Original Research

Anterior knee pain and its intrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng

Siyabonga H. Kunene, Serela Ramklass, Nomathemba P. Taukobong
South African Journal of Physiotherapy | Vol 74, No 1 | a452 | DOI: https://doi.org/10.4102/sajp.v74i1.452 | © 2018 Siyabonga H. Kunene, Serela Ramklass, Nomathemba Taukobong | This work is licensed under CC Attribution 4.0
Submitted: 06 February 2018 | Published: 13 September 2018

About the author(s)

Siyabonga H. Kunene, Department of Physiotherapy, University of the Witwatersrand, South Africa
Serela Ramklass, School of Clinical Medicine, University of KwaZulu-Natal, South Africa
Nomathemba P. Taukobong, Department of Institutional Planning, Sefako Makgatho Health Sciences University, South Africa

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Background: Anterior knee pain (AKP) is the most common injury among runners, especially in females and young runners. Because of a deficit of rehabilitation services in under-resourced communities, runners train and compete with injuries, resulting in further complications.

Objectives: This study aimed to determine the prevalence and modifiable intrinsic risk factors for AKP among runners in under-resourced communities in Ekurhuleni, Gauteng Province.

Method: This cross-sectional study included a population of 347 runners from six running clubs. Convenience sampling was used to recruit 183 participants aged between 13 and 55. A standardised questionnaire determined AKP prevalence, and 12 physical tests screened for modifiable intrinsic risk factors. Descriptive and inferential statistical tests were used to analyse the data.

Results: AKP was present in 40% of participants, particularly in males (57.9%) and young runners (57.9%) with 3–5 years of running experience (31.1%). Anterior knee pain was significantly associated with age (chi-square [χ2] = 6.484, p = 0.039) and running experience (χ2 = 8.389, p = 0.036). The modifiable intrinsic risk factors found to have contributed significantly to AKP were: tight hamstrings (odds ratio [OR] = 1.021; p = 0.051); tight iliotibial band (OR = 1.1; p= 0.046); weak quadriceps (OR = 0.15; p = 0.040); weak hip muscles (OR = 1.13; p = 0.004) and patellar tilt abnormalities (OR = 1.33; p = 0.015).

Conclusion: Anterior knee pain and various modifiable intrinsic risk factors were found among these runners. These findings suggest that management of AKP should take into consideration the effect of these identified modifiable risk factors to improve management outcomes. A community-based rehabilitation approach should be considered, given the lack of resources in low socio-economic communities.

Clinical implications: The results from this study make explicit the risk factors associated with AKP, particularly in runners from under-resourced communities. These are important considerations in the development of rehabilitation programmes to manage AKP.


anterior knee pain; prevalence; modifiable intrinsic risk factors; runners


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