What is Runner’s Knee and How to Avoid It?

If you love to run, you probably are no stranger to the everyday aches and pains of muscles, tendons and ligaments as they rest and heal after a good long run. You also have learned to tell the difference between “normal” pain and pain that indicates an injury may have occurred.

Running relies a great deal on the efforts of the hip, knee and ankle joints, but the knees tend to be particularly vulnerable to running-related injury. In this article, learn more about one single injury that accounts for up to 16.5 percent of all runner’s injuries – runner’s knee.

What Is Runner’s Knee?

The official medical name for runner’s knee is patellofemoral pain syndrome, or PFPS. The name arises in part from the word patella, which is the medical term for “kneecap.”

Unfortunately, while doctors found it easy enough to come up with a name for runner’s knee, they still aren’t completely sure what causes it. The current reigning theories for why some runners and cyclists may be more susceptible to runner’s knee than others include the following:

  • Past surgical trauma.
  • Overuse of the knee joint.
  • Past history of injury to the kneecap itself.
  • Muscle weakness or imbalance surrounding the knee joint.

Doctors have also created a profile of who is more at risk to develop runner’s knee:

  • Younger runners (teens through early adulthood). The theory here is that a more mature or senior runner’s knee pain is more likely to stem from arthritis rather than pure runner’s knee.
  • Female runners. Here, it is thought the wider pelvis causes the bones of the knee joint to intersect at more of an angle.
  • Overweight or obese individuals. People carrying excess weight can put extra pressure on the knee joint just from daily activities.
  • Some sports or exercises. Jumping, lunging, squatting, stair-step movements and even just sitting with bent knees can all cause more pressure on the knee joint. Also, some professionals, especially those that involve manual labor, can negatively impact the knee joint.

It is also important here to note that “runner’s knee” is not an injury exclusive to runners. Athletes that pursue other sports, individuals whose careers require a lot of physical exertion and non-runners can also develop the condition.

What Are the Symptoms of Runner’s Knee?

While doctors are not yet certain exactly what causes runner’s knee, they do understand the general range of symptoms the condition can cause.

Here is a general list of commonly reported patient symptoms:

  • Dull pain in front of, behind or just under the kneecap area.
  • Popping or grinding of the knee joint.
  • Sudden buckling of the knee joint.
  • Swelling around the knee joint.
  • Pain that arises in the kneecap area but the exact location can’t be identified.
  • Pain that comes and goes and is worse during certain activities, such as walking down stairs or after sitting or laying down for a time.

There can be other symptoms as well, but these are generally the symptoms used to make an initial diagnosis of runner’s knee.

How Is Runner’s Knee Diagnosed?

To date, diagnosing runner’s knee has primarily been a process of elimination. In other words, after ruling out all other potential causes for knee pain, runner’s knee is the explanation that remains.

The first step in the diagnostic process occurs when the person begins to feel symptoms and seeks out medical care. Often the first point of contact is the family physician, who will then do a basic exam, take a list of symptoms and perhaps order some tests.

These tests will not be able to diagnose runner’s knee, since currently there is no known diagnostic process specific to this condition. However, the tests can rule out other conditions with similar symptoms. Tests may include blood work, X-rays, CT scans or MRI scans.

If nothing catches the doctor’s attention from the patient’s test results and the patient matches one or more of the risk factors mentioned here (see earlier section), a diagnosis of runner’s knee will likely be rendered.

What Type of Treatment is Available for Runner’s Knee?

Luckily, the treatment process is slightly more precise than the diagnostic process. With proper treatment and rest, up to 90 percent of all patients will recover fully.

The first step in treatment is to determine the degree of mis-alignment in the knee joint. This can help doctors and physical therapists create a customized treatment plan to strengthen surrounding muscles and reduce pressure on the knee joint area. In most cases, surgery is not recommended and physical therapy is the preferred course of action.

It can take up to six months before physical therapy begins to deliver lasting results, and in most cases the exercises will need to be continued after recovery has been achieved. This will safeguard against a recurrence of runner’s knee.

Other treatment helps that can relieve pain and promote healing include these:

  • RICE (Rest, Ice, Compression, Elevation). This is particularly beneficial when done in the first 24 hours following an injury.
  • Icing the knee to reduce inflammation as needed.
  • Moderating or eliminating certain activities or exercises.
  • Over the counter pain relievers and anti-inflammatories as needed.
  • Using sports tape to stabilize the knee.
  • Using shoe inserts or insoles to correct mis-alignment or gait issues.
  • Switching to low-impact fitness training (such as the elliptical machine).
  • Taking more frequent breaks while exercising or training.
  • Trying different footwear.

Can Runner’s Knee Be Prevented?

Since the causes for runner’s knee are not well understood, it is not possible to verify if total prevention is possible.

However, there are some steps that can reduce the likelihood of developing runner’s knee, including running on low-impact surfaces, wearing the right footwear, increasing running or cycling distance gradually and strengthening all muscle groups required for the activity being done.

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