Knee problems and running go hand-in-hand, unfortunately. And “runner’s knee” is such a generic term that it can’t even be considered a real diagnosis. Sadly, a lot of healthcare providers are not great at diagnosing knee problems and, as you can imagine, trying to treat something when you’re not sure what the problem is in the first place is a recipe for a lot of wasted time and effort.
In this article we’ll explore how to figure out what kind of knee problem you’re having. In future articles, we’ll explore some things you can do to help yourself, but here’s a little hint: a roll of RockTape and watching our video on how to tape a knee will yield surprisingly good results!
Most common knee discomfort* related to overuse from running is either something called “iliotibal band syndrome” (ITBS) or “patellofemoral discomfort* syndrome” (PFPS). And, believe it or not, simply knowing where the discomfort* is located is half the battle! What confuses matters is that different sources of discomfort* and multiple problems can co-exist, but as a rule, ITBS is going to be discomfort* that is at its worst on the outside of the knee while PFPS will be most discomfort*ful in the front of the knee.
The iliotibial band is a big section of connective tissue that is found on the outside of the leg. When it gets irritated, that usually happens in the section that attaches to the leg near the knee, hence why the discomfort* is going to be on the outside of the knee. ITBS tends to be worse when going down steps or descending hills. In fact, a lot of people with ITBS will remember first noticing it on a long descent while running. ITBS usually starts quickly, rather than being a slight nagging problem that develops over weeks of time. Sitting for a long period of time can cause aggravation of the discomfort* on the outside of the knee and the discomfort* of ITBS is pretty consistent and doesn’t change location much, if at all.
Patellofemoral discomfort* involves more of the kneecap (patella) and its related structures, so it tends to affect the front of the knee. It will feel discomfort*ful directly underneath the kneecap or around the edges of it. When you poke around your knee, the edges may be tender to the touch and pressing your kneecap down will probably not be something you want to repeat! PFPS tends to hurt going up stairs or on ascents while running, but it will probably hurt on the descents, too. PFPS tends to be something that starts as an annoyance and develops slowly over months or even years. ITBS happens much faster. Bending the knee can hurt and activities like full depth squats will probably aggravate PFPS. Patellofemoral discomfort* goes hand-in-hand with the alignment of the kneecap, so structural problems like flat feet, valgus (“knock-knee”) knees or a host of problems that can affect the position of the kneecap itself will usually be a factor in the problem.
If you experience knee trauma, swelling, instability (“I feel like my knee is giving out”), or locking/clunking of the knee, you should see a healthcare provider sooner than later. Also tingling and numbness is not part of either of these common versions of “runner’s knee,” so those are worth a visit to a doctor, too. In fact, this article is really intended to arm you with information for when you do see your doctor for your knee problems, not to replace a proper diagnosis and professional opinion.