Runner's Knee
Description
Three bones meet in the knee: the thighbone (femur), the shinbone (tibia), and the kneecap (patella). When the leg moves, the kneecap slides along a shallow groove in the femur known as the trochlear groove. The joint is cushioned and made smooth by articular cartilage, which wraps around the ends of all the bones in the joint. Repeated stress of the joint, whether due to age, injury, overuse, abnormal alignment, or muscle weakness, can weaken and soften the articular cartilage. This phenomenon goes by many names: anterior knee pain syndrome, runner's knee, patello-femoral syndrome, or chondromalacia patellae. Doctors estimate that about one-half of all non-injury knee pain complaints are due to this disorder.
When afflicted with the condition, the patient's knee rubs against the trochlear groove, instead of gliding smoothly across it. The damage may range from a slight abnormality of the surface of the cartilage to a surface that has been worn away completely to the bone. Anterior knee pain can present a diagnostic challenge because of the complex anatomy of the knee.
Symptoms
- Pain in the front of the knee, especially when using stairs or climbing up or down hills
- Squatting, lunging
- Pain may radiate toward back of knee
- Cracking or grating in the knee
- Knee seems to “catch”
Cause and Risk Factors
Causes
- Overuse
- Chronic Injury
- Muscle weakness (of the vastus medialis)
Risk Factors
Risk factors include participation in high-impact sports like running, skiing, soccer, and high-impact aerobics, and trauma. The Q-Angle, the angle formed by the thighbone and the patellar tendon (the misnamed ligament that stretches from the kneecap to the shinbone) is also a major factor in the development of anterior knee pain syndrome. Quickly-growing teenage women most often have a more acute Q-angle than others, and are thus at the highest risk group for developing the condition. Old age and a knock-kneed or bow-legged stance also increase the risk for developing anterior knee pain syndrome.
Treatment
Immediate Action
- Call your doctor.
- Take aspirin or an anti-inflammatory medication, such as ibuprofen, if needed.
- Avoid kneeling, climbing too many stairs, or sitting too long.
- Avoid jumping sports like basketball or volleyball.
- At your doctor’s advice, do low-impact exercises to strengthen the knee muscles. S/he may refer you to a therapist for exercises.
Procedures
Surgery may be necessary in some cases. Your surgeon or physician may recommend arthroscopic surgery to assess the extent of the injury and smooth the surface of the cartilage. Other procedures to correct alignment of the kneecap may be undertaken simultaneously.
Prevention
Check with your doctor before beginning any sport or exercise routine. Also, stay away from activities that require deep knee bending especially if you are at risk for chondromalacia patellae or already have low-grade knee symptoms.
Last updated: 26-Oct-01
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