Patellofemoral pain, commonly referred to as runner's knee, is one of the most common reasons patients seek care in Physical Therapy clinics.  In short, the symptoms are caused by abnormal forces between the knee cap and thigh bone.  The condition is effectively treated by Physical Therapy interventions including manual therapy, exercise, and gait retraining.  The goal of these interventions is to normalize the forces across the knee joint and improve the capacity of the body to absorb their sport's forces.  A recent study compared different Physical Therapy interventions to determine which was most effective for improving patellofemoral pain symptoms.

A randomized controlled trial in the British Journal of Sports Medicine examined the impact of either education on training and symptom management, or exercise and an education program, or gait retraining and an education program on knee pain symptoms among 69 runners (Esculier et al. 2017).  The followed the runners on these 8 week programs on outcomes at 1, 4, and 5 months.  They were assessed for subjective reports of pain as well as strength and running mechanics.  As expected, each group improved over each time period but strength gains were seen in only the exercise group and improved gait mechanics were only seen in the gait retraining group.  Importantly, education on symptom management offered the largest impact on the runner's improvements and remained the most important factor for recovery.  

Why to perform static stretching AFTER running:

The ability of an individual to reach maximal performance in distance running is determined by VO2 Max (the body’s ability to utilize oxygen), lactate threshold, and running economy. Running economy is determined by the oxygen cost to perform a given aerobic activity a sub maximum level. Similar to miles per gallon in a car, an athlete with a better running economy can sustain a given intensity and distance while preserving glycogen compared to a less economical runner. Prior research has indicated static stretching prior to a run will reduce running performance and should be replaced by more of a dynamic running warm up. In comparison, static stretching performed 2-3 days per week, 2-3 repetitions held for 15-60 seconds per stretch for muscles of the lower extremity after running. In practice we see a lack of hip flexor, quadriceps (rectus femoris), and calf flexibility to be some of the leading causes of mobility loss in a runner. This improvement in running mechanics will improve running economy in a runner leading to decreased injury risk and improved running performance. To learn more about the evaluation and treatment of running economy contact the experts at mendcolorado.com.