What is Runner’s Knee?

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Runner’s knee is the nickname given to a condition called Patellofemoral Syndrome (PFS) or Patellofemoral Pain Syndrome (PFPS) as it’s sometimes called.  The patella is the kneecap, and patello is the Latin version of the word from which it originated.  Femoral refers to the thigh bone (femur), and Syndrome is basically a collection of symptoms.  Altogether PFS essentially covers any pain or disorder that affects the knee cap or femur.

How to know if you have runner’s knee

One of the first things you will notice with runner’s knee is the pain.  Any movement, particularly sports could make the pain flare up.  It will usually happen after an extended training session and the pain will be prominent around or just under the knee cap area.  Most patients describe the pain as a dull ache or pressure, however, some experience a very sharp pain too when carrying out certain movements, such as doing squats or going down the stairs.

What causes it?

Runner’s knee is a problem in the joint that lies between the knee cap and the femur.  It happens when there’s an increased friction in the joint and can be caused by any of the following:

  • Muscle imbalance:  Sometimes the Vastus Lateralis and ITB muscles, that are located on the external side of your thigh, become stronger than the Vastus Medialis and adductors that are located on the inside of the thigh.  As a result the patella gets dragged away from the groove.
  • Wearing a knee support:  It’s not uncommon to see a runner wearing a knee support.  Many of them do this just to keep the joint warm.  The problem is that sometimes, knee supports can do more damage than good, especially those that encase the whole knee and don’t have a hole for the patella to fit through.  These put a great deal of pressure on the knee cap.
  • Tight quadriceps or iliotibial band (ITB):  If these muscles become too tight an increased pressure is put on the on the knee cap and femur.  This pressure creates friction in the joint that could eventually wear out the cartilage and lead to osteoarthritis (OA) if not treated soon enough.
  • Falling arch in foot:  A falling arch in the foot causes the rear foot to rotate and drag as a result.  The knee cap then has to sit in a diagonal position in order to adapt.
  • Chondromalacia:  This is degenerative disease that affects the cartilage in the joint.  As a result the bones are unable to move smoothly and the joint becomes severely inflamed.
  • A misaligned knee cap:  If the knee cap doesn’t sit properly in the groove of the femur, friction is created whenever there is movement.  This happens where the bone’s not covered in cartilage and causes a great deal of inflammation as the bones rub against each other.
  • Muscle tightness:  If you suffer with muscle imbalance or use one side more than the other chances are those muscles are tighter, causing the patella to be dragged from its groove.
  • Wide hips:  Having wide hips means your legs need to rotate slightly making the knees point inwards when walking.
  • Congenital bone malformation:  This is a rare condition in which the patella naturally doesn’t fit in the groove.
  • A micro-patella:  A smaller patella in comparison to the femur will create an added pressure on the joint and make people more susceptible to develop a friction problem.

What treatment is available?

There are various treatment options available for runner’s knee, depending on the severity of it.  Here are a few of them:

  • Firstly and most importantly you need to control the inflammation and the best way to do this is with ice and physiotherapy.
  • If you have wide hips or falling arches, try a stretching to limit the risk of muscle tightness and to improve your posture.
  • If you know you have a micro-patella then the only real way to limit the damage is by ensuring your muscles are kept flexible and balanced.  This will decrease the risk of pressure build up in your joints.  Also make sure you use ice after every training session to keep inflammation down to a minimum and wear good orthotic insoles.
  • For tight quadriceps and ITB a stretching is recommended to relieve some of the pressure on your knee cap.
  • If you wear a brace, just ask yourself if you really need it.  If you think you could manage without it, it may be worth removing the brace altogether.  Just check with your physician or a brace specialist to see what they advise first.

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