Runner’s knee is named for its high incidence among runners who develop irritation between the kneecap and thighbone. The pain can be sharp or dull and can last for several months if ignored. A cracking sensation can occur behind the kneecap. It is twice as common in women as men. Other names for this condition include patellofemoral syndrome and chondromalacia patella.
While sometimes hard to identify an exact cause, several key factors are known to be involved. Malpositioning of the kneecap or chronic wear of the surface of the kneecap can lead to pain. Tight hamstrings or calf muscles as well as tight or weak quadriceps can affect patellar tracking and lead to pain. Recent injuries, flat feet, or muscle imbalance also can lead to pain.
There are several tips to prevent this painful condition. First, STRETCH ! Maintaining flexibility is key, including your core and all major muscle groups like the gluteals (buttocks) hamstrings, quadriceps, and calf muscles. Cross-training to maintain general conditioning is important. Slowly increasing milage no more than 10% a week. Avoid sudden changes to your routine. Good running shoes that are right for you are also important. A good specialty running store will give good advice on the right shoes.
Initial treatment is always nonsurgical. Rest and avoid running – try switching to swimming for a few weeks. Icing will help reduce inflammation as will an ACE wrap. Use anti-inflammatory medications if these simple treatment are not helpful. After a time of rest, conditioning may help improve your knee further. I often refer athletes to physical therapists who are experts in rehabilitating you with a painful knee.
Good pictures of the problem area, including an x-ray and an MRI are often helpful to confirm the diagnosis.
Over the past several years, new alternative treatments have shown great promise. This inlcudes two different kinds of injections: PRP and amnioFix. PRP, or platelet rich plasma, as been shown in a few research studies to result in improvement in pain and function.
A new type of injection is derived from amniotic membranes. This protective layer contains growth factors and is taken from healthy mothers who have donated these tissues after a Cesarean section. The membrane is then purified and cleaned, and turned into a stable powder which can be rehydrated and used in the office. The goal of this material is to reduce inflammation, scar formation and enhance the healing of soft tissues. While new to the sports medicine world, it has been used several hundred thousand times for other applications. This is an alternative to PRP.
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The last resort treatment, one which I rarely use, is surgical to treat problems inside the knee or affect the tracking of the kneecap. This can involve another regenerative-type procedure in which a ‘healing response’ is created by creating small micro-injuries to the tissues.
If you have questions about runner’s knee or patellofemoral knee pain feel free to contact me at Ask Dr. Hacker or through my office directly.