Runner’s Knee

What is Runner’s Knee?

Runner's knee, also called patellofemoral pain syndrome, refers to pain under and around your kneecap. Runner’s knee includes a number of medical conditions such as anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella that cause pain around the front of the knee. As the name suggests, runner’s knee is a common complaint among runners, jumpers and other athletes such as skiers, cyclists, and soccer players.

Anatomy of the Knee

Pain usually occurs under or around the front of the kneecap (patella) where it attaches with the lower end of the thighbone (femur). The patella, also called kneecap, is a small flat triangular bone located at the front of the knee joint. The kneecap or patella is a sesamoid bone that is embedded in a tendon that connects the muscles of the thigh to the shin bone (tibia). The function of the patella is to protect the front part of the knee.

Causes of Runner’s Knee

Runner’s knee can result from poor alignment of the kneecap, complete or partial dislocation, overuse, tight or weak thigh muscles, flat feet, and direct trauma to the knee. Patellofemoral pain often comes from strained tendons, and irritation or softening of the cartilage that lines the underside of the kneecap. Pain in the knee may be referred from other parts of the body, such as the back or hip.

Symptoms of Runner’s Knee

The most common symptom of runner’s knee is a dull aching pain underneath the kneecap while walking up or downstairs, squatting, kneeling down, and sitting with your knees bent for long period of time.

Diagnosis of Runner’s Knee

To diagnose runner's knee, your doctor will review your symptoms, medical history, any sports participation and activities that aggravate your knee pain. Your doctor will perform a physical examination of your knee. Diagnostic imaging tests such as X-rays, MRIs, and CT scans, and blood tests may be ordered to check if your pain is due to damage to the structure of the knee or because of the tissues that attach to it.

Treatment of Runner’s Knee

The first treatment step is to avoid activities such as running and jumping that cause pain. Treatment options include both non-surgical and surgical methods.

Non-surgical Treatments for Runner’s Knee

Non-surgical treatments consist of rest, ice, compression, and elevation (RICE protocol); all assist in controlling pain and swelling. Your doctor may recommend an exercise program to improve the flexibility and strength of the thigh muscles. Cross-training exercises to stretch the lower extremities may also be recommended by your doctor.

Other non-surgical treatments include:

• Knee taping: An adhesive tape is applied over the patella, to alter the kneecap alignment and movement. Taping of the patella may reduce pain.
• Knee brace: A special brace for the knee may be used during sports participation, which may help reduce pain.
• Orthotics: Special shoe inserts may be prescribed for those with flat feet, which may help relieve the pain.

 Surgical Treatments for Runner’s Knee

In some cases, you may need surgery, which includes arthroscopy and realignment. During arthroscopy damaged fragments are removed from the kneecap, while realignment moves the kneecap back to its alignment, thus reducing the abnormal pressure on cartilage and supporting structures around the front of the knee.

Prevention of Runner’s Knee

The following are the ways to prevent runner’s knee:

• If you are overweight, you may need to control your weight to avoid overstressing your knees.
• Gradually increase the intensity of your workout.
• If you have flat feet or other foot problems, use shoe inserts.
• Avoid running on hard surfaces.
• Wear proper-fitting, good quality running shoes with good shock absorption.
• Avoid running straight downhill. Instead, walk down or run in a zigzag pattern.
• Warm-up for 5 minutes before starting any exercise. Also stretch after exercising.