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How to recover from runner’s knee

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Mr Nirav Shah

If you are a keen runner, you’re probably already familiar with the term ‘runner’s knee’. It’s used to describe several conditions that affect the knee joint:

  • Patellofemoral pain syndrome (PFPS) is a common form of runner’s knee that causes pain and stiffness around the kneecap. The pain usually comes on gradually and increases during or after activity.
  • Iliotibial band syndrome (ITBS) affects the iliotibial band, which is a thick band of fascia that runs down the side of your leg, from above your hip to below your knee. It becomes tight and inflamed, causing pain around the outside of your knee.
  • Chondromalacia patella is the softening and deterioration of the cartilage underneath the kneecap. This can cause the knee and thigh bone to rub together painfully.

Symptoms of runner’s knee

Runner’s knee usually causes a dull pain in front of your knee joint, around or behind your kneecap. This may get worse when you move your knee, for example running, standing up from sitting, using the stairs, kneeling and squatting.

Your knee joint may appear swollen and feel tight or tender. You might also experience a grinding sensation or a clicking noise when you flex your knee.

These symptoms can be the result of other conditions, for example, arthritis. You should always seek the advice of your GP or a specialist. They may need to take an X-ray to confirm your diagnosis.

What causes runner’s knee?

It’s not only running that can trigger runner’s knee. Any sport or activity that puts stress on your knee joints can cause injury. For example, walking, cycling, football, rugby, skiing, jumping and aerobics.

Even desk workers can develop runner’s knee from continually sitting with a bent knee.

Common causes and risk factors include:

  • Overuse of your knee joint
  • Poor technique/training mistakes
  • Malalignment of your bones
  • Partial or full dislocation of your kneecap
  • Injuries to your hip or ankle
  • Underdeveloped hip muscles
  • Tight muscles or tendons
  • Flat feet
  • Inadequate foot support
  • Arthritis
  • Excess body weight

Women have an increased risk of runner’s knee because the alignment of their knee joint is different from men’s.

To reduce your risk of runner’s knee, maintain a healthy BMI and avoid placing excess stress on your joints.

Give your body time to recover in between exercise and always stretch afterwards. If you start to increase the intensity or frequency of your training, do so gradually. Wear well-fitting, appropriate trainers with proper arch support.

The NHS has put together some excellent knee strengthening exercises runners. You can find them here.

How to treat runner’s knee

Rest

Rest your knee and only return to running or exercise when it’s no longer painful. Avoid anything that makes your symptoms worse, for example sitting or standing for long periods.

Ice

You can relieve pain and swelling by applying ice to the area. Don’t apply it directly to the skin (this could cause frostbite), and only ice your knee for up to 20 minutes at a time.

Compression

Wrap your knee in an elastic bandage to restrict swelling and support your joint.

Elevation

When you’re sitting or lying down, use a pillow to elevate your leg above your heart to further reduce inflammation.

Medication

If you need pain relief, you can take an over-the-counter nonsteroidal anti-inflammatory drug (NSAIDs) such as ibuprofen.

Exercise

Gentle strengthening and stretching exercises can help to build stability, increase flexibility and reduce tightness in your knees and hips.

Orthotics

If your feet are the cause of your injury, orthotics or arch supports will help to improve the position of your feet.

If these measures don’t improve your symptoms within 6–8 weeks, you may need to see a specialist. Mr Nirav Shah is a consultant orthopaedic surgeon in Sussex who specialises in conditions that affect the knees and hips.

Occasionally, surgery is needed to repair or replace damaged cartilage. Very rarely, the position of the kneecap needs correcting to ensure even wear.

If your knee is painful and inflamed, you may be suitable for a cortisone injection. Cortisone is a powerful anti-inflammatory. It can be very effective at reducing pain in the short-term, allowing you to strengthen your knee without discomfort.

Your GP can refer you to an orthopaedic surgeon for a consultation. Or you can refer yourself directly for a private assessment.

To arrange an appointment with Mr Shah, fill out our contact form, or contact Mr Shah’s secretary on 01903 707373.

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