The case of the runner’s knee (also known as patellofemoral pain (PFP) is an injury that is overlooked by many on their quest to keep up their running streak.
But between all the miles racked up from roadrunning, and possibly not having enough days off, it's easy to see why running would take its toll on your knees.
Often times, a knee injury is an easy fix, healed over time dedicated to rest and recovery. But bulletproofing your knees with a stretching and strengthening routine will take you those extra miles and help prevent further injury or pain later down the line.
As much as you want to keep on running, it's best not to ignore those niggling knee pains. Instead, incorporate knee strengthening exercises into your regular resistance training routines, warm-ups and cool-down routines.
Before we get into the exercises you should be doing to strengthen this joint, we'll explore how exactly runner’s knee is caused, and the anatomy of the knee, so you can understand what muscles you’re using when you run, and how to protect them.
HOW IS RUNNER’S KNEE CAUSED?
Too much bending of the knee and the impact of high-stress exercises like running, plyometrics and HIIT can take its toll on your knees, causing irritation, inflammation and pain at the front of the knee, and muscles surrounding the knee cap.
Wearing ill fitting running shoes can bring on knee pain, especially if they lack arch support or aren’t accommodating enough for wide, or flat feet. Proper arch support will prevent excessive pronation and will reduce the strain on your knees.
Both hypermobility and fallen arches can lead to overpronation which increases internal tibial rotation which can cause knee pain, to prevent this ensure you wear stability running shoes with added support or guards to keep your foot stable.
This tends to be caused by sitting too much, overuse, or not stretching after exercise. It can cause the knee cap to be out of place. For example tight quad muscles can pull on the hip bones, make your hips shift forward which puts extra stress on the knee joint. If your hamstrings are weak or tight, it can make it hard for your leg to fully stretch out forward when running, which means more time in a bent knee position, which can result in knee pain.
Repeated stress on the patella can cause micro traumas and scarring on the knee that can lead to injury such as Patella Tendinitis which affects the tendon connecting your shinbone and kneecap. Other patella conditions include Patellar Malalignment (position of the knee) and Chondromalacia Patellae (break down of cartilage).
Ditching the treadmill for outdoor running this winter? Learn how to layer correctly with our guide on how to dress for cold weather running.
What Are The Muscles In The Knee?
Runner’s knee generally refers to pain in the muscles that attach to the patella ligament at the front of your knee, also known as the anterior knee.
The muscles in the knee are made up by two large muscle groups - the hamstrings that are found behind the knee (posterior) and the quadriceps that join to the front of your knee (anterior) and across the femur.
The four muscles of the quadriceps which control extension of the knee are:
The hamstrings function as knee flexors to bend your knee and are made up of following three muscles:
Knee pain from running will normally be experienced at the front of the knee which will be felt directly around or behind the patella, whereas if you have pain inside the knee this could indicate bone bruising, or an injury to the medial meniscus cartilage which runs through the inside of the knee cap.
Any pain on the side of your knee could be the result of an IT band tear or more serious injury to the lateral part of the knee may down to LCL injury, or lateral meniscus tear.
Please see a medical professional if you're experiencing any long-term knee pain.
10 Knee Strengthening Exercises For Runners
Knee strengthening exercises take into account your entire upper leg muscles. Think of it like a domino effect, if your quads are stronger, your hips will be stronger, which will also make your knees stronger, and the same applies for the hamstrings. Developing hamstring and quadricep strength improves knee flexion, stability, and hip flexion.
Targeting the core will also help to improve your balance and stablilize your body so that your knees aren't under so much pressure, minimizing risk of injury and pain.
So we've put together a series of ten knee strengthening exercises for runners to strengthen the the knee joint and surrounding muscles.
These exercises can be performed together as part of a stretching routine, we recommend repeating each exercise 2-3 times.
Muscles targeted: quadriceps, glutes
Begin in a standing position with your back pressed to the wall and your feet positioned a foot away from the wall
Slide your back down the wall into a squat position
Hold the position for 30 seconds to 1 minute and return to the starting position
This exercises helps to strengthen your quadriceps
Standing Hamstring Stretch
Muscles targeted: hamstrings
Begin in a standing position, keeping your hands on your hips for stability
Step one foot out in front of you about a foot lengths away from the back leg
Lift up straight through the spine keeping the tension, with your shoulders rolled back and hips bent
Pause here for 30 seconds to a minute to feel a deep stretch in your hamstrings
Repeat on the other side
Standing Quad Stretch
Muscles targeted: quadriceps
Begin in a standing position by a wall or chair you can hold onto for stability
Bend one knee bringing it towards your glutes
Hold the position for 30 seconds to 1 minute to feel the stretch in your quads
Return to start position and repeat on other side
Single Leg Glute Bridge
Muscles targeted: hip flexors, quadriceps, hamstrings, glutes, core
Begin lying supine on the floor with your knees bent and hands by your side
Engage your core and lengthen one leg out, keeping one foot on the floor
Push through your foot to slowly lift your hips up into a bridge position keeping your one leg extended
Hold for a second at the top, squeezing your glutes and core
Return back to the starting position and complete 10 repetitions
Repeat on the other side
Step-Up With Knee Drive
Muscles targeted: quadriceps, core, glutes
Begin standing with feet hip-width apart in front of a box, bench or step
Step left foot onto the box and drive the other knee up towards the chest at a 90 degree angle to the hip
Slowly lower the left foot back to the floor and step down
Repeat for 10 repetitions then swap sides
Optional: To advance this exercise, hold a single dumbbell with the hand that’s on the same side as the leg that you’re stepping up with, the opposite hand should be free, and other leg is driving upwards.
Sitting Leg Raises
Muscles targeted: quadriceps, hamstrings, hip flexors
Begin sitting up straight on a chair
Lift one up so it’s horizontal, your quads should be contracted in this position
Keeping the contraction, bend the leg at the knee and return back to the horizontal position
Repeat 10 times then swap legs
Single-Leg Box Step-Down
Muscles targeted: quadriceps, hip flexors, glutes
Begin with your arms raised in front at shoulder height
Stand with left foot firmly planted on a bench, box, or step and the other foot close to the edge
Bend the left knee and slowly lower the right foot straight down the side of the box and touch the floor with your heel
Use your left leg to extend and push into the box, lifting your right leg off the ground and back onto the box
Repeat for 10 repetitions and swap legs
Muscles targeted: quadriceps, hamstrings, glutes, calves
Begin standing with your feet hip-width apart with your hands at your side
Step your left leg forward, keeping your right foot in place and bend both knees at a 90-degree angle
Your front knee should be in line with your toes, and your back knee should be hovering as close to the floor as you can get
Lift your chest and engage your core as you push through the front foot to return to the starting position
Repeat 10 times then switch legs
Optional: To advance this exercise, hold a dumbbell in each hand whilst performing each rep
Lying Hamstring Curl With Dumbbell
Muscles targeted: glutes, hamstrings
Place a single dumbbell vertically on the floor and place one foot either side of the dumbbell
Lower down into a prone position with your elbows and hands beside your head, or head resting on your hands
Engage your glutes
Flex your feet, squeeze the dumbbell with your feet and bend your kneed to lift off the floor towards the glutes, squeezing your glutes and hamstrings as you do so
Hold for a second at the top and lower back down whilst still engaging your legs and glutes
Repeat 10 times
Muscles targeted: glutes, hip rotators
Begin lying on your side with your legs, with your hands rested under your head and legs stacked on top of each other
Bend your knees 90 degrees with hips about 45 degrees keeping your knees and hips stacked
Keeping your feet together, open the knee of the top leg like a clam, rotating through the hip so your knee points towards the ceiling
Engage your glutes and pause at the top
Lower your top leg back down and repeat 15 times
Repeat on the other side
Optional: To advance this exercise, use a resistance band around your thighs, or modify to lift your bottom hip off the ground as you open your hips in a clam
See You At The Finish Line
Incorporating knee strengthening exercises into your weekly routines can help strengthen the muscles around your knees, leading to improved stability and reducing the risk of injury.
If you've just started running, it's even more crucial you focus on stability and mobility so you don't have to suffer with runner's knee later down the line. But no matter where you are in your running journey, it's important not to neglect strengthening the knees so you can run your best, not just at the beginning of your run, but at the last mile too.
Needing some extra support for your knees during your lifting sessions? Learn all about the benefits of wearing knee sleeves and how they can help you your next leg day.