Do you suffer from a condition commonly known as "Runner's Knee"? The medical term for this is Patellofemoral Pain Syndrome. This pain begins when the patella bone and femur bone begin to rub against each other causing damage to the cartilage in your knees. This cartilage is vital and acts as a shock absorber. When it wears down, many people feel pain behind their knee cap.
Symptoms include soreness behind, around, or in the center of the patella. It may feel as though your knee is "cracking" or could "give out." The pain can range from sharp, dull, sudden, or chronic. Some people find that the only time they do not feel pain is when they are running, but admit that the pain comes back afterwards.
Who is at Risk?
Runner's Knee is common among younger recreational runners. It can affect one or both knees. According to the British Journal of Sports Medicine, women are twice as likely to have problems with it than men. They believe it is due to the fact that women have wider hips, which make the angle between the thigh and knee wider, thereby resulting in more stress to the knee cap.
Although the name implies that only runner's are at risk for this ailment, that is not the case at all. It can strike anyone who regularly puts stress on their knees, such as people who climb stairs often, or do physical exercise like squats. Doctors think that some people suffer from Runner's Knee due to misalignment, foot problems, or prior knee trauma.
Is it a Permanent Condition?
The good news about this condition is that with proper attention, it does not have to be a permanent issue. However, there is also some bad news about this ailment. If one does not work on this issue, it can result in permanent damage, even disability.
What are my Options for Recovery?
Below is a list of some secrets that are believed to help aid the recovery of the patellofemoral pain syndrome.
#1: Evaluate your posture
Professionals believe that Runner's Knee is an issue due to improper posture while running. It might be wise to have a friend videotape a run for you so you can evaluate your posture and technique. If a runner’s hip stabilizers are weak, the thigh will rotate internally when the foot hits the ground. The body naturally compensates with this movement in order to keep the pelvis stabilized. However this is not the optimal movement and thereby causes the pelvis and thigh to tilt. This motion makes the knee be pinched between the bones and causes damage to the cartilage. This condition is referred to as a "knock-kneed runner." If you fall into this category, there is hope; you can train yourself to contract the outside muscles of your hips which will keep your pelvis level. With work, the muscles will gain strength and natural alignment, resulting in relief for the knees.
#2: Determine if you are a "Heel-Striker"?
Are you a heel striker? If the answer is yes, then this "over-striding" increases your risk for Runner's Knee. Studies have revealed that striking your heel on the ground first greatly increases the amount of shock your knee absorbs. Once again, if you are not sure if you do this, you should ask a friend to videotape a run and then evaluate your techniques. If you discover that you are, indeed, a heel-striker, you can train yourself to run by landing flat with your feet underneath your hips, rather than out in front of your body on your heel. It may take some work, but in the long-run it will greatly reduce damage to your knee cartilage.
#3: Evaluate your Shoes
The shoes you are using may not give your feet the support they need. Consider visiting a shoe store that specializes in running shoes. They should have experts available to give you advice, as well as, machines that can scan your foot and determine a better brand of shoe or sole insert that would better complement your running style and foot shape. Orthotic Shoes can improve your balance and support, which are two important factors for your body. Another important tip is to discard your shoes as soon as they lose their shape. If the structure of the shoe or insole has broken down, it is no longer giving the maximum support.
#4: Consider Muscle Strengthening and Stretching
Doctors believe that knee problems are a direct result of weak hip, thigh, and leg muscles. One of the best ways to protect your knees and other joints is to actively engage in stretching and focus on realignment. Yoga can be a beneficial activity for runners to engage in. People claim that it can provide balance, open up your hips, and strengthen the stabilizing muscles that surround the joints. "A lot of these injuries result from motion or mobility problems in the hip or low back," explains Dr. Aaron LeBauer, a physical therapist based in Greensboro, North Carolina. "Or it can be an instability issue because of lack of core engagement. If you have an imbalance that causes the leg to be unstable, it may be a hip control issue."
#5: Consider Hiring a Coach
A trained coach can help you correct and fine-tune your techniques in order to maximize your capabilities. They can point out your errors and give you the keys to retraining yourself. It may seem extreme, but if running is something you are passionate about, the knowledge of an expert will only benefit you. If you live in an area where it is hard to find a local coach you can find an online coach who will provide instruction via videotapes.
#6: Take a Supplement that Supports Bone and Joint Health
Natural supplements can help the body rejuvenate sore areas. Glucosamine Sulfate is believed to help restore the cartilage and synovial fluid around the joints. Also Chondroitin Sulfate has good benefits for joint pain. Many researchers have found that when used in conjunction with each other Glucosamine and Chondroitin sulfates have had repeated success in easing joint pain while helping the body replenish the cartilage that has been lost. Many people who experience pain are deficient in Magnesium or Vitamin D. If you are concerned about your levels, you should have your doctor check for you.
#7: Avoid Running on Hard Surfaces
Running on concrete or asphalt can cause a hard impact, thereby stressing the structure of the body. Maybe you should consider taking a break from your normal run, and seek out an unpaved walking path, field, beach, or trail. Your knees might appreciate the break. These softer surfaces will absorb the impact and significantly reduce the strain on your joints. Many runners find that using low impact surfaces not only minimizes the shock but also strengthens the stabilizer muscles around the joints. Replacing even just one run a week will provide relief from Runner's knee.
#8: Kinesio Tex Tape
Kinesio Tex Tape is an adhesive tape that is applied to the knee in a specific way to provide support to the muscles, ligaments, and tendons. Many individuals prefer this to braces because it is less bulky. It is believed that Kinesio tape can reduce pain, optimize performance, prevent injury, promote circulation, improve healing, and re-educate the neuromuscular system.
#9: Cupping Treatment
A cupping treatment is a great way to improve the circulation for the knee, treat the injury, and help with pain. This is a natural treatment that is practiced in Traditional Chinese Medicine and has been around for centuries. This practice uses heated glass cups that are applied to the problem areas and create suction to stimulate energy flow. Practitioners can use different methods to create suction in the cups. One way is to swab rubbing alcohol on the bottom of the cups, then light it with a flame and immediately put the cup over the affected area. Another way is to hold the bottom of the cup over a small flame then apply the heated cup to the knee. There is no reason to worry about the heat, this is a pleasant experience for many people. No flames are ever used near the skin. Cupping is a good way to revitalize circulation to specific parts of the body, and is also beneficial for removing blockages, opening channels, and supporting the healing process.
#10: Wear a Knee Brace
A knee brace is designed to give your knee the compression and support that it needs. It will reduce the amount of shock that your knee is forced to absorb. The main function for the brace is to reduce the anterior knee pain. This is one of the most readily used remedy for many types of joint pain. It has been used by many in the world of athletics.
#11: Consume a Ginger Extract
Ginger is said to have anti-inflammatory properties when consumed. It contains numerous potent substances known as phytonutrients that fight inflammation. According to the Journal of Medicinal Food, ginger acts just like NSAIDs do by inhibiting the enzymes cyclooxygenase-1 and cyclooxygenase-2. (COX 1 and 2). Other research discovered that ginger impedes several genes that contribute to inflammation.
#12: Take a Fish Oil Supplement
Not only is this oil good for your brain, but it also has anti-inflammatory benefits for the body. Research indicates that this oil can decrease the enzymes that lead to cartilage destruction. The Omega 3 Fatty Acids found in fish oil have been shown to reduce inflammation and increase circulation throughout the body. Many researchers believe it promotes joint lubrication, decreases stiffness in the joints, and minimizes tenderness in the joints.
#13: Unpasteurized Apple Cider Vinegar
Many people have found that consuming a health drink composed of distilled water, unpasteurized apple cider vinegar, molasses, and honey, provides relief from painful knee ailments. Researchers claim that this drink contains enzymes that stop the buildup of calcium on the joints.
#14: Drink Oatstraw Herb Tea
Oatstraw Herb tea is very high in calcium and magnesium, along with protein, and many other beneficial minerals. It is also very high in silica which is a vital nutrient for healthy bones, skin, hair, and nails. Many doctors recommend this tea for patients with broken bones. It is known to stimulate blood circulation, relieve painful joints, and decrease swelling. It is an amazing herb that provides a strengthening effect on the entire body. For best results, drink two to three cups, three to four days a week on a regular basis. It needs to build up in the system, but once it does it has lasting effects.
During your off-time you should consider visiting an acupuncturist. Acupuncture is well known for improving blood circulation, which aids the body in clearing blood channels, thereby reducing pain. Increased circulation also provides a more healing environment. Healing is key when dealing with runner’s knee and acupuncture can be highly beneficial to this process. It can also help release tight muscles.
#16: Apply Mustard and Olive Oils
You can make a combination of Mustard Oil and Olive Oil to rub on your painful knee. Mustard Oil is said to relieve muscle and joint pain because it stimulates blood flow in the affected area. Increased blood supply to the area would help decrease any inflammation, ease stiffness, and provide pain relief.
#17: Consider replacing a run or two with a low impact form of exercise
Try giving your knees a break from the high impact stress that comes with running. Rather than running, perhaps you could add a day of swimming, or low impact cardio such as elliptical training. Maybe even a day of biking would be enough to give your knees the much needed rest they deserve. These low impact forms provide legitimate cardio training and muscle strengthening while minimizing the impact to one’s knees. Replacing even just one workout a week could provide significant relief from Runner’s Knee pain.
#18: Maintain a Healthy Weight
By maintaining a healthy weight, you will prevent your already strained joints from extra stress. Many medical professionals believe that excess body weight, whether body fat or muscle mass, can significantly increase the amount of joint strain. This high level of strain combined with a high impact exercise, like running, will cause cartilage to break down.
#19: Hot and Cold Packs
A routine of applying a heat pack or ice to the knee would aid swelling and pain. This method does not prevent or resolve the problems within the knee, however it does provide pain relief post-run.
#20: Give yourself some rest
I know it might be tough to do, but it might be best to give your knee a break and do some of the remedies mentioned above. Perhaps, a week or two off, would give you the time to rehabilitate and rejuvenate your knee and no longer deal with the painful symptoms of Patellofemoral Pain Syndrome. As stated in the beginning of this article, Runner's Knee does not have to be a disabling ailment. It is possible to rid your knee of this pain.
What if none of these options help me?
These steps are the least invasive options available to help ease your Runner’s Knee pain. However, if no relief can be found, surgery is an option to deal with the issue. For severe Runner’s Knee, Doctors can perform two types of surgery: Realignment surgery or Arthroscopy surgery.
In this surgery, surgeons cut open the knee and realign the knee caps. This is said to relieve pressure on the cartilage, as well as the supporting structures that are located around the front of the knee. The surgery can last from one to two hours. Typically, an incision from four to five inches is made on the top of the knee cap. The knee cap will be moved to the proper place and elevated. This surgery will require a hospital stay of at least two days in order for medical professionals to keep an eye on you while you become accustomed to walking with crutches.
Since this is such an invasive means to fix the problem, it will require time to heal and, most likely, physical therapy. One will experience much pain in the days following the surgery, and will need to give themselves an ample break from training. A brace will be placed on your leg after the surgery. It supports the knee and allows only specific movements of the knee. It only allows you to use your newly fixed knee in ways that complement the surgery. This brace must be worn for the first six weeks after surgery. Crutches will be used for up to twelve weeks. During the first six weeks, no weight on the knee is allowed. A follow up appointment and X-ray will happen at the six week mark to make sure the bone is healing before you are allowed to start putting weight on the knee. After this step is taken doctors will decide if weight can be applied gradually. Another X-ray will happen at the twelve week mark in order to confirm that the bone is healing sufficiently.
Arthroscopic surgery is usually performed as an outpatient procedure and is done in order to clean up the frayed cartilage in the affected knee. It involves the insertion of small tools and a camera through small incisions, usually about ¼ inch thick on either side of the joint. This camera is a tube-like viewing instrument that contains optical fibers and lenses, and is used by the surgeon to monitor the surgery and to see the damaged bone, joint, and cartilage that are being worked on. Your surgeon will be able to easily find pieces of bone and frayed cartilage in order to remove them from the affected area. Having this ability will greatly improve the outcome of this surgery, since your surgeon will be able to see the troublesome knee and can find other issues and decide if other repairs need to occur while inside the body. Once the procedure is complete, the surgeon will close up the incisions. Since this surgery is usually performed as an outpatient procedure, patients are normally allowed to return home on the same day as the surgery.
Recovery from this surgery varies among individuals and is dependent on how much repairing actually had to take place. It could take anywhere from weeks to months. Some people recover quickly from such invasive means while others find that they take longer to recover. More than likely, crutches will need to be used for a few weeks. Physical therapy may also be necessary depending on how invasive of a procedure was needed. If the surgery is successful, relief will be experienced. Once again, by having this surgery done, you will need to make sure to give your body enough time to recover before returning to training.
When are Surgical Procedures Necessary?
Most individuals who suffer from Patellofemoral Pain Syndrome can be treated successfully without resorting to surgery. If you have tried numerous methods to relieve your Runner’s Knee without success, it might be time to speak to your medical professional. Surgical options are usually only performed when all conservative options have been exhausted and unsuccessful.