Runners

Patellofemoral pain is common in runners. But, the good news is that through simple tips runners can improve patellofemoral pain. We recommend that if patients have patellofemoral pain during running, they should:

• Keep pain at no more than 2/10 during running. For reference, 0 = no pain; and 10 = the worst pain they could imagine.
• Knee pain needs to return to pre-training level within 60 minutes post-training, without increases in the following morning.

1. Increase training frequency to decrease each session’s duration (for example, instead of running 5km, 3 times in a week, run 3km, 5 times in a week).

2. Decrease running speed by approximately 10-20%. For example, if a patient normally runs 5 minutes per km, try running at 6 minutes per km.

3. Try using a run-walk program where patient does walking breaks. For example, run for 4 minutes, walk for 1 minute.

4. Avoid downhill and stairs running, and gradually reintroduce once pain has settled to an acceptable level (no more than 2/10).

5. Try increasing the number of steps patient’s take per minute, without running faster. It is often achievable to increase by between 5 and 10%, and this frequently leads to less load on the knees. This can be done by thinking about taking shorter faster steps, using a metronome, or running with music at a set tempo (beats per minute) similar to how many steps per minute patient’s aim to take. According to experts, this is likely to be most effective in people who take 170 or less steps per minute.

As pain reduces, patients may gradually reintroduce their normal running behaviour, including returning to longer runs, increasing speed, removing walking breaks and reintroducing hills and stairs. Try to only change one thing at a time, and ensure as patients do this, their pain remains no more than 2/10. See the infographic on the right for clarification.

Here are 5 tips to help runners with patellofemoral pain achieve less pain during and after running (see the video below).