Running is an easy and effective way to improve your fitness, and is usually suitable for almost any healthy sports enthusiast. After a couple of weeks of training, you can experience the joy of running, which is refreshing for both the body and the mind. Anyone who enjoyed moving around as a child will surely agree with the statement that people have an innate passion for running and a desire to run.

However, running does not always go smoothly. The muscle and tendon discomforts that appear while running are certainly familiar to every runner. Most of these would be preventable with proper warm-up and light stretching. The importance of initial warm-up in the prevention of muscle and sprain injuries increases in cold weather. If these aches extend over time, then running should be temporarily interrupted, or replaced by cycling or other exercise until the symptoms have ceased.

Runner’s knee and anterior knee pain are the most common stress injuries affecting knee joint. Runner’s knee is a discomfort that feels like pain on the outer side of the knee. In this stress injury, the fascia of the outer thigh, the so-called tractus iliotibialis, causes friction at the femoral condyle during the knee flexion and extension. The most common cause for developing a runner’s knee is running too much too fast, running on slippery roads, or in slopes as well as a foot /ankle malalignment (often over pronation). For example, running downhill can expose a runner to this injury.

Anterior knee pain occurs on the front of the knee and it often affects the kneecap or the tendons attached to it. This affection is usually caused by a loading failure affecting front side of the knee during running, which may be due to, for example, weakness of the quadriceps muscle, poor muscle balance between the quadriceps and hamstrings, tightness of the hamstrings, or a malalignment of the ankle or pelvis.

Both of these stress injuries cause pain in the knee area, which often gets worse while running, even to the point that the runner is forced to stop. Treatment primarily consists of avoiding pain-inducing stress and proper physiotherapy: improving the quadriceps strength and muscle balance, pelvic core training (gluteus), correcting any possible malalignment (ankle, knee, pelvis), stretching and massage.

The stress injuries described above rarely require surgical treatment, although in the most severe cases, recovery from runner's knee may take months. However, when diagnosing and treating these typical injuries of runners, it is important to remember that sometimes knee pain may be caused by, for example, meniscus lesion or knee cartilage damage. In addition, athletic adolescents have their own specific knee-related stress injuries that should be considered when pain occurs. If symptoms get worse or prolonged over time, it is advisable to seek an expert to confirm the diagnosis and undergo the best suited treatment.

Lasse Lempainen
Orthopaedic Surgeon