Runner’s Knee (Patellofemoral Syndrome)

By Frank Rown, MD 

Runners, jumpers and other athletes such as skiers, cyclists and soccer players put heavy stress on their knees. Runner’s knee is a term used to refer to a number of medical conditions that cause pain around the front of the knee (patellofemoral pain). These conditions include anterior knee pain syndrome, patellofemoral malalignment and chondromalacia patella.

The knee is a complex structure and is very sensitive. A number of factors can contribute to runner’s knee, including: malalignment of the kneecap, complete or partial dislocation, injury, tightness, imbalance, or weakness of thigh muscles and even flat feet.

Patellofemoral pain may be the result of irritation of the soft tissues around the front of the knee. Strained tendons are fairly common in athletes. Other contributing factors to patellofemoral pain include overuse, obesity, muscle imbalance and inadequate stretching. Pain that begins in another part of the body, such as the back or hip, may cause pain in the knee (referred pain).

Symptoms include a dull, aching pain under or around the front of the kneecap (patella) where it connects with the lower end of the thighbone (femur). Pain occurs when walking up or down stairs, kneeling, squatting, and sitting with a bent knee for a long period of time.

Risk of Runner’s Knee can be diminished with strengthening the quadriceps muscle to keep the patella tracking properly, losing weight to avoid overstressing your knees, a 5 minute stretch to keep the knee flexible, avoid sudden increases in training, use of good quality running shoes, and proper running form. Avoid running on concrete or hard surfaces.

Treatment of Runner’s Knee begins with resting the knee until the pain and swelling go down, Physical Therapy can help regain full range of motion, strength, power, endurance, speed, agility, and coordination. Most programs emphasize strengthening the quadriceps muscle. Other nonsurgical treamtments involve taping the kneecap or using a special brace for knee support during sports participation. Special shoe inserts (orthotics) may sometimes be prescribed and may help relieve the pain. 95 percent of the time nonsurgical treatment succeeds. If needed surgical treatment includes arthroscopy to remove fragments of damages cartilage, or realignment that reduces abnormal pressure on the kneecap.