After exercising, you may notice that you have pain around your knee cap. At first, you think you just overworked your joints doing that particular workout, but the pain doesn't go away. In fact, the pain seems even to be getting worse after each subsequent workout. For knee pain that doesn't go away or gets worse, it's time to see your health care professional for an examination. Pain behind the knee cap could be runner's knee. What is runner's knee, and how do you treat it?
Runner's knee can happen to anyone, including those who do not run at all. The kneecap is known as the patella, and runner's knee is a term used to describe pain around and behind the knee cap. It encompasses several conditions that affect the patella, such as chondromalacia patellae, patellofemoral malalignment, anterior knee pain syndrome, and iliotibial band syndrome. While running is the most common cause for runner's knee, any activity that continuously puts stress on the knee joint can be a cause. These activities can include jumping, walking, cycling, skiing, and playing soccer.
The symptoms of runner's knee include a grinding or popping in the knee, swelling, and knee pain typically behind the kneecap. Iliotibial band syndrome will cause pain on the outside of the knee because that's where the iliotibial band runs from the tibia to the hip. Tenderness around the kneecap is another symptom of runner's knee, as is an increase in pain when you bend your knee for stairs or squats. If you're experiencing any of these symptoms, it may be time to see your health care professional.
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What Causes Runner's Knee?
Runner's knee can be caused by torn or worn cartilage, strained tendons, or irritation of the soft tissues in the knee. Contributing factors include:
- Arthritis.
- Fractured patella.
- Inadequate or incorrect stretching prior to activity.
- Partial or complete dislocation of the patella.
- Trauma to the patella.
- Flat feet.
- Overuse.
- Tight or weak thigh muscles.
- Synovial plica or plica syndrome with the joint lining that becomes inflamed or thickened.
- Misalignment of the patella.
Ways to avoid these contributing factors or to reduce your risk of runner's knee include using orthotics for flat feet or wearing the proper footwear in general. You can also work on building your quad and hip strength to reduce your risk of knee pain. Finally, switch up your exercise routine so that you're not constantly putting the same strain on your knees and allow yourself to change it up when you need to rest your knee more or take a rest day if needed.
Knee pain Warning Signs
Seek medical attention if you experience the following:
- Inability to bear weight. If you cannot put your full weight on your knee to stand or walk, you may have a more serious injury.
- Sudden swelling. Anytime your body swells quickly, it typically indicates severe trauma.
- Deformed joint. If your knee has a deformity that makes your kneecap look smaller, bigger, or just plain different from your other knee, you may have more damage to your knee.
- Intense pain. If you're experiencing pain in your knee that's severe or not controlled with self-care and nonsteroidal anti-inflammatory drugs, it may be an indication of a more serious condition.
How Do You Treat Runner's Knee?
After a thorough examination, including X-ray imaging, your doctor might diagnose runner's knee. Runner's knee is typically treated using self-care techniques and adding proper stretching and strengthening exercises. In rare cases, an orthopedic surgeon may need to replace or remove the damaged cartilage or reposition your patella.
Self-care techniques for runner's knee include:
- Rest. Take the time to listen to your body and give it a break when needed. Allow your knee time to heal by avoiding strenuous activities, or even consider using crutches until your knee is better to stay off your leg altogether if the pain warrants it.
- Ice. Injuries such as knee pain should be iced for 15 to 20 minutes several times a day using ice packs, bags of ice cubes, or even bags of frozen vegetables.
- Compression. Wrap your knee using an elastic bandage to help control the swelling. It needs to be snug but not so tight that it cuts off your circulation or causes additional pain.
- Elevate. Prop your knee with some pillows when you sit to ice it. Elevating it may also help reduce the swelling and pain.
- NSAIDs. Use non-steroidal anti-inflammatory drugs, which are available over the counter, to relieve the pain and reduce the swelling. NSAIDs include naproxen sodium like Aleve and ibuprofen such as Motrin IB or Advil. Acetaminophen like Tylenol is another option, but if you have kidney issues or high blood pressure, you should avoid it.
Additional treatment options for runner's knee include:
- Orthotics. Correctly positioning your foot and ankle through the use of custom shoes and orthotics can help prevent knee pain.
- Tape. Tape or brace your knee during activities to provide your knee with pain relief and additional support.
- Physical therapy. Your health care professional may recommend you see a physical therapist to instruct and demonstrate specific exercises to help you regain the strength in your knee and avoid future damage.
How Can You Prevent Runner's Knee?
Ideally, it's best if you don't have to treat runner's knee because you successfully prevented it from happening to you in the first place. There are several tips to avoid runner's knee, including:
- Use proper footwear. Quality shoes with good shock absorption that fit comfortably and adequately are your first defense against runner's knee. You may also want to wear orthotics if you have flat feet or other foot issues that interfere with the correct foot positioning.
- Use proper form. Having a tight core will help prevent you from leaning either too far back or too far forward while running.
- Consider the surface. Try to exercise on a smooth, soft surface. Avoid concrete or asphalt when possible, and run or walk in a zig-zag when coming down a steep hill.
- Work up to it. Make changes to the intensity and duration of your activities gradually.
- Stretch. Make sure to warm up by stretching. If you need direction, talk to your doctor or physical therapist about stretching options.
- Stay in shape. Keep your overall health in good condition by eating a healthy, balanced diet and getting regular exercise.
If you or a loved one are experiencing knee pain and are interested in orthotics as a treatment option, reach out to Dr. Schoene for a consultation or examination.