Runner’s Knee: What is it, and How is it Treated?

The old saying “You can have too much of a good thing” may be true when it comes to exercising to the point of injury. Specifically, an injury called Patellofemoral Pain Syndrome (PFPS), commonly known as Runner’s Knee.

Runner’s Knee is most commonly accompanied by pain in the front of the knee or around the kneecap (patella) where the knee connects to the lower thigh bone (femur). The main cause of this pain is running or other activities that repeatedly stress the knee joint.

Symptoms of Runner’s Knee

Typically, Runner’s Knee feels like a dull pain on the sides or front of the kneecap, especially when bending the knee. Other symptoms include:

• Pain increases while running, jumping, squatting, or climbing stairs
• Decreased range of motion when bending the knee
• Swelling around the kneecap
• Popping or crackling noises within the knee
• A sensation of grinding in the knee, also called crepitus, or stiffness after periods of rest when you try to bend it

If you have Runner’s Knee, your pain will only intensify over time without proper healing, so it’s important to visit your doctor for a proper diagnosis.

Diagnosing Runner’s Knee

If you are experiencing these symptoms, it’s best to see a pain management specialist who will diagnose the condition by considering these factors:

• Overall health
• Health history
• Age
• Pain level
• Results of a physical exam and x-rays

A pain management specialist will want to make sure you are not experiencing a more serious knee issue like an ACL tear or chronic underlying joint issue.

Causes of Runner’s Knee

PFPS is the most common overuse injury, affecting about 25% of male runners and 30% of female runners. However, there are contributing factors, which are:

• Overuse of the knee joint
• Problems with kneecap alignment
• Certain anatomy or body types
• Weak muscles surrounding the knee
• Improper equipment use or sports training techniques
• Changes to footwear
• Hard playing surfaces

Although PFPS has been dubbed Runner’s Knee because it is so prevalent in runners, anyone can develop PFPS when overusing the knee. However, the condition is most often seen in younger individuals, professional athletes, and females.

Professional athletes, especially in sports with a lot of running, jumping, and kicking are at risk of developing Runner’s Knee. The condition is typically seen in younger individuals (adolescents and young adults).

Women are more prone to Runner’s Knee because of their anatomy. For example, because women typically have wider hips than men, the hip muscles tend to be weaker, putting more pressure on the knees. Ligaments are generally looser in women, which can cause the kneecap to slide. The way a woman’s leg is aligned affects the way she lands during a running stride, which in turn can damage the knee. Plus, changing hormone levels in a female affect the structure and function of muscles, tendons, and ligaments — thus creating a higher possibility of injury and pain.

Runner’s Knee Treatment

Treatment for Runner's Knee varies depending on the underlying cause and severity of symptoms. The most common first step is to practice the RICE method:

• Rest: To alleviate the pain, it’s important to take time to rest to prevent it from getting worse. Runner’s Knee could sideline your activity for up to six weeks.
• Ice: Applying ice to the knee decreases blood flow, which can reduce inflammation and tenderness. Ice is most helpful when used in the first 24 hours after the pain begins.
• Compression: Compression bandages or sleeves help reduce swelling while also stabilizing your knee joint.
• Elevation: Keeping your injured knee elevated when sitting or lying down as much as possible, especially in the first 48 hours after injury, can reduce swelling and keep the blood from pooling.

If you need additional relief from the pain, nonsteroidal anti-inflammatory drugs (NSAIDs) may help. NSAIDs like Ibuprofen and Tylenol are over-the-counter pain medications that can help reduce inflammation and pain. It’s best to consult your doctor on the proper dosage of the medication and to ensure it will not interfere with any medications you are currently prescribed.

Physical therapy may be recommended to help strengthen your leg and knee muscles while improving flexibility. A brace may also be used to provide additional support during your recovery. In severe cases, steroid injections or surgery may be necessary to relieve long-term pain and prevent further damage.

Preventing Runner’s Knee

Once you get back on your feet and you are ready to ease back into your exercise routine, there are some preventative measures you can take to try and prevent Runner’s Knee from recurring:

• Stretch before and after running
• Increase activities gradually
•  Wear better running shoes
• Run while leaning forward with knees bent
• If you are overweight, losing weight can relieve stress on the knees.

Runners should also try to cross-train. Experts say having weak thigh muscles, tight hamstrings or a tight Achilles tendon can place unnecessary strain on the knee structure, which puts too much work on that joint. A proper warmup, stretching, and strengthening can help prevent Runner’s Knee from becoming a recurring injury.

Your pain management specialist may also recommend the use of orthotics in your running shoe for better arch support, as well as wearing a knee brace for running.

Whether you are a long-time runner or new to the sport, taking steps to prevent injury is key to your success. Should you find yourself experiencing Runner’s Knee or any pain associated with exercise, it is best to book an appointment with an affiliated pain management specialist at National Spine & Pain Centers.