Patellofemoral Pain (Runner’s Knee)

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.

Cause

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
  • 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, 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).

In some people with runner’s knee, the kneecap is out of alignment. If so, vigorous activities can cause excessive stress and wear on the cartilage of the kneecap.

This can lead to softening and breakdown of the cartilage on the patella (chondromalacia patella) and cause pain in the underlying bone and irritation of the joint lining.

Symptoms

  • 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.

Conditions

  • Anterior Cruciate Ligament
  • Bursitis – pes Anserive
  • Cartilage Injuries
  • Degenerative Joint Disease (Osteoarthritis)
  • Iliotibial Band Syndrome
  • Knee Sprains & Strains
  • Lateral Collateral Ligament Injuries
  • Loose Bodies
  • Medial Collateral Ligament (MCL) Injury
  • Meniscus Tears
  • Osgood Schlaater Disease
  • Osteochondritis Dissecans
  • Osteonecrosis of the Knee
  • Patella Tendonitis
  • Patella Tendon Rupture
  • Patellofemoral Pain Syndrome (Runner’s Knee)
  • Posterior Cruciate Ligament Injury (PCL)
  • Quadriceps Tendon Tear
  • Unstable Kneecap

Treatments

  • Anterior Cruciate Ligament Repair (ACL)
  • Arthroscopic Chondroplasty
  • Arthroscopic Meniscus Repair
  • Autologous Chondrocyte Transplantation
  • Bilateral Knee Replacement Surgery
  • Cartilage Transplant
  • Computer-Assisted Total Knee Arthrhoplasty
  • High Tibial Osteotomy
  • JOURNEY II Total Knee Replacement
  • Knee Arthroscopy
  • Lateral Collateral Ligament (LCL) Repair
  • Medial Collateral Ligament (MCL) Repair
  • Meniscus Repair
  • MPFL Reconstruction of the Patella
  • OCE – Repair of the Osteochondritis
  • Partial Knee Replacement
  • Partial Knee Resurfacing
  • Partial Menisectomy
  • Posterior Cruciate Ligament (PCL) Repair
  • Revision Knee Surgery
  • Subchondroplasty
  • Total Knee Replacement ~ VERILAST
  • Total Knee Replacement ~ VISIONAIRE
  • Uni-Compartmental Joint Repair

Conservative Treatments

The Orthopedic physicians at Peninsula Bone & Joint Clinic provide conservative treatment options for Knee conditions and injuries.

Diagnosis

Physical Examination & Patient History

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

Treatment Options

Non-Surgical

After resting the knee until the pain and swelling go down, you may need reconditioning to regain full range of motion, strength, power, endurance, speed, agility, and coordination.

Your doctor may prescribe an exercise program to normalize the flexibility and strength of thigh muscles, or recommend cross-training exercises that emphasize stretching the lower extremities. Your doctor will tell you when you may gradually resume running and other athletic activities.

Other nonsurgical treatments 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.

Surgical

When needed, surgical treatments include:

Arthroscopy

The surgeon removes fragments of damaged kneecap cartilage through a small incision, using a pencil-sized instrument called an arthroscope.

Realignment

The surgeon opens the knee structure and realigns the kneecap, reducing the abnormal pressure on cartilage and supporting structures around the front of the knee.

Conservative Treatment Options

  • Non-Operative Knee Injury Treatments

Treatment Highlights

Innovative Implant Design

Smith Nephew JOURNEY II BCS knee is a second-generation knee replacement that combines the stability and natural motion of the human knee with new low-friction materials that may extend the life of the implant.

This Implant Technology is one of several innovative implant solutions  provided by Dr. Robert Detch of Peninsula Bone & Joint Clinic.

Peninsula Bone & Joint Clinic

The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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