Knee Pain – Heather Camenzind

Mark: Hi, it's Mark from Top Local. I'm here with Heather Camenzind and she's a physiotherapist at Insync Physio in Vancouver in the Cambie Street area. And we're going to talk about knee pain while running. How are you doing Heather? 

Heather: I'm good. Thanks for having me Mark. 

Mark: So knee pain from running. This is a new thing, or there's been an increase in it because of something. 

Heather: Yeah, it's not a new thing, treated a lot of it before. But I'm seeing an increase in the past year. I think with the current status of our globe and with the pandemic, we're seeing a lot of people that have taken up running as their form of exercise with the gym schedules being modified and closed. So I'm seeing an uptake in the clinic with knee pain. 

Mark: So is there specific things that cause knee pain from running? 

Heather: There's many different causes. But a lot of them that we're seeing is a breakdown for the underside of the knee cap. So it's basically, it's a rubbing on the underside of the kneecap on the end of the femur bone. And there can be different causes to why that breakdown is happening. And so that's why a physiotherapist can help with that. 

Mark: So what's the protocol. What does treatment look like when you're faced with a client coming in? 

Heather: Yeah, a typical treatment will start with a history of how long that they had the pain. Where does the pain, can they describe it? And you just have a good chat about that. And what are some factors that may be contributing to that? So changes in current training schedule, have they significantly increased how much they're running or the terrain that they're running on? 

Other things that can affect it are their footwear? Have they made a change to their shoes? Or lifestyle changes. So that's what we're seeing a lot of right now is the lifestyle changes. I think people are trying to be active, but we're also told to stay at home a lot right now. And so I think people are sitting more than they typically would in the past.

Mark: So give us a couple example things of how you would treat this. Couple of causes, a couple of treatments. 

Heather: Yeah, so different ways that we can treat it is sometimes it's just that the hip flexors and the quads are more tight. And so we have to release the tension through there. So the physio might work with some manual therapy on that, and then give you some exercises such as foam rolling, and some stretches to open up the quad and the hip flexors.

Another common thing that we're seeing is that people are weak in their glute muscles. So, especially their glute medius muscle. That's the muscle on the side of your hip that helps control the alignment of your knee. And a lot of just like leg lifts out to the side. Or like your figure four stretch is a very common stretch that people know, are ones that can help with that hip tightness that will help with the alignment of the knee.

Mark: And what's I know it's case dependent, of course, but what would be a more typical treatment program and what might it affect how effective it is? 

Heather: Yeah, so different things that can affect like how much progress you see is a, I counsel people on is kind of like, the more often you do your exercises and how frequent you do them, you'll get a better bang for your buck so to speak. If you're consistent with them, you'll notice progress sooner and faster. If you're maybe do them once a week, yeah, you may get there. It will improve. It'll probably just take a lot longer. So the more consistent that you are at home the better it is. You only really see your physio probably once a week maybe for maybe half an hour, 45 minutes an hour, if you're lucky. So there's so many more hours in the day that you can be working on things yourself. 

The other thing is just, can the physio diagnose and figure out what is the major contributing factor for you? Is it just a modification that needs to be done to your training program? Have you increased things too quickly? Or can they narrow in on the specific weaknesses that are contributing to your knee pain. Such as glute weakness, or maybe it's your running shoe? So it's proper diagnosis of what is the main cause. And then you'll start to see progress. Typically we see progress within six to eight weeks that you're seeing significant progress with it.

Mark: And I guess depends on how much the pain is and the cause whether somebody has to totally stop their running program in order to let the healing happen. How does that work? 

Heather: Exactly. So some people come in and they're, they're very flared up. Everything is hurting, just walking and it's very sore. Those people benefit from just allowing their nervous system, allowing their body, the inflammation that's there to calm down.

So we have to say, I'm sorry, you have to stop running right now. Others it's maybe their knee pain only comes in 45 minutes into their run or something. It comes on later and then their body tolerates it quite well. They don't really get too aggravated after. So those people we're able to work with them and just modify their running program and get them doing the right exercises. And then we're able to maintain their running. So it depends on the person. And sort of a case-by-case basis on what I typically recommend for them. 

Mark: So if you put the work in and you listen to your physio and have the right shoes and don't crank it up too much, within six weeks, eight weeks, you're probably back running as hard as ever and all the things you want to do without pain.

Heather: That's the hope. Yeah, definitely. 

Mark: So there you go. If you want some expert advice on how to deal with your knee pain while running, or any kind of knee pain or any kind of shoulder problems or neck or back, or you name it basically toes to the top of your head, this is a person to call. Heather Camenzind. You can reach her at Insync Physio to book an appointment. Insyncphysio.com book online. You can see there, they've got both the Vancouver and Burnaby booking systems are hooked up. Very easy to use. Or call the office at 604-566-9716. Thanks Heather. 

Heather: Thank you very much. Bye.