Helen has increased the frequency, length, and speed of her runs, resulting in what the Guru believes to be Runners Knee

February 3, 2015


I asked the Guru a question before and got a really helpful response, so I’m hoping you can help me out again! 🙂

I run regularly and have been running on and off for 9 years. I am overweight and have been heavier in the past, and have run at all weights. So my knees have probably taken a pounding (I have also had long periods of inactivity). Since Christmas I have increased the frequency, length, and speed of my runs, perhaps a bit too quickly (although I don’t run fast or far by most standards, generally c.5k at 8min per km in recent runs). I also regularly do other activity: yoga, pilates, swimming, spinning, and fitness/conditioning classes, including some with weights. When I started running nine years ago, I used to get injured very easily, mostly my ankles being painful/swelling, but by doing Couch to 5k and cross-training I got past this stage and I have been injury-free for the last year of regular exercise.

In the past week or two I have noticed a problem with my left knee. It is not really a pain or an ache, but more like an increased awareness of the joint. I feel it while running,  walking/climbing stairs, and sitting. It is generalised around the kneecap and just feels ‘funny’, sort of like a tightness or stiffness, with occasionally a more localised twinge. Since the
weekend (when I ran 5k) it has been swollen and puffy above the knee cap. I could feel it particularly in squats and lunges in a body pump class yesterday and I felt less stable in these positions. When I touch the front of the kneecap there is a small (orange pip-sized) squishy lump in the middle, which is not painful. Right knee has none of these symptoms. I can
bear weight on left knee, run, and walk, and there is no real pain, so I don’t want to see a doctor.

It would be great to get advice on how best to act to stop this becoming an injury that would stop me exercising.. I am thinking I should be cautious and stick to swimming, yoga, and pilates (avoiding positions that require kneeling directly on left knee) until it gets back to normal. Should/could I be doing anything else, like physio exercises, ice, deep heat, a compression bandage, wearing flat shoes ? Or am I overthinking this and should just power on with spinning and running?

Thanks for your help!



February 3, 2015

Hi again Helen

I must say it does sound like a super common runners complaint, runners knee where your knee cap gets either overloaded by too much of the wrong sort of running or it doesn’t move very happily in the groove at the front of your thigh.

The squishy thing at the front sounds like a pre patella bursa and may or may not be relevant, but I’ll take it as not at the mo.

The question I’m desperate to be answered is how old are your current runners and how much mileage have they done?

The Guru

Six Physio
Helen replied immediately:

Thank you for this response. The trainers I use for running outdoors are quite old: I bought them in 2012 and have done a fair few miles in them. They don’t seem especially worn down, though.

Enabling the Guru to respond:

Hi Helen

I think I’d go for the most “obvious” win first of all – and that’s your shoes.

It’s not necessarily the wear, but it’s the amount of support they should give versus what they are now giving.

Change the changeable – treat yourself to a new pair of kicks!

Break them in slowly and see how your knee responds…

The Guru

Six Physio

Guru Responded

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