RUNNER’S
KNEE

OrthoWashingotn Knee Surgery

RUNNER’S KNEE

Anatomy

Normal knee anatomy

Description

Cause

Overuse

  • Use of improper sports training techniques or equipment

Patellar Malalignment

  • Problems with the alignment of the legs between the hips and the ankles. Problems in alignment may result in a kneecap that shifts too far toward the outside or inside of the leg, or one that rides too high in the trochlear groove—a condition called patella alta.
  • Muscular imbalances or weaknesses, especially in the quadriceps muscles at the front of the thigh. When the knee bends and straightens, the quadriceps muscles and quadriceps tendon help to keep the kneecap within the trochlear groove. Weak or imbalanced quadriceps can cause poor tracking of the kneecap within the groove.

Symptoms

  • Pain during exercise and activities that repeatedly bend the knee, such as climbing stairs, running, jumping, or squatting.
  • Pain after sitting for a long period of time with your knees bent, such as one does in a movie theater or when riding on an airplane.
  • Pain related to a change in activity level or intensity, playing surface, or equipment.
  • Popping or crackling sounds in your knee when climbing stairs or when standing up after prolonged sitting.

Home Remedies

Activity Changes

The RICE Method

  • Rest. Avoid putting weight on the painful knee.
  • Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly on skin.
  • Compression. To prevent additional swelling, lightly wrap the knee in an elastic bandage, leaving a hole in the area of the kneecap. Make sure that the bandage fits snugly and does not cause additional pain.

Medication

Doctor Examination

Physical Examination

  • Alignment of the lower leg and the position of the kneecap
  • Knee stability, hip rotation, and range of motion of knees and hips
  • The kneecap for signs of tenderness
  • The attachment of thigh muscles to the kneecap
  • Strength, flexibility, firmness, and tone of the hips, front thigh muscles (quadriceps), and back thigh muscles (hamstrings)

X-Rays

Treatment

Nonsurgical Treatment

  • Physical therapy exercises. Specific exercises will help you improve range of motion, strength, and endurance. It is especially important to focus on strengthening and stretching your quadriceps since these muscles are the main stabilizers of your kneecap. Core exercises may also be recommended to strengthen the muscles in your abdomen and lower back.
  • Orthotics. Shoe inserts can help align and stabilize your foot and ankle, taking stress off of your lower leg. Orthotics can either be custom-made for your foot or purchased "off the shelf."

Surgical Treatment

  • Debridement. In some cases, removing damaged articular cartilage from the surface of the patella can provide pain relief.

Lateral release. If the lateral retinaculum tendon is tight enough to pull the patella out of the trochlear groove, a lateral release procedure can loosen the tissue and correct the patellar malalignment.

If tightness in the lateral retinaculum is pulling your kneecap to the side,
your doctor may recommend lateral release surgery to cut the ligament.

Prevention

  • Wearing shoes appropriate to your activities
  • Warming up thoroughly before physical activity
  • Incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity
  • Increasing training gradually
  • Reducing any activity that has hurt your knees in the past
  • Maintaining a healthy body weight to avoid overstressing your knees

Disclaimer

OrthoWashington in Kirkland, WA is a premiere orthopedic practice and surgery center with surgeons and doctors serving patients in the greater Bellevue and Seattle areas.

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a dba of Washington Sports Medicine Associates
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