Runner's
Knee

Definition
Chondromalacia Patella, or "Runner's Knee", occurs when repeated
stress on the knee causes inflammation and a gradual softening of the
cartilage under the kneecap (patella). The inflammation of the cartilage
prevents the kneecap from gliding smoothly over the end of the thigh
bone (femur) and therefore causing pain and swelling of the knee. The
underside of the kneecap should be smooth and move within the femoral
groove (a groove on the thigh bone). If the kneecap is pulled sideways,
it becomes rough like sandpaper and the symptoms appear.
Symptoms
Runner's Knee is typically associated with a pain that increases gradually
over a period of time, often a year of longer, until it is severe enough
that the athlete seeks medical attention. Symptoms usually occur beneath
or on both sides of the kneecap. Pain may be intensified with activities
such as a short run, squatting or jumping. Stiffness may occur simply
from prolonged sitting or descending stairs. Runner's knee accounts
for 25% of the overuse injuries treated in sports clinics. Teenage girls
are most commonly affected, but any active person age 14 or over may
experience this pain syndrome.
Causes of Injury
· Overpronation causes the lower leg to rotate inward due to
the unstable pronated foot. The kneecap moves in an abnormal side to
side motion instead of gliding within the normal track of the femoral
groove on the thigh bone.
· Weak quadriceps may contribute to injury because the thigh
muscles normally aid in proper tracking of the kneecap.
· Muscle imbalance.
· Direct or repeated trauma.
· An untreated ligament injury.
· Some athletes may experience pain in one knee if they continually
run along the same side of the road. The tilt in the road accentuates
the pronation of the foot thus resulting in the abnormal tracking of
the knee.
· History of trauma.
Short Term Treatment
· Decrease activity and consider swimming. When recovering avoid
any exercise that puts weight on a bent knee.
· Rest if the knee is painful and swollen.
· Ice treatment for 15 minutes twice daily after activity to
reduce pain and inflammation.
· Aspirin or ibuprofen. Or consult your physician about more
sophisticated and effective anti-inflammatory medication.
· Shoe changes - increase stability/motion control
Long Term Treatment
· Physiotherapy including stretching and strengthening exercises
for the quadriceps, hamstrings and calves.
· Orthotic devices to correct abnormal foot mechanics.
Once the causes are determined and the appropriate steps have been taken
to treat the condition, Runner's Knee should not keep the athlete from
activity.
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