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Knee Pain: Runner's Knee

Aching pain behind the kneecap. Pain begins and progresses slowly. It appears in healthy, athletically active young people between 12 and 35 years old, and is twice as common in women as in men. This is the most common knee problem for runners.

In the normal human body the kneecap, which is also known as the patella, will move up or down slightly without touching the femur or thighbone when a person is running. This is because the impact of the body weight is evenly distributed on the foot. But in cases where the foot rolls inward the kneecap is pulled inward. When this occurs the quadricep muscles will naturally pull the kneecap outward. These two opposing forces will cause the kneecap to rub against the thighbone which results in the diagnosis of runner's knee.

Causes

• Muscle imbalance or compression at the knee that pulls the kneecap sideways out of normal alignment.
• Direct blow to the kneecap.
• Injury resulting from extreme flexing of the knee, as in squatting and kneeling.
• Congenital abnormal development in the knee.
• Overstress of the knee as can occur in any running sport, such as jogging, sprinting, football, basketball or soccer.

Signs and symptoms

• Pain beneath or on the sides of the kneecap crepitus (grinding noise), as the rough cartilage rubs against cartilage when the knee is flexed.
• Pain is most severe after hill running.
• Swelling of the knee

Diagnosis

• Diagnosis of a runner's usually is confirmed with a complete medical history and a physical examination.
• X-rays of the knee to rule out fracture. Special views can reveal misalignment or tilting of the patella.

Treatment

Medical Treatment

• Often none is necessary after diagnosis and prescription of medications and special shoes (sometimes).
• Rehabilitation of the quadriceps muscles and hamstrings is sometimes necessary following surgery.

Home Treatment

• Rest is essential. Trying to "Work through" or "run through" pain worsens the condition.
• Don't kneel or climb stairs unless you must.
• Apply ice bags for 10 minutes 3 or 4 times a day for 3 to 4 days.
• After ice treatments end, apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Your doctor may prescribe hotchpotch shot devices, knee straps or braces.

Prevention

• Strengthen and condition upper leg and hip muscles for maximum strength, flexibility and endurance before you start competition or vigorous physical activity.
• Avoid deep squats or activities that compress the kneecap.
• Don't use knee wraps for weight-lifting. Wraps increase knee compression.