Runner's Corner

November 2008 ::  Index of issues

Managing Runner’s Knee or  Chondramalacia

November 2008 Runner’s Corner

By Kitty A. Consolo, Ph.D.

        This month’s Runner’s corner will address runner’s knee.  Keep in mind this advice is help you manage this problem, however you may need to also consult a sports medicine professional who treats runner’s such as a podiatrist or orthopaedic physician. 

Runner’s Knee Definition and symptoms

Runner’s knee or chondramalacia of the patella, is a condition that causes pain in and around the front of the knee or the kneecap.   If you have pain on the side or when you bend the knee or put weight on it, it is likely a different condition and you should see a sports medicine physician.  Runner’s knee can occur while running, going up and down stairs or after sitting for awhile and then start walking.

Causes:

  There are usually 4 factors that can cause runner’s knee that can occur singly or together.  These are:

1.      Foot instability such as too much pronation.

2.      Short calf or hamstring muscles which will create postural instability.

3.      Legs of different lengths

4.      Improper shoes, running on slanted surfaces or over training.

Treatment:

For most runner’s, the problem is the foot so treat the foot not the knee, though if the knee is sore, it can help

  1. Do ice massage
  2. Use foot supports.  I have a high arched foot and found that arch supports have helped.  You may want to try some over the counter ones first before going to a sports podiatrist and see if they offer some relief.  I purchase mine online.
  3. Add flexibility exercises to the calf and hamstring.  After your muscles are warm, stand arms length against a wall, bend your knees and leave your heals on the ground. This is a great calf stretch.  Take care NOT to stand on the edge of stairs and drop your heals, this is too much of  a stretch and will hurt your Achilles tendon over time.  To stretch the hamstrings, lie down on your back with one leg bent.  Be sure that your back is flat.  Take the other leg and try to raise it with the knee straight but not locked until it is around 90 degrees or so.  Hold these stretches for about 20-30 seconds and never do them if you feel pain.
  1. Equalize leg length differences—again you may want to buy some pads over the counter and see if it helps before having orthotics made. 
  1.  Be sure you have good shoes and the right shoe for your foot type.  High arched feet need a neutral shoe with lots of cushioning, average arches need a stability shoe and low arches or flat feet need a motion control shoe. 
  1. Wear a knee strap.  I have found relief from a Knee support strap from a number of retailers.  The strap has Velcro on one side and all you have to do is thread one end through a plastic opening and pull it back, attaching the Velcro to the outside part of the knee.  The strap should be just below the knee cap and not pulled to tight.  I found I can not only run without pain with it but also race with it.  It has also helped me reduce knee pain from driving.  The strap comes in small, medium, large and extra-large.  (see pictures below)

 

I hope this information helps you and always be sure to get a sports medicine professional who treats runners involved if your runner’s knee is not helped by these suggestions.  Hope to see you running healthy on the roads.