Common Running Injuries - Runner’s Knee

The symptoms usually begin with a deep, dull, vague pain. The patella grates or crunches when the knee is bent.

’Runner’s Knee’ (or chondromalacia patellae or patellefemoral syndrome), is a wearing of the surface of the patella (kneecap) and the femoral (thigh bone). The cartilage surfaces disintegrate due to excessive or abnormal contact with each other. This causes (and is caused by) an abnormal uneven movement of the patella on the flexion and extension of the knee joint.

Symptoms

When the patella has become damaged and roughened, pained swelling may occur, particularly when a strong load is placed on the knee joint. Activities that increase the load include squatting, downhill running or walking downstairs.

The symptoms usually begin with a deep, dull, vague pain. The patella grates or crunches when the knee is bent. There may be some swelling, usually when the problem has become a long-term injury. Activity and pressure increase pain.

 

Cause

The causes are varied and often inter-related. There may abnormal bio-mechanics such as excessive pronation (inward roll of the foot), femoral torsion (twisting) or a high small patella. There is usually soft tissue (muscle) tightness in virtually any of the muscles that move or stabilise the knee joint.

There’s often a misalignment of the pelvis and excessive tension in the muscles that attach on to it. Or it may be that you have been overtraining.

 

Treatment

In most cases, if the problem is caught early, it can be resolved.

The initial pain and inflammation can be eased with regular applications of ice. Rest from all aggravating activities is usually necessary. Taping for an abnormal patella position may also be required.

The real long-term treatment, however, is the correction of the faulty bio-mechanics and release of over tight muscles. Deep neuromuscular massage and osteopathic joint manipulation of the lower lumbar spine and pelvic misalignments are of great help. Orthotics may sometimes be advised.

Thigh extensions can aggravate the problem. Many people with this injury have been advised to build up the muscle using thigh extension exercises with weights. This only helps occasionally and often only temporarily. Thigh extensions can aggravate the problem, adding a further load to already over-taut, over-tired soft tissue structures.

When the bio-mechanical and soft tissue problems are dealt with, the injury can usually be resolved. While most cases can take months to heal enough so that there is no discomfort, you may need regular maintenance treatment for some time.

 

Prevention

Runners should use self-massage techniques (ask your sports osteopath), along with their regular stretching routine to help prevent the problem returning. Icing the knees after every run will also help.

Avoid squats once you’ve had Runner’s Knee and don’t overdo the hill work. Make sure you have cushioned shoes to decrease impact and shock.

 

Graeme Stroud ND, MRN, DO, ACOH is an osteopath, naturopath, certified zen body therapist and a qualified healer.