What Are The Symptoms Of A Runners Knee
The main symptom of a runners knee is a pain on the lateral or outer side of your knee. You can also feel pain in different parts of the iliotibial band somewhere between your hip and your knee.
You can usually feel swelling on the outer side of your knee, and it hurts when you put pressure on this spot.
That is the tendon of your iliotibial band.
This pain can occur during running, walking or climbing stairs. Symptoms may vary according to the severity of your condition. It can be a dull, stabbing or sharp pain.
Usually, in rest, you dont feel pain at all but when you start moving your knee it, may feel stiff and tight. You may be able to walk it off sometimes partly.
Unfortunately, its not entirely clear what causes a runners knee. There are however a few factors that may contribute to the arising of a runners knee.
A study suggests that excessive hip adduction increases the tension on the iliotibial band. Due to the adduction of your hip, your iliotibial band stretches. When you put a load on a pulled muscle or tendon, it tends to harden, making it tens.
Limited strength of your hip abductors like your glutes, increases hip adduction. Training your hip abductors may overcome this cause for iliotibial band friction syndrome.
Another study suggests that an increase in internal rotation of the knee is a risk factor for developing runners knee.
It positions the insertion of the iliotibial band more anterior.
Surgery For Runners Knee
Surgery is rarely indicated for patellofemoral knee pain. If all conservative measures have failed and an individual is unable to participate in desired activities without significant pain, a surgeon may attempt to alter mechanics of the knee through a procedure such as a lateral release. In this procedure, the lateral patellofemoral ligament is cut to decrease the pull on the patella to the outside of the knee and attempt to improve tracking along the trochlear groove of the femur. The decision for surgery requires a lengthy discussion with the surgeon, reviewing several factors, including: the medical history of the patient; the likelihood for success of the procedure; and whether or not it will restore the individuals ability to perform athletically.
Fortunately, with appropriate pelvic and lower limb strengthening and modification of risk factors for patellofemoral pain, the vast majority of cases resolve and individuals can return to their full athletic potential.
What Is Runners Knee What Does It Feel Like
Runners knee is the name commonly used to describe two different medical conditions:
- Patellofemoral Syndrome
- Iliotibial Band Syndrome
The disorders that often cause runners knee include:
- Knee Injury Due to Trauma
- Repetitive Motion
- Weak Muscles in the Upper Leg
- Foot Problems That Cause the Patients to Walk Differently
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Additional Treatment For Iliotibial Band Syndrome
It may be a good idea to have an analysis of your running stance, technique and footwear at this point. Having an expert evaluate and tweak your technique can help tremendously.
A strengthening program, physical therapy and exercises, and manual therapy such as trigger point work can help, too.
Runners Knee Myth: My Kneecap Doesnt Track Properly
This is the most commonly cited cause of runners knee. The idea is that the patella tracks within the groove in your femur. But when it doesnt slide evenly in this track, you can end up with PFPS.
This tracking problem is why most treatments focus on
- strengthening the quadriceps
- stretching the IT Band
- using knee braces
- taping the knee
But unfortunately, theres no clear relationship between a tracking problem and your PFPS .
The patella is more dynamic than we give it credit for: it can move all over the place. If you lie down so your leg is straight and youre not holding any tension in your knee, youll notice the patella seems to hover over the knee joint. Manipulating it in all directions is quite easy.
Like many things in biology, theres no clear definition of what normal tracking is for the patella. Several studies have shown that tilting or displaced kneecaps during activity shouldnt be construed as abnormal. Indeed, abnormal may be normal!
Healthy knees do all kinds of weird things and its virtually impossible to tell an injured knee from a healthy knee by looking at the position of the patella.
So if your treatment focuses on correcting the alignment or function of your patella, you should find better treatment.
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Why Choose Cooper To Diagnose And Treat Runners Knee
Cooper University Health Care has a team of seven fellowship-trained and board-certified sports medicine specialists with extensive experience in diagnosing and treating runners knee. You can count on us for:
- Fast access: Our policy is to see patients within 24 to 48 hours of a sports injury, whenever possible
- Comprehensive diagnostic resources: Your doctor will take a thorough health history, perform a physical exam, and order state-of-the-art diagnostic imaging, when necessary
- Personalized treatment: Treatment is personalized based on your age, general health and severity of symptoms, and may include:
- Rest/restricting activity until the pain subsides
- Cold packs to reduce pain and swelling
- Elevating the leg
Runners Knee: Anatomy And Causes
Structurally, your knee joint is composed of three bones: the lower end of the femur , the upper end of the tibia , and the patella . There are four ligaments that stabilize the joint and bones. Muscles in the knee are connected to the bones by tendons. And, articular cartilage in the joint both protects other components and enables smooth, easy movements to take place.
Patellofemoral pain syndrome impacts the nerves within the soft tissues and bones around the kneecap. Another knee condition that may occur simultaneously is chondromalacia patella, which refers to the breakdown of the articular cartilage beneath the kneecap. This doesnt directly cause pain, but the softening of this cartilage can cause inflammation that leads to discomfort.
What else causes runners knee? It is commonly defined as an overuse injury, forming after repeated instances of vigorous physical activity. While, true to its name, this injury affects runners, it can also impact anyone who repeatedly climbs stairs, squats, or suddenly increases their activity routine. Improper exercise techniques can also cause patellofemoral pain syndrome.
Another common reason this injury happens is the misalignment of the patella. When the kneecap becomes pushed to one side of the groove, the positions creates an increase of pressure between the back of the patella and trochlea. This irritates the surrounding soft tissues. An orthopaedic physician can determine if your kneecap is positioned properly.
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How Long Does Recovery Take
To recover from runners knee pain, you should start by resting. You may need to cut back on running or other sports, or stop entirely until you feel better. Avoid other activities that increase your pain, like going up and down stairs, as much as possible.
How long it takes to recover from runners knee will vary for everyone. With rest and ice, your pain may go away in two to three weeks. Or, you may need to see a physical therapist who can recommend strengthening and stretching exercises to help you get back to running.
See a doctor if your knee pain doesnt go away after three weeks. You may need an X-ray, CT scan, or MRI to determine the cause of your pain.
It may not be possible to entirely prevent runners knee pain, but the following steps may help alleviate symptoms:
- Reduce high-impact physical activity. Alternate running days with non- or low-impact activities, like swimming and yoga.
- Gradually increase mileage and intensity. Running too many miles, too quickly, may lead to knee pain.
- Adopt a healthy lifestyle. Being overweight or obese can put additional stress on your knees during physical activity. If youre concerned, talk to your doctor about a safe weight loss program.
- Stretch and warm up before and after every workout.
- Check your shoes. You may need shoes with additional support or orthotic inserts. Runners should also replace their shoes every 300 to 500 miles.
Arthritis In Your Knee
Arthritis can happen in any joint in your body, but it’s especially common in your knee. It can make it hard to do things like walk or climb stairs.
Osteoarthritis is one of the most common kinds of arthritis. It’s the “wear and tear” kind that usually affects people over 50. OA happens slowly, and it hurts more over time. The cartilage wears away in your joint, and, just like with runner’s knee, bone rubs on bone and causes pain.
If you have OA, your knee may feel stiff and swollen and you may have trouble bending and straightening it. It’s often worse in the morning or during rainy weather. Your knee may buckle or feel weak.
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Point Runners Knee Treatment Plan:
Runners Knee The Injury Process
At the root level, runners knee develops when the patella tracks incorrectly over the femoral groove, which a groove in the thighboneas you use your knee.
Under normal conditions, the patella rests in the femoral groove and glides effortlessly up and down as you bend and straighten your knee.
But when the patella is misalignedor tracking out of its normal range it can irritate the nerves around the kneecap and damage the cartilage beneath the patella, leading to knee pain and eventually, runners knee.
Not Just Runners
As I have already stated, Runners Knee is the most common overuse injury among runners, but it can also strike any athlete in a variety of fieldsespecially sports that require plenty of cutting and sharp lateral movements, such as skiing, basketball, and tennis, or any type of sport thats arduous activity on the legs.
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What Is A Runners Knee
Irritation of the iliotibial band causes your runners knee.
Therefore the official name of this injury is the iliotibial band friction syndrome.
MedicineNet explains it perfectly:
The iliotibial band runs along the lateral or outside aspect of the thigh and is an important structure that stabilizes the outside of the knee as it flexes and extends.
Inflammation of the iliotibial band can occur as it crosses back and forth across the bony prominence of the femoral epicondyle as the knee flexes and extends.
Your iliotibial band starts at the outer side of your hip and ends on the outer side of your lower leg.
Your thigh bone bulges on the lateral side right above your knee.
When you bend and extend your knee, your iliotibial band has to cross this bulge, just like a speed bump.
Usually, this crossing is no problem because there is not much friction. However, when you iliotibial band gets to tight, friction might increase. It causes irritation and inflammation of the iliotibial band.
That is what we call a runners knee and causes pain.
Solution: Stretch And Foam Roll
The best way to avoid and treat tightness is by working on overall flexibilityin other words, stretching and foam rolling every day, Kaiser says. To stretch your hamstrings, simply lie on your back and pull one leg gently back toward your chest. For your hips, perform a running lunge: With one foot in front, place the opposite knee on the ground and press your hips forward, engaging through your back glute.
To get into your piriformisthe small muscle under the glute max that helps with hip rotation and can also cause tightnessdo a figure four stretch. Lying on your back, cross left ankle over right knee, grab the back of the right thigh and pull it toward your chest.
Using a lacrosse ball or tennis ball to roll out the posterior glute muscle, IT bands, quads, and hamstrings is also a good idea, Kaiser says.
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Should I Get A Bone Scan Or Mri
In all my research, personal experience, interviews, and coaching experience, Ive never found mention of MRI or CT Scans being helpful in diagnosing Patellofemoral Pain Syndrome.
However, bone scans have shown to be worthwhile for chronic sufferers who want a more definitive diagnosis. If the patella is truly distressed or tired like we discussed in the previous section, it will show up on a bone scan. A bone scan works when youre given an injection with a tiny amount of radioactive material. It shows up on the scan and spreads wherever your blood goes .
Bone scans are expensive and Id ask your doctor if its appropriate if you have chronic PFPS. My research has concluded that this type of scan can confirm a PFPS diagnosis and help isolate the overused tissue.
How To Get Back Running After Runners Knee
Here are the three keys to return safely to running after runners knee
Take your Time
Returning back to running, of course, will depend on how severe you damaged your knee.
Thus, its hard to guess how much recovery time you will need, especially when you put into consideration the biomechanical causes of the condition.
You cannot fix your muscles imbalances or running mechanics overnight.
So this cannot be rushed up. No one can
For instance, you may only need a few days off if you spot runners knee early, but if you have been running through pain for a while, you may need a lot longer.
But as a general guideline, full recovery from runners knee can take from four to eight weeks of no irritating activitiesincluding running and other activities that require a lot of knee bending and twisting.
To stay on the safe side, opt for cross-training activities that dont aggravate the pain and require minimum knee twisting and effort.
Take up aqua jogging, swimming, and the like.
And if a cross-training activity leads to knee pain, you shouldnt be doing it.
The same approach applies for other knee injuries such as ITBS and patellar tendonitis.
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Runners Knee : How To Handle Knee Pain After Running
- PostedMay 12, 2021
Runners knee;is a frustrating injury and one of the most common sources of knee pain after running. But how do you know if you have runners knee in the first place?
Also known by its more formal name patellofemoral pain syndrome , runners knee is a genuine source of anxiety for both runners and physical therapists because theres no consensus on what causes PFPS or how to treat it.
So if you do have runners knee, the treatment options are muddled and not definitive. Frustrating, isnt it?
Thankfully, there are still some very good options. Its always best to focus on prevention first. Youd rather devote a small amount of time to staying healthy than a large amount of time to getting healthy, right?
Patellofemoral Pain Syndrome responds well to conservative treatment and the pain is typically a dull ache, rather than a sharp stabbing feeling.
Your ongoing health and prevention of future cases of PFPS will also depend more on your training than specific preventive exercises. Indeed, how you train is the most critical factor to staying healthy!
The nature of PFPS is that you may experience mild symptoms of the injury for a long time. While your training may not be significantly limited by the injury, its often punctuated by the constant annoying ache of runners knee.
Lets discuss how this injury happens and how to know if you have runners knee.
Other Treatments To Consider
Although Load management and exercise rehab is seen as the most effective stand-alone treatments, they are not always as successful as we would like them to be. So, for those stubborn cases it might be beneficial to consider additional treatments:
- Knee taping and bracing
- Foot orthoses
- Bloodflow restriction training
These treatments are beyond the scope of this post and should be discussed with your Biokineticist.
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What Causes Runners Knee
Runners knee can happen for a variety of reasons, many of them having to do with the muscles and bones of the leg. Some of the more common causes are:
- Direct trauma to the knee. Falling on your knee or taking a blow to the knee can dislocate the patella or move it out of place, causing it to track incorrectly along the femoral groove.
- Excessive training or overuse. Repeatedly bending and flexing the knee can irritate the nerves around your kneecap and strain your tendons to the point of discomfort.
- Misalignment of the patella. If your kneecap is out of alignment, activities like running or biking can wear down the cartilage of the kneecap , which can lead to pain and irritation in the underlying bone and joint lining.
- Tight or weak leg muscles. Tight hamstrings and calf muscles can put excessive pressure on the knee when you run, and weak quadriceps muscles can result in misalignment of the kneecap.
- Foot problems. Flat feet, also called fallen arches or overpronation, can stretch the muscles and tendons of your leg and lead to pain in the knee.