Knee injuries are the most common running injury to sideline a runner. There are many different types of running knee injuries. However there are three that are most common, easy to diagnose and do not require surgery. These are Iliotibial Band Syndrome (ITB), “Runners knee” also known by many other names such as Chondromalacia, Patella Femoral Stress Syndrome, Patella Femoral Pain Syndrome, Patella Tracking Errors and Malicious Misalignment Syndrome, Patella Tendonitis or “Jumper’s Knee” and sprains of the medial meniscus and medial collateral ligament/MCL. One of the reasons there is so much confusion surrounding running knee injuries is due directly to all of the aforementioned names and the inability of the doctor or therapist to accurately diagnose the condition. An inaccurate diagnosis will lead to ineffective treatment and unnecessary pain for the patient. In addition to needing an accurate diagnosis it is extremely important that we figure out WHY you are getting the problem. It is easy to say running caused it or that it is due from repetitive strain. On the surface these explanations might make sense but think about it. If you ran on both legs and the injury is due to repetitive strain/running then why did you only get injured on your left knee or only on your right knee? Obviously there is something unique about that side of your body that is causing you to be prone to injury! Once we know WHY you got the injury we can take steps to remove that variable which will allow your body to function the way it was designed too.
Iliotibial Band Syndrome is a running knee injury that usually affects new runners that have increased their distance too quickly. It also affects more experienced runners who do the same relative thing. For example; a new runner may get it doing their first “long” run feeling pain develop in the lateral (side) of their knee once they reach a certain mile in their run. The pain will usually get progressively worse striking sooner into the run, causing considerable pain after the run, hurting while going up and especially down stairs. Biking and swimming usually cause no pain at all and are effective ways to cross-train while recovering from Iliotibial Band Syndrome. More experienced runners will similarly increase their mileage to quickly sometimes after taking a period of time off from running longer distances. They may decide to run a marathon and due to their past success ignore proper training protocols resulting in lateral knee pain that gets progressively worse eventually forcing them to stop running. ITB is not difficult to treat in its early stages. Unfortunately most runners will continue to run on it employing strategies such as Ibuprofen, ice and some form of massage that only helps them worsen the condition.
“Runners Knee” or Chondromalacia also causes many runners to stop their training. It affects female runners more commonly than male runners due to women having a larger hip-to-knee ration resulting in a larger Quadriceps-angle. A large Quadriceps-angle is known to cause excessive foot pronation and excessive torque at the knee while running or jumping. This causes your knee-cap to track incorrectly eventually resulting in grinding and pain. The resulting situation is why the condition has so many names. It hurts when you run, therefore the name “Runners Knee”. Women get it more than men due to having a larger hip-to-knee ratio and so the term malicious Misalignment Syndrome is often applied. Patella Tracking Error simply describes what happens to your knee-cap because of having a large Quadriceps angle and the Latin term, Patella Femoral Pain Syndrome and Patella Femoral Stress Syndrome are simply saying “Your knee hurts” in Latin. Runners who have this condition report pain early in the run that may not get progressively worse during the run but the pain remains after running, sometimes lasting for days. Going up and down stairs tend to cause pain as does prolonged sitting with your knee bent such as sitting at a desk or driving.
Patella Tendon Tendonitis or “Jumper’s Knee” is the third most common condition to affect runner. It begins with specific pain beneath (inferior) to the kneecap and can result from an excessive Quadriceps angle, overpronation or overuse. If the runner continues to run on it the condition may progress to patella Tendonosis which occurs due to excessive scar tissue formation. There are many proven and effective strategies to correct both Patella Tendonitis and Patella Tendonosis and get the patient back to running quickly.
The first involves the thing all runners to not want to hear “REST”. If your knee pain is gradually getting worse what makes you think it will not continue to do so eventually forcing you to stop running? Not resting early on results in you being injured further and having to rest even longer. Rest from running done at the right time can speed recovery and allow the runner to still achieve their goal. How much rest will depend on how soon following the INITIAL injury (when you first felt the pain) you rest.
The second method to treat knee pain is “Quick fixes” and home remedies. Most runners I see in my clinic have tried all of the traditional home remedies like icing their knee, Ibuprofen, stretching and strengthening. There are vast amounts of information on the internet concerning these home knee treatments so I will not talk about these except to say that they often do not work. For Iliotibial Band Syndrome there are a few of home therapy tools that can be extremely effective in fixing Iliotibial Band Syndrome…..if done correctly
Home Remedies for ITB
- The Stick or the Pro-Tech Roller
- Foam Roller or Trigger Point Roller
- Pro-Tech Iliotibial Band Compression Band
- SUPERFEET running shoe insoles
- Rocktape or Kinesiotape
Home Remedies for Runners Knee
- Pro-Tech knee compression sleeve
- SUPERFEET running orthotic insoles
- Rocktape or Kinesiotape
Home Remedies for Patella Tendonitis
- Pro-Tech Patella Tendon Compression Band
- Rocktape or Kinesiotape
All of the above self-treatment tools have been effective for many runners if used correctly. Sometimes your condition is too progressed for these home remedies alone to work or provide enough help in reducing your knee pain. If you have been suffering from knee pain or have been diagnosed with Iliotibial Band Syndrome or Runners Knee and it is not getting better consider making an appointment with Dr. Runco at the San Diego Running Institute. The San Diego Running Institute employs all of the same sports medicine treatment options that would be afforded a professional athlete. We use Ultrasound, Electrical Stimulation, A.R.T, Gua Sha/Myofascial Release, Kinesiotaping, Custom Orthotics, Alter-Gravity Treadmill Technology/Rehabilitation and teach patients self guided home physical therapy programs. When the right treatment strategy is employed for the right condition patients get better…..fast.
Dr. Runco is a knee specialist and has helped hundreds of runners and non-runners with their running and non-running related knee injuries. If you have questions regarding your knee condition please email Dr. Runco at Drrunco@sdri.net or if you prefer to just schedule an appointment with Dr. Runco call 858-268-8525.