Is Runner’s Knee Inevitable? Treatment and Prevention

If you’re active and develop a pain behind your kneecap, you could have what’s called patellofemoral pain syndrome, or more commonly, “runner’s knee.” It’s most often the result of movements that load the knee joint when it’s in a flexed position.

Dr. Richard Bernstein at Santa Cruz Osteopathic in Capitola, California is an osteopathic physician — that means he’s a fully licensed doctor who takes a whole-person approach to medicine, helping prevent illness and injury. Dr. Bernstein combines his extensive knowledge of the musculoskeletal system with the latest advances in medical technology to provide the most comprehensive treatments for his patients. He not only wants to talk to you about treating runner’s knee, but about working to prevent it in the first place, too.

More about runner’s knee and its symptoms

Your kneecap, or patella, is a free-standing bone that covers your knee joint, cushioning it during movement. When you bend the knee, the patella slides forward in a groove in the femur (the bone in your upper leg), preventing your tibia (lower leg) from jutting outward.

Runner’s knee comes from three problems in your lower body. First, whenever you run, you place stress on your bent knee as you push off it to move forward. If you don’t have good body mechanics, the motion causes the condition’s telltale pain. A confirmation that it’s runner’s knee is that you have more pain when you’re running downstairs, descending steep hills, or doing squats.

Second, runners tend to have strong hip flexors and weaker posterior hip muscles. With the muscle weakness, the femur bone rotates inward, making the patella strike the edge of the femoral groove instead of sliding smoothly along it, causing pressure and pain.

Third, tight muscles can be as much of a cause of patellofemoral pain as weak muscles, and can also lead to a limited range of motion in the hamstrings or hips.

In addition to the pain, characteristic symptoms of runner’s knee include swelling around the knee joint and a popping or grinding sound as you move.

Women are more prone to runner’s knee because they have wider-set hips; people with flat feet wearing poorly fitting shoes tend to get it too. Buying quality shoes with rigid arch and heel support, ample cushioning, and a wide toe box should help, as can custom-designed orthotics.

Treating runner’s knee

The best news about runner’s knee is that it isn’t a structural problem — your ligaments and cartilage are fine. Instead, the problem lies in how your muscles function through repeatedly pounding the pavement.

As a result, runner’s knee can be successfully treated without surgery. You can start with RICE:

• Rest: stop running until you heal
• Ice: apply ice packs to reduce pain and swelling
• Compression: wrap your knee in an elastic bandage or sleeve to restrict swelling
• Elevation: elevate the foot above the knee and the knee above the heart to reduce swelling

You can take over-the-counter pain relievers and anti-inflammatories, such as aspirin, acetaminophen, or ibuprofen.

After the pain and swelling have subsided, Dr. Bernstein may recommend physical therapy or stretching and strengthening exercises to restore your knee’s full strength and range of motion. Stretching and strengthening are both essential to build up weak hips and inner quads as well as loosen tight hamstrings or hips.

He may also give you a knee brace to provide extra support and pain relief or recommend that you wear custom-made shoe inserts that provide all the cushioning and support you need to improve your body mechanics.

Preventing runner’s knee

Preventing problems from happening is always preferable to treating them once they do happen. The American Academy of Orthopaedic Surgeons recommends taking the following preventive measures:

• Stay in shape: ensure overall health and conditioning are good
• Lose weight: if you’re overweight, reduce the stress by shedding the pounds
• Stretch first: do a five-minute warm up and stretching exercises before hitting the pavement
• Increase training gradually: if you go too fast, your knees can’t take the stress
• Use proper running shoes: good-quality shoes and orthotics for support
• Use proper running form: keep your body upright and knees bent, run on a soft surface, use a zigzag pattern when heading down a steep incline

Runner’s knee is not inevitable. With the proper precautions and training, you can hit the pavement without overstressing your knees. To learn more, or to schedule a consultation with Dr. Bernstein, call us at 831-464-1605, or book online with us today.