Runner’s Knee: A non-discriminatory form of knee pain

Runner InjuryWhat is “Runner’s Knee”?  Runner’s knee is pain and inflammation that involves the kneecap, quadriceps tendon, and the surrounding soft tissues involved in knee extension. It is caused by irritation and excess loading of the cartilage lining on the under surface of the kneecap and the subchondral bone in the knee. Damage and irritation to the fat pad and other soft tissues in the knee can be sources of pain as well. While as you no doubt guessed runner’s knee is most often associated with long distance running, but any activity that places significant stress on the front of the knee can cause the same symptoms, hence the “non-discrimination”. This includes running, repetitive jumping, weight lifting, prolonged kneeling on rocky ledges, extreme stair climbing etc. Symptoms include pain in the front of the knee and around the knee cap. The pain can linger or even increase after activity and can also be aggravated by sitting for long periods.

Some of the risk factors that can increase you chance of developing runner’s knee are (in no particular order):

• Direct trauma to the kneecap
• Overuse with running and jumping activities
• Valgus collapse or “Knock Knees” resulting in patellar tracking problems
• Weakness or imbalance in the quadriceps and hamstring muscles
• Flat feet/overpronation

As there are multiple risk factors, strategies for prevention are also diverse. First make sure you have the right equipment. Use the proper foot wear including orthotics if necessary, if you are unsure what the proper foot wear is go to a reputable shoe store, run coach or podiatrist and have someone help you determine what the best foot wear is for you and your goals. While bicycling is typically considered a low impact activity the repetitive motion over several miles can cause significant stress to the knee if your set up is not right, so if you are having knee pain with bicycling a proper bike fit is a good place to start. Strength and flexibility training with obvious emphasis on the muscles affecting knee joint stability and motion is key: quads and hamstrings, plus work on the calves and hip muscles as well.

Conservative treatment for this condition is relatively straight forward most of the time. Avoid aggravating activities (if it hurts don’t do it). Correct imbalances, faulty biomechanics and tracking problems through exercise, movement training, and possibly bracing or taping; then gradually return to your normal pain free activity. I know for some of you however rest is not a word you understand or accept, so here are some other options for you. If running is your passion you can make several modifications that may help reduce the stress on the knee and reduce the discomfort:

Reduced body weight running in an AlterG anti-gravity treadmill is a great way to get your miles in pain free.

If you run a lot of hills or on the sidewalk you can reduce your impact by switching to running on a flat artificial track such as the one you might find at your local high school.

Losing weight.

Switching to a lower impact activity while you allow your body to recover such as swimming or biking is a great way to stay active without aggravating the affected tissues.

Anti-inflammatory medications can help relieve the pain, but be cautious, pain is one of your body’s ways of telling you something is wrong. Follow all warnings on the label and know that prolonged use can inhibit your body’s natural repair process.