Runners Knee

Runners Knee

Runner’s knee, also called patellofemoral pain syndrome or chondromalacia, is a common knee issue for runners, cyclists, walkers even in most in other sports.

The main symptom is an aching pain around the kneecap (patella) and can be as a result of the following:

1. Overuse injury. Repeated bending and straightening of the knee joint can irritate the nerves situated in and around the kneecap. The tendons can also become overstretched, reducing the stability of the knee joint and resulting in the knee pain.
2. A direct trauma to the knee such as a blow, knock or fall.
3. Biomechanical misalignment. If any part of the skeletal system is out of alignment, the load passing through the joints is not even. The knee is a common joint to take this ‘overload’ and result in pain in the knee joint. Sometimes, the patella itself is out of alignment and can cause the resulting pain. Misalignment could also occur if a runner has a dominant side during their gait or if their footwear has been changed (different shoes have different degrees of support which will distribute the load differently through the joints).
4. Problems with the feet. Runners with flat feet (over-pronation of the ankle) are also more prone to suffering from runner’s knee pain. The tendons and muscles are stretched during the impact of landing which again will reduce the support and causing uneven load through the knee joint
5. Weak musculature. Muscular imbalances around the knee joint will again place uneven load through the joint and could cause uneven load through the knee joint. Hip stability is also paramount as rotating the joint from its neutral position will also place unequal load through the joints.

Other symptoms of runner’s knee could be the following:

• Pain behind or around the kneecap, primarily where the femur and patella meet.
• Pain upon flexion of the knee joint when walking, squatting, kneeling, or even just sitting.
• Pain that is exaggerated upon walking downstairs or down an incline.
• Swelling of the knee.
• A popping or grinding (crepitus) sensation might be felt in the knee.

For most minor to moderate cases of runner’s knee, they should hopefully heal on their own but it can be sped up by doing the following:

• Resting the knee and avoid as much loading through the knee as possible.
• Cryotherapy (Ice/frozen peas etc.) will reduce pain and swelling to the knee. Never have direct contact of ice with the skin – use a towel. This can be done for about 20-30min every 4 hours for a few days or till the pain and/or swelling has gone.
• Compression of the knee joint. Use elastic bandages or sleeves to give the knee support and reduce blood flow to the area. A Physio can also apply strapping to facilitate correct tracking of the patella.
• Elevation of the knee above the height of the hip will facilitate reduction of swelling.
• Controlled stretching and strengthening exercises with correct technique will help to correct incorrect patterning and misalignment issues.
• Orthotics, which will be built up by a podiatrist or you could get them off the shelf (only if recommended by a Physio), may help with pronation of the ankles.