Conditioning: Phase 2

The following is the second of four phases that will guide you from Runner’s Knee injury toward healthy running. Progress from each phase as instructed.

Duration: 2 Weeks (at least)
Goal: Introductory Loading and Strengthening
Frequency of Exercises: 3 x per week (day off in between). Stretching can be done daily.
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up).

Squats (With Band): 3 x 8 reps (slowly: 3 seconds down, 3 seconds up). With your legs parallel, slowly lower to the ground by bending your knees to 90 degrees, mild pain okay (<3/10). Purpose: increase load capacity of the knee and IT Band.
Single Leg Glute Bridges: 3 x 12 reps. On your back with one knee up. Bring hips up and down slowly. You should feel muscle work on the thigh and hips. Purpose: increase glute strength to reduce knee caving in.
Front Plank: 3 x 30 seconds or until fatigue. On your elbows and knees, bring your knees off the ground and hold. Try to keep your body level throughout this exercises by keeping your hips level and engaging your abdominals and glutes. Keep your elbow below your shoulders and push up to engage your scapular muscles. Purpose: strengthen core and glutes for running form stability.
Side Steps (With Band): 3 x 12 steps (each direction); some pain okay. Place the band around your foot/ankles, step side to side in a slight squatting position while keeping your body aligned and your feet facing forward. You should feel muscles working on the side of your hips. Purpose: increase glute strength to reduce knee caving in.

Side Planks: 3 x 30 seconds (each side, or until fatigue). With elbow aligned with shoulders, come up on your side. Keep your body straight throughout. Purpose: improve hip strength and core stability to reduce risk of knee caving in.
Single Leg Calf Raises (On Step): 3 x 12 reps (each leg). Place your toes on a step with heel off of the step. Come up and down, raising straight up in the air without moving forward. Purpose: increase calf strength to reduce knee flexion with running.
Single Leg Balance (Moving): 3 x 30 seconds (each leg). Stand with both hands on your hips and your feet directly under you. Keeping your pelvis as stable as possible, bring one leg up without causing your pelvis to tilt or rotate. Once stable, bring one leg slightly up, moving it out, forward, out, and then back in an arch-like motion. Purpose: improve postural balance and stability.
Walking and/or Biking, or can begin a Run/Walk Progression.

Stretching: Quads and Calves (1 minute per side). Purpose: reduce compression forces on knee.
- Quads: With one leg on the table/couch/bed, the other leg is off the table. Grab a belt or two (or Resistance Strap) and hook one end on your foot that is on the table. With your body aligned up straight, begin to pull your heel towards your hips until you feel a moderate stretch in the front of the thigh. Hold for at least one minute. If pain increases, place a towel under your thigh to pre-stretch the quad.
- Calves: 1 minute per side. Standing with one foot back, place your toes on a half roll or rolled-up towel to increase stretch. Lean forward while keeping your knee straight.
- Hip Flexors: In the kneeling position with your arms supported on the wall, engage your abdominals by doing a posterior pelvic tilt (i.e. low back is flattened with a limited curve). Engage your glutes on your kneeling side and keep your body as a unit until you feel a stretch in the front of your hip. You may increase your stretch by leaning away from the side.

TO GRADUATE TO PHASE 3

You should be able to do a squat (10 reps) and split squat (10 reps) with no more than 1/10 pain level for at least 4 consecutive exercises sessions. (See below for video reviews of each exercise).

Principles of Runner’s Knee: A Review

CAUSE – overuse and/or overloading of the patella
NEED – offload and reduce compression forces on the patella, and also increase quad and glute strength
PLAN – once pain is decreased, gradually reload the patella to increase strength

Still Need Help?

You are welcome to meet virtually with our PT for additional feedback and assessment. Otherwise, continue to the next step to learn how best to manage the pain from your injury.