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What can happen if I don’t treat runners knee properly?

Runner’s knee doesn’t discriminate and affects anyone from beginners to the most experienced of athletes. Any activity that adds heightened stress to the area can cause the injury, including running, cycling, walking and contact sports. As the most common running injury, it is an ailment that should not be ignored. Research has shown that runner’s knee makes up 16.5% of runners’ injuries and you are more likely to suffer if you are female and around middle age. Overweight individuals are also more prone to the disorder; because of the added stress to the knee joint.

Runner’s knee is a broad term used to describe pain located around the kneecap, with the causes varying from patient to patient. A condition known as patellofemoral pain syndrome is a consequence of the kneecap (patella) sitting incorrectly over the groove in the thigh bone (femoral groove). On straightening or bending the knee, the kneecap doesn’t track correctly, which causes irritation in the femoral groove.

Poorly conditioned thigh and lower leg muscles lead to weak or tight quads which can’t support the patella, causing a misalignment between the patella and femoral groove. Inflexible hamstrings can put further pressure on the knee, irritating the joint. If there is malalignment of any bones from your hips to your ankles, this can cause pressure in certain spots, reducing the overall fluidity of the kneecap and thigh bone.

Problems with your feet, such as fallen arches (flat feet) or hypermobile feet and overpronation (arches roll inward or downward) will alter the way we walk, resulting in knee pain. While biomechanical issues can be to blame, further causes of runner's knee include overuse and repetitive use of high stress exercises. Any injuries or trauma to the area are further factors for pain presenting in the knee. This can lead to a condition recognised as chondromalacia patella, which is a definition of the cartilage underneath the kneecap beginning to soften or disintegrate.

Symptoms of runner's knee are generally pain around the knee area. This can manifest itself as pain behind or around the kneecap, particularly where the knee meets the thigh bone. The pain will commonly be felt whenever the knee is in use, such as:

  • walking
  • kneeling
  • sitting or standing
  • keeping the knee in one position for a prolonged period.

Further symptoms can include swelling, a feeling of pressure and a grinding or popping sensation in the area.

To confirm that runner's knee is the root of your pain, a medical review and physical examination will be required. If there is further doubt, your doctor may order blood tests and the use of imaging technology such as an x-ray or MRI scan.

There are various treatment options available for runner's knee, which will vary based on your prevailing symptoms and diagnosis. For this reason, it is always advised that you seek professional medical help before commencing any treatment. Methods may include resting your knee for a period of time and elevating your knee whilst sitting or lying down. Applying ice on the area will reduce pain and swelling. Taking non-steroidal anti-inflammatory medication, such as ibuprofen, will also decrease inflammation and pain. It may seem counterintuitive, but once the pain and swelling has subsided, physical therapy that includes strengthening and stretching exercises for your quadricep muscles can assist with your recovery time. This will increase the range of movement and strength in the joint. Depending on the cause of your pain, the knee may benefit from being wrapped or the use a knee brace could be the answer. This can also prevent any recurrence of the problem. If your pain is a result of any foot problems, a shoe orthotic may be required. If all the above treatment options have been exhausted and pain is still prevalent, surgery may be required.

If runner's knee is left untreated, it can contribute to a range of issues. The most obvious is that the pain and inflammation will not subside by itself, thus resulting in a halt to any exercise or running. If the disorder is a result of malalignment, then damage to the cartilage in the joint is likely. This is because the role of the kneecap is to protect the knee joint, so if the malalignment remains, then the protection will cease. This can hasten the onset of arthritis and cause permanent and lifelong damage to the joint. If you delay the treatment of runner's knee, you are increasing the likelihood of complete or partial kneecap dislocation, substantially increasing pain in the area. The key is to not ignore any pain you experience whilst running or partaking in exercise. This will significantly reduce the likelihood of any further and permanent damage and will require less invasive treatment methods.

Prevention of runner's knee is possible. Regular strengthening exercises and staying in shape will keep your knee joints in good health. If you are overweight, losing weight will reduce the stress on the area, thus decreasing the likelihood of runner's knee occurring. Research has shown that using a knee brace can prevent any further onset of the problem, as it maintains the position of the knee. It is also recommended that you gradually increase your training levels, and train within your body’s limits. By using the correct running shoes and maintaining a proper posture, you are further lowering your chances of developing problems.

It is always best to explore options with a healthcare professional. They will tailor a treatment plan to suit your needs, meaning you can return to your previous fitness level as soon as possible. Everyone’s recovery time is different, as we all heal differently. The prognosis is good if you take it easy on your knee. The most important point to make about any knee pain is not to ignore it!