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.
How Is Runners Knee Treated
Your healthcare provider will figure out the best treatment based on:
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How old you are
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Your overall health and health history
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How much pain you have
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How well you can handle specific medicines, procedures, or therapies
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How long the condition is expected to last
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Your opinion or preference
The best course of treatment for runner’s knee is to stop running until you can run again without pain. Other treatment may include:
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Cold packs
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Recovery From Runners Knee
If your runners knee stems from overtraining or tight muscles and youre experiencing mild symptoms, then the following tips can help get you back on the road to recovery. However, if your knee pain stems from an injury or if you are in extreme pain, its always best to consult with a healthcare provider.
Now, lets get into it. Most advice out there says that the best thing to do for runners knee is to stop running altogether until the condition improves. For most of us, thats not ideal, especially when it takes an average of 4-6 weeks to recover from runners knee!
Here are some methods that can help you recover faster.
Modified Side Plank With Reps
Begin in a side-lying position with your knees bent on top of one another. Distribute your weight onto your knee and forearm facing the floor. While keeping your feet and knees on the floor, side bridge up by pushing your bottom knee into the floor to lift your pelvis up and forward. Hold this position for a moment, then slowly lower down and repeat. When you are elevated your bottom knee, hip, and shoulder should all be in one line
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Knee Pain Isn’t Something Runners Should Just Accept As A Part Of What It Means To Be A Runner Or Assume That Injections Or Surgery Are The Only Or Best Option
Although this condition of knee pain can seem fairly straightforward, PFS pain can come from a variety of different structures such as the knee cap, patella tendon, fat pad, surrounding muscles, and ligaments.; Though it can be easy to categorize the pain as PFS, it is harder to identify what structure is the actual source of pain.
At 901PT, we take a closer look at the symptoms during a thorough examination to pinpoint the exact cause. We also examine above and below the knee because weakness and tightness in these areas can have a significant effect on the stress being placed on the knee and be key contributors to PFS.
Keep reading because this article will help to shed light on a few of these issues and what to do about them.
***One key point before moving on: Despite what is the actual source of pain, the overall goal is to assess if the painful tissue in the knee is able to cope with the load placed on it, and then form a plan to help the body heal and regain its resiliency to a load of running . Too many times we find people are overly focused on the actual source of pain and feel paralyzed or frustrated by this.
However, it is our experience that by focusing on the environment around the painful knee and addressing the excess load being placed on it, we can achieve a successful outcome and keep our runners running without having to take a prolonged break or need an x-ray or MRI that can, honestly, lead people down an unnecessary pathway.
Now back to the knee-
Strengthening/motor Control Exercises To Improve Hip Recruitment
There are a variety of excellent exercises that you can perform as part of your exercise routine to improve the strength and motor control of your hip abductors, extensors, and external rotators. A study by Messier et al. discussed how increased muscle strength of the lower extremities increases the shock absorption capabilities of the muscles surrounding the knee joint, which ultimately results in lower loading loads of the knee .
Why do runners need to perform strength training? Look below at this infographic!
- HOW: Begin on your side with your leg on top straightened out. Follow the video for instructions with the arms to create more core work. Place a band just slightly above your knees for additional resistance. Elevate the top leg towards the ceiling and back wall simultaneously. Avoid crunching at your low back or rotating your body open towards the ceiling.
- FEEL: You should feel the outer hip, particularly the glute muscles with this exercise. You can place your top hand on your pelvis to assure the motion is coming from the hip and not the lower back.
- COMPENSATION: Avoid rotating your entire trunk or performing a side crunch with this exercise. Make sure the shoulder that is facing the ceiling stays in front of the shoulder that is against the floor.
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Pain Itself Is The Problem
Many theories about the nature of the damage underlying the pain of PFPS have come and gone. The reason behind this revolving door of proposed etiologies is that, unlike other injuries such as knee meniscus damage, there is often no obvious structural abnormality associated with PFPS, whether the joint is examined by X-ray, MRI, or surgical arthroscope. Within the past 15 years, this reality has lead orthopedists to a revised view of PFPS in which pain itself is regarded as the essence of the injury. This, in turn, has led to a new approach to treatment that focuses on symptom management rather than healing.
In the past , if you were diagnosed with PFPS as a runner you would be advised to stop running. Today, however, experts like Greg Lehman, an Ontario-based physiotherapist, advise runners with overuse injuries including PFPS to do as much running as they can within an acceptable pain range.
To get back to 100% of running you need to start with something less than 100%, he writes on his website. As a runner, you dont just want to be free of pain; you want to be able to do the training necessary to achieve your goals without pain. Theres a big difference. Sure, rest may fix your pain, but only through running can you develop the tissue durability required to handle intensive training.
Warm Up And Cool Down
It’s essential to warm up properly before you start running. Five to 10 minutes of brisk walking or gentle jogging before you start will warm your muscles up and help prevent injury.
To cool down, carry on running at an easier pace or walk for 5 to 10 minutes. This will help your body recover after your run.
See;Tips for new runners for more information about warming up and cooling down, as well as running technique.
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Natural Treatment For Runners Knee
Patellofemoral pain syndrome, commonly just called runners knee, has been found to be one of the leading exercise-related injuries in adults ;even more common than other running injuries like iliotibial band friction syndrome, plantar fasciitis, meniscal injuries of the knee and tibial stress syndrome.
Although for some adults knee pains only start when they first pick up running, experts believe that running alone isnt;usually;the single cause of runners knee. The majority of those with patellofemoral injuries experience pain due to a combination of both extrinsic and intrinsic factors. This includes things like poor form or training errors when exercising, wearing worn-out or old shoes, exercising on uneven surfaces, muscle imbalances and/or aggravating previous injuries. Runners arent the only athletes prone to knees injuries either; those who walk cycle a lot, or anyone performing lots of repetitive bending, jumping or bouncing can also get runners knee.
What can you do to help reverse and treat runners knee symptoms? Natural treatments for runners knee include stretching the legs, strengthening the hamstrings and quadriceps to decrease compensations, seeing a professional for postural alignment adjustments and healing inflamed connective tissue using approaches like prolotherapy/PRP.
Runners Knee Quick Facts
- Also known as patellofemoral pain syndrome, anterior knee pain, and, formerly, chondromalacia patellae.
- It is very common, affecting up to 15% of all runners at some point in their running career.
- It is an injury that gradually comes on and slowly worsens. It is not caused by trauma.
- Runners Knee is different from IT Band Syndrome, Patella Tendinopathy, and Osgood Schlatters.
- Most people recover successfully from Runners Knee after 612 weeks of Physiotherapy exercises.
- Surgery/invasive treatments are not usually required.
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What Causes Pfp Syndrome
Patellofemoral pain syndrome is an overuse disorder. These happen when someone does the same movements that stress the knee over and over again.
In PFP syndrome, repeated bending and straightening the knee stresses the kneecap. It’s most common in athletes.
Some people with PFP syndrome have a kneecap that is out of line with the thighbone . The kneecap can get out of line, or wiggle as it moves along the thighbone, because of muscle weakness, trauma, or another problem. If this happens, the kneecap doesn’t glide smoothly over the thighbone when the knee bends and straightens. The kneecap gets injured and this causes the pain of PFP syndrome.
Severe Runners Knee Cases
In some severe cases of runners knee, the above steps may not help as much.
So what to do then?
Well, severe cases of the runner may need immediate surgery to fix the damage.
A surgeon could take out the injured cartilage or mend the position of the patella.
Hopefully, you will never have to endure severe cases of runners knee.
This conditionand most other running injuriescan be easily treatedwhen spotted at the right time and before they get any worseand with the implementation of the right preventative strategies.
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Exercises And Stretches For Runners Knee
Rest is important, but that doesnt mean you have to lie on the couch for the next week. Try doing the exercises below 3 to 5 times a week for 6 weeks.
Know before you move: These exercises are general suggestions that may help your knee, but a physical therapist can give you a proper evaluation, determine why you have runners knee, and create the best course of action for your pain and injury.
What To Do About Runner’s Knee
Doyou have a recurrent dull ache in the front of your knee that is limiting your running?;
Is your knee tender to the touch on or around your knee cap?
Does your knee hurt after youve been sitting for too long or maybe first thing in the morning?
Does your knee feel like it pops or clicks more frequently?
These are all typical complaints that characterize Runners knee,” clinically known as Patellofemoral Pain Syndrome . Runner’s Knee/ PFS pain is mostly caused by overuse rather than a traumatic injury.
Runners with this injury can often continue to run without having to completely stop. Stopping all activity may stop the pain from getting worse but it’s more important to address the underlying issues so that the pain does not return or just hang around.;
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Can I Train Through Runners Knee
Even though I said before that running on PFPS is a bad idea, it likely wont make the pain worse .
You wont destroy your kneecap by running through the dull ache that accompanies PFPS. You probably wont wear away the cartilage underneath your patella. Youll be forced to stop by more severe pain before you do anything truly destructive.
But there are risks. Youll prolong your recovery and you could set yourself up for more severe problems in the future. Carefully weigh these risks with your love of running.
Dont Make Any Drastic Changes
It might be tempting to think about making major changes to your running you blame your shoes,;your stride,;your gait;or your speed for your injury. But this isnt the time for dramatic changes, like swapping to a hugely different pair of shoes. Dont go from 10mm drop to barefoot in an attempt to cure your knee pain.
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Will Runners Knee Get Worse If You Continue To Run Through The Pain
Your pain may get worse in response to activity in the short term, but that doesnt mean that your knee actually is getting worse.
Let me explain
Remember that cartilage change is often unrelated to pain, and that either way, cartilage change as a result of activity takes months and years, not weeks!
Its certainly sensible to look to get patellofemoral pain under control as quickly as possible, but do not despair if you have an event that you absolutely have to run, you can consider doing so if your pain is tolerable.
What Are The Signs & Symptoms Of Pfp Syndrome
Patellofemoral pain syndrome causes pain under and around the knee. The pain often gets worse with walking, kneeling, squatting, going up or down stairs, or running. It may also hurt after sitting with a bent knee for a long time, such as in a long car ride or in a movie theater.
Some people with PFP syndrome feel a “popping” or creaking after getting up from sitting or when going up or down stairs.
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Who Gets Pfp Syndrome
Patellofemoral pain syndrome usually happens in people who do sports that involve a lot of knee bending and straightening, such as running, biking, and skiing. It also can;happen to people, particularly young women, who do not do a lot of sports.
PFP syndrome is more common in women and happens most often to teens and young adults.
Tight or weak leg muscles or flat feet can make someone more likely to get PFP syndrome.
Mix Up Your Workouts With Cross Training
One of the best ways to avoid overuse injuries like runners knee is by cross-training cardio with strengthening exercises. Try adding a few back, abdominal, and hip strengthening exercises into your workouts to help give your knees more support.
Below are a few exercises you can try to strengthen your hips and legs to reduce knee pain.
Even if youre not very active, consider adding these exercises to your daily routine. You might be surprised at how effective they can be at building muscle strength and reducing joint pain.
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Causes And Risk Factors For Runners Knee
Runners knee can be caused by several factors, including one or a combination of the following:
- Training errors. A sudden increase in the volume or intensity of training may place excessive stress on the patellofemoral joint. Likewise, inadequate recovery time or excessive hill work may do the same.
- Overuse and overtraining of the knee. Prolonged periods of heavy use and training can cause runners knee in even the most conditioned athletes, if adequate time for recovery is not provided. For example, a distance runner completing a particularly rigorous week of training may develop runners knee pain.
- Injury. An injury to the ankle, hip, or knee can change the knees biomechanics, eventually leading to runners knee symptoms.
- Focal weakness. Weak or underdeveloped thigh or hip muscles can cause the patellofemoral joint to bear a larger stress burden with activity. Over time this can lead to the development of runners knee.
- Excessive body weight. Being overweight can cause unwanted stress on the knees. When walking across level ground, each step places 1.5 times an individuals body weight worth of pressure on their knees.2
- Flexibility. Particularly tight quadriceps , gastrocnemius , iliotibial band , or hamstrings may predispose someone to runners knee.
- Gender. Women have an increased risk of runners knee, as women have wider hips and different knee alignment than men.