in the front of the thigh.  Jumper’s knee is caused by repetitive strain to the patellar tendon, and accounts for about 5% of all running injuries.  Patients with jumper’s knee usually experience pain and stiffness at the front or below their patella and/or in the quadriceps, as well as an aching sensation that’s usually brought on after exercise.

Patellar instability

Patellar instability is a general term used to describe intermittent pain that comes with the feeling of the patella moving excessively or being unstable.  This pain can be felt under, around, or most commonly, in front of the patella, and may also occur with swelling or a locking sensation.  Patellar instability is the result of the patella sliding out of place, and if left untreated, can lead to further injuries like a knee dislocation or runner’s knee.  About 50% of patients who dislocate their knee once will do it again in the future, which makes proper treatment incredibly important.

How physical therapy can help

donjoy-durasoft-cold-pack-kneeFor runners who come to Strulowitz & Gargiulo Physical Therapy with knee injuries, we typically prescribe a period of activity modification, a personalized treatment program based on the results of their evaluation, plus the use of a brace.  Each treatment program is different based on the specific type of injury, its severity, specific impairments identified, and the abilities and goals of the patient.  In most cases treatment will involve icing for pain reduction, taping and/or compression of the knee, stretching exercises to increase the flexibility of the legs and hips, and strengthening exercises to specifically address weakness and muscle imbalance at the knee, hip and trunk.  We will also advise injured runners on how to improve their running stride, some training mistakes to avoid and other ways to prevent another injury.

 

The role of knee braces

Webtech Knee Strap for Running

In addition to our physical therapy treatment program, in many cases we also recommend that a patient wears a knee brace to alleviate pain and prevent future running injuries.  Braces come in a variety of sizes and styles, and they are each designed for a specific function, but knee braces for runners generally help by providing stability and absorbing shock.  We recommend the following braces from BetterBraces for the running knee injuries discussed in this article:

DonJoy Performance Webtech Knee Strap: relieves pain from jumper’s knee

DonJoy Reaction WEB Knee Brace: ideal for runner’s knee, jumper’s knee and patellar instability

DonJoy Performer Patella Knee Support: provides support and compression for patients with patellar instability

DonJoy Performance Webtech Short Knee Brace: effective for runner’s knee, jumper’s knee and patellar instability

For additional braces that are ideal for running knee injuries, view the full selection of running knee braces from BetterBraces.  For more information on injury treatment and prevention, or for any pain you may be experiencing due to running, contact your local physical therapist to schedule an appointment.  For those in New Jersey’s Hudson County area, contact us at Strulowitz & Gargiulo Physical Therapy in Jersey City, NJ by calling 201-792-3840.  One of our trained physical therapists will determine what type of injury you have and what treatment—and brace—is best for you.

Carl Gargiulo PT, DPT, OCS is the president and owner of Strulowitz & Gargiulo Physical Therapy. He has provided physical therapy services to the Hudson County area for more than 30 years and specializes in sports medicine for adults and children, as well as work-related injuries.

Sources

http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

http://jama.jamanetwork.com/article.aspx?articleid=1886192

http://www.webmd.com/fitness-exercise/running-injuries-causes-prevention-treatment

http://running.competitor.com/2014/08/injury-prevention/running-knee-injuries-101_110938

http://www.medicaldaily.com/run-your-life-6-health-benefits-running-just-5-minutes-every-day-322050

http://runnersconnect.net/running-injuries/

http://runnersconnect.net/running-injury-prevention/why-runners-get-hurt/

http://www.aapmr.org/patients/conditions/msk/pages/runfact.aspx

http://runnersconnect.net/running-injury-prevention/runners-knee-symptoms-causes-and-research-backed-treatment-solutions-for-patellofemoral-pain-syndrome/

https://www.oapublishinglondon.com/article/683

http://www.aafp.org/afp/2007/0115/p194.html

http://noyeskneeinstitute.com/unstable-kneecap/

http://orthoinfo.aaos.org/topic.cfm?topic=a00350

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