Many more of us have taken up running since lockdown. It is a great form of exercise that gets us out in the fresh air, doesn’t cost anything and doesn’t require any special equipment (except for a decent pair of running shoes). But with this increase in popularity has come a rise in the number of people developing a painful condition called Runner’s Knee.
What is Runner’s Knee?
Runner’s Knee is a repetitive strain injury that affects the knee joint. There are two types of Runner’s Knee: iliotibial band syndrome affects the side of the knee (causing lateral knee pain) while patellofemoral syndrome affects the front of the knee (causing anterior knee pain).
Which type do you have?
Iliotibial band syndrome (ITBS) is caused by the tendon on the side of the knee and thigh, or the underlying structures, becoming fatigued and irritated. It mostly affects the side of the knee facing outwards and causes strong pain just above the lateral epicondyle (the bump that sticks out on the side of your knee and is sensitive to pressure). It doesn’t cause hip or thigh pain. With ITBS you will normally start to develop pain – which can come on quite quickly – when going downhill or downstairs. Pain tends to be less intense when going uphill.
Patellofemoral pain syndrome (PFPS) is more common than ITBS. The location of the pain may vary but it normally occurs around and under the kneecap. Although it often affects runners and hikers, it can also occur in people whose job involves a lot of sitting as keeping the knee constantly flexed puts strain on the kneecap. The condition also affects teenagers. Pain tends to develop when going uphill or upstairs and may come on gradually over months or even years. It is often worse when ascending but it can also be painful when going downhill. Deep knee bends aggravate the problem, as does sitting with your knees bent. Another strong indicator that you have patellofemoral pain syndrome rather than iliotibial is that the pain tends to fluctuate, both in intensity and where it is located.
Who is affected by Runner’s Knee?
Despite its name, Runner’s Knee doesn’t just affect runners. It is also common in people who walk long distances, hikers, triathletes and cyclists.
Diagnosing Runner’s Knee
It is important to get an accurate diagnosis if you suspect you have Runner’s Knee as the condition cannot be treated effectively without this. Your orthopaedic consultant will carry out a physical examination and ask how and when the pain developed. You may also be given an X-ray, which can assess if the patella is moving correctly over the femur or an MRI scan, which will enable the consultant to see the soft tissue structures (tendons, ligaments and meniscus).
Treating Runner’s Knee
For mild cases of Runner’s Knee or if you haven’t experienced symptoms before, try using the RICE method (rest, ice, compression, elevation) to relieve pain. You can also take anti-inflammatory medication and a physiotherapist may recommend stretches for tight muscles and to improve strength. Shoe inserts may be advised for some people who have an abnormal foot structure or movement patterns when running and, in some cases, taping or a patellar brace may be used to support the patellar. If you are running incorrectly, correcting this through specialist training can reduce strain on the patellofemoral joint.
Rarely, surgery may be needed to adjust the mechanics of the knee. Lateral release involves cutting the lateral patellofemoral ligament to reduce the pull on the patellar to the outside of the knees. Your orthopaedic consultant will discuss the most appropriate type of treatment for your particular type of Runner’s Knee.
Preventing Runner’s Knee
Runner’s Knee is a painful condition that can become chronic, so it is best try and prevent it from developing in the first place if possible. A physiotherapist can devise a programme of exercises that reduce abnormal stresses on your kneecap, including improving quad and hip strength. Using strips of athletic tape on your knees when you run can help you to alter your knee mechanics by providing visual cues when your knees are not being used correctly.
If you injure your knee during sport or any other activity, it is important to get a proper diagnosis if the symptoms persist or are severe.
Castle Orthopaedics has a number of specialist knee consultants who can diagnose and treat all types of knee conditions, including Runner’s Knee. Contact us to arrange an appointment.