About Knee Pain in Runners

Running can be hard on the knees.

Chronic knee pain is a common challenge for runners. The repetitive motion and impact of running may lead to overuse injuries that can vary in intensity from mildly annoying to severely debilitating. Although the exact cause of pain varies between runners, treatment recommendations are almost universal.

Symptoms

The most common cause of knee pain in runners is patellofemoral pain syndrome, also known as runner's knee. If you have runner's knee, you will usually feel pain behind or below your kneecap. It feels like a dull ache that gets worse with physical activity, deep knee bends, walking down stairs and standing up after sitting for a long time.

Mechanism

Your kneecap (patella) sits on a little groove at the bottom of your thighbone (femur). Normally, when you bend and straighten your leg, the kneecap glides smoothly over groove. With runner's knee, the kneecap becomes misaligned and no longer glides smoothly when the leg bends. The off-track movement causes friction and painful irritation.

Clarification

Cartilage under the kneecap may become degenerated, a condition called chondromalacia patella. Chondromalacia patella also sometimes is called "runner's knee." Although the two conditions are closely related, they are not the same. Runner's knee doesn't necessarily involve damaged cartilage, while chondromalacia patella, by definition, means exactly that.

Other Contributors

Iliotibial band syndrome (IT band syndrome) can also cause knee pain in runners. The IT band is a thick band of fibrous tissue that runs from your outer hip to the outside of your knee. Being bowlegged, having flat feet or running on uneven terrain can cause the band to become irritated and painful. Compared to runner's knee, pain from IT band syndrome is usually felt on the outer edge of the knee.

Causes

Knee pain may be related to something you can't control like the shape of your knees, the way they're positioned, having flat feet or having high arches. Women are more prone to knee pain because wider hips cause the thigh muscles to pull on the knee at an increased angle. Pain may also be caused by muscular imbalances. Tight calf muscles, tight hamstrings and weak thigh muscles can all contribute to knee injury.

Immediate Treatment

To treat knee pain immediately after a run, follow R.I.C.E.--rest, ice, compression and elevation. Sit or lie down with your leg elevated on a pillow, and hold an ice pack to your knee for 20 minutes. You can use an elastic bandage to help compress the joint and keep the ice pack in place. This will help to decrease pain and inflammation right after activity.

Long-Term Treatment / Prevention

Increase your mileage gradually--never more than 10 percent per week. Create a strong, stable environment for your knees by stretching and strengthening your leg muscles. Also be sure to wear athletic shoes that support your foot type and your running style. For help, visit a specialty running store for a professional evaluation. Pain from IT band syndrome can be alleviated with deep tissue massage or by self-massaging the outer leg on a foam roller. For severe cases of knee pain, medical intervention like cortisone shots or surgery may be necessary.

References

• Runner's Knee (Patellofemoral Pain)
• Iliotibial Band Syndrome: A Common Source of Knee Pain