Runner's Knee

Runner's knee is a common overuse condition that causes pain around the kneecap, particularly in runners and other athletes. The term is often used to describe patellofemoral pain syndrome or chondromalacia patella, conditions where the kneecap doesn't track properly during movement.

The condition typically develops from repetitive stress on the patellofemoral joint, often due to improper running biomechanics, muscle imbalances, or sudden increases in training intensity. Runner's knee can significantly impact an athlete's ability to train and compete, making early diagnosis and treatment important.

At Mountain Spine & Orthopedics, our sports medicine specialists use comprehensive evaluation including gait analysis and imaging to identify the cause of runner's knee and create a personalized treatment plan focused on correcting biomechanics and restoring pain-free running.

• Front-of-knee pain around or behind the kneecap
• Pain that worsens with running, especially downhill or on uneven surfaces
• Pain after running or during the 'cool down' period
• Pain when climbing stairs or squatting
• A grinding or popping sensation when bending the knee
• Stiffness, especially after periods of inactivity
• Pain that may improve with rest but returns when running resumes

Several factors increase the risk of developing runner's knee:

• Sudden increases in running mileage or intensity
• Improper running biomechanics or form
• Muscle imbalances, particularly weak quadriceps or tight hamstrings
• Overpronation (flat feet) or other foot problems
• Running on hard surfaces or uneven terrain
• Wearing inappropriate or worn-out running shoes
• Previous knee injuries that may have altered mechanics
• Weak hip stabilizers that affect knee alignment

Diagnosis begins with a comprehensive physical examination and detailed history of running habits and training patterns. Our specialists assess muscle strength, flexibility, running biomechanics, and identify any structural or biomechanical issues that may contribute to the condition.

We may use X-rays to assess kneecap alignment and rule out other conditions. In some cases, MRI review may be ordered to evaluate cartilage health or identify other structural issues. Gait analysis may also be performed to assess running mechanics.

Non-Surgical Treatment Options

Initial treatment focuses on physical therapy referrals to strengthen the quadriceps and hip stabilizers, improve flexibility, and correct running biomechanics. Activity modification, including reducing running mileage or intensity, is also important during the initial healing phase.

Injection or Interventional Care

For patients with persistent pain, corticosteroid injections may provide temporary relief. Biologic injections like PRP may also be considered in some cases to help reduce inflammation and promote healing.

Surgical Treatment Options

Surgery is rarely needed for runner's knee and is typically reserved for cases with significant structural issues or when conservative treatment fails. Procedures may include arthroscopic procedures to address cartilage damage or realignment procedures to correct patellar tracking, performed using minimally invasive techniques.

Runner's knee pain is typically felt in the front of the knee, around or behind the kneecap. The pain is often described as a dull ache that develops during or after running, particularly with longer distances or increased intensity.

The pain is often worse going down hills or stairs than up, as descending places more stress on the patellofemoral joint. Many runners notice the pain starts gradually and worsens as their run continues. The pain typically improves with rest but returns when running resumes. Our comprehensive treatment approach addresses both the biomechanical cause and any associated inflammation, allowing runners to return to pain-free training.

Several strategies can help prevent runner's knee:

• Gradually increasing running mileage and intensity (following the 10% rule)
• Maintaining strong quadriceps and hip stabilizers through regular strength training
• Improving flexibility in the hamstrings, calves, and IT band
• Using proper running form and technique
• Wearing appropriate running shoes and replacing them regularly
• Running on softer surfaces when possible
• Addressing muscle imbalances through targeted exercise
• Seeking early evaluation from a sports medicine specialist when symptoms first appear

If you're experiencing knee pain related to running, schedule a consultation with Mountain Spine & Orthopedics today. Benefit from expert evaluation and personalized treatment to resolve your runner's knee and get back to pain-free running. Same-day and next-day appointments are often available.