Theo is suffering from long distance runners knee

October 10, 2016

Hi there,

I completed an 90km ultra marathon in mid-August. For the last 20km or so I ran with a fair bit of pain in my knees. I didn’t run at all for a week, went of a pre-booked hiking weekend and then rested completely for several weeks. Two weeks ago I ran again for the first time and could only run 7km without the pain starting to come back in my left knee. I left it another week and tried again and this time the pain came back at 4km.

My question is, can phisio help my situation do you think, or would you just recommend complete rest for several weeks or even months?
PS: Its not an IT band issue.. rather its pain within the knee itself..


October 10, 2016

Hi Theo

You’ve long distance runner’s knee – which is the same as runner’s knee or patellofemoral joint pain, but with a fair chuck of distance added in!

Rest may help, but by no means as a guarantee as most PFJP, especially related to how you patella (knee cap) moves is not self limiting.

Think of it as you’ve got a bruise on the back surface of your kneecap – either due to something biomechanical (how you move your knee) or attritional (you’ve done too much).

If you give the “bruise” enough time, and you don’t poke the bruise (i.e. don’t load it with running) it may get better – but how long is a mystery.

What is more common is that you’ve very slightly altered the way you move due to distance, natural imbalances and load – and now the straw has broken the camels back and you’ve been “bruised”. Only if you don’t change the way you move, the “bruise” can’t get any better…

So yes, Physio would be a great place to start – they would need to identify who you’ve got the issue, the what’s wrong is pretty easy. You’ll need to work on your gluts, patella mobility and control of what you do. Taping is also a great pain reliever to allow you to do a little more.

Have a go at self taping your knee

Guru Responded

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