In this article, we’ll explore runner’s knee, which I also call office knee, as it affects both the runner and the seated office worker/long commuter alike. We’ll delve into what runner’s knee actually is, some other names and conditions it’s diagnosed as, and the role of the vastus lateralis and vastus medialis muscles in the condition.
Runner’s knee, which is often diagnosed as just arthritis, is actually a patellofemoral issue that causes pain around the front of the knee. It’s a common condition among runners, but can also affect athletes of all sorts, as well as individuals who sit for long periods of time. The pain is felt when walking or running, typically gradually getting worse once it starts. Pain is also sometimes felt going up or down stairs, or in exercises that require the knee to be loaded intensely or with volume, like your squat lunge/variations.
The exact cause of runner’s knee is believed to be related to the way the patella (kneecap) moves along the femur (thigh bone). The patella is held in place by the quadriceps muscle group, which includes the vastus lateralis and vastus medialis muscles. These muscles attach to the patella and work together to control the movement of the kneecap.
Many people who do a lot of long distance running or have to sit for long stretches of time can become anterior dominant. This means that muscles in the front of the body, in this case the quadriceps, become stronger than the muscles on the back of the body, in this instance the glutes and the hamstrings. This becomes an issue because human beings are posterior dominant in nature. Consequently, the posterior muscles can usually handle more volume than the anterior muscles. Human beings can get runner’s/office knee because they overuse their quadriceps while greatly under utilize their glutes and hamstrings. We see this in distance and recreational runners because they rarely achieve full hip extension as they are usually jogging and not sprinting. Office workers are seated for much of their day, which turns on the hip flexors and causes the glutes to be completely inactive.
Research has shown that the vastus lateralis and vastus medialis play a key role in the development and treatment of runner’s knee. The vastus lateralis is a large muscle on the outside of the thigh, while the vastus medialis is much smaller and located on the inside of the thigh. These muscles work together to stabilize the patella and control its movement during activity.
In some individuals with runner’s knee, the vastus lateralis may be overactive or “dominant,” leading to a shift in the patella’s position and increased stress on the joint. Conversely, the vastus medialis may be weaker or underactive, which can contribute to instability and improper tracking of the patella. These mechanics can cause a problem in the way the patella moves along the femur. Many times irritation and inflammation of the cartilage and soft tissues surrounding the knee cap are the result. This can lead to pain and discomfort.
Treatment for runner’s knee typically involves addressing the underlying mechanical issues that are contributing to the condition. This may include exercises to relax the quadriceps muscles, enhance knee stability, strengthen the glutes and hamstrings, and improve the overall balance of the quadriceps muscle group.
If you or someone you know is having a knee issue like this, send them to MadLab Performance. We’ll take care of them!
Dan Gilbert, CSCS