Is ‘runner’s knee’ a real problem?

Is ‘runner’s knee’ a real problem (and is it as big a one as people think?)

‘Runner’s Knee’ could be any one of many diagnoses, so, as a term, it is not really a diagnosis – it is a symptom. Consider this: Meriam Webster’s “Medical Definition of ‘Runner’s Knee: pain in the region of the knee especially when related to running that may have a simple anatomical basis (as tightness of a muscle) or may be a symptom of iliotibial band syndrome or chondromalacia patellae.” It can be a real problem, and it can be a big one if not well understood by the patient or treating healthcare provider, like a physical therapist. If your pain does not subside quickly after running, or is so bad that you cannot increase your running distance due to pain, then it is best to get a full mechanical evaluation from a trained provider (and given the answer to question 1 above, imaging should not be necessary first.)

How do your knees affect your stride?

Technically speaking your knees (the joint parts) do not affect stride since running is a “mid-range” motion. Walking, on the other hand, does involve end range extension, so limited extension could have an effect – but not in running. Pain in the knee is likely to affect your ability to tolerate a running stride, and your body will find ways to avoid pain – thus affecting your stride in varying ways. There is no typical way this happens, so if you have knee pain, you need to have a good mechanical examination to find out how to best treat or manage it.

What is a surprising fact about knees that most people don’t know? 

The most relevant misinformation about knees for patients is that radiologic findings (either x-ray or MRI) are what’s responsible for their pain. On the contrary – something ‘wrong’ found in imaging is most likely NOT associated with pain! In one study of 24 elite athletes NOT complaining of knee pain, “EVERY knee imaged had at least one structural anomaly” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083196/). The rate of “false positives’ (what researchers call it when a positive test for a disease is incorrect because the patient does not actually have the disease) varied from around 50% to 80% in this study. So, if your knee hurts, and you get a radiological diagnosis, you have a high chance of getting misdiagnosed. Better to get a full examination to get a better clue as to the source of pain. 
Nick Rinard MPT; Cert. MDT