Knee injuries are incredibly common, accounting for up to 50% of all running injuries.
1-Runner's knee
It’s the most common cause of knee pain after running and is also known as patellofemoral pain syndrome.
Pain starts around the kneecap after running or if you bend your knee for a long time.
You feel a dull, aching pain around or behind the kneecap, or patella and pain increases when walking, climbing, descending stairs, squatting, kneeling, running, sitting down, standing up, or sitting for a long time with the knee bent.
Cause of runner's knee (Patellofemoral pain syndrome)
1- Patellofemoral pain syndrome occurs due to overuse of the joint while running which puts pressure on the kneecap so the tissue becomes inflamed and irritated.
2- Dislocation of the kneecap, complete or partial dislocation.
3 -Trauma to the kneecap.
4 -Weak muscles of the thigh.
5- Arthritis
6- Fractured Kneecap
7- Plica syndrome or synovial plica syndrome(Thickening and inflammation of the lining of the joint ).
Diagnosis and treatment of runner's knee
Doctors can diagnose a runner’s knee easily by complete history, X-rays, MRI, and CT scans.
After diagnosis, treatment should be started quickly but you should try RICE first to relieve knee pain after running:
1- Rest
If you have knee pain after running or whatever the cause, you should take a rest to reduce stress on your joint and allow your muscles to relax.
2- Ice
Apply ice or frozen peas on your knee for up to 30 minutes to reduce knee pain and swelling.
3- Compression
Use an elastic bandage or sleeve to wrap your knee to reduce knee swelling but take care not to be tight to allow blood supply to the tissues.
4- Elevation
Place several pillows under your knee joint when sitting to limit knee swelling.
If you have severe knee swelling, keep your foot elevated above the knee joint and the knee above the level of the heart.
If you still feel knee pain after doing RICE, you may use some medications such as aspirin, ibuprofen, and naproxen but ask for your doctor's advice before using any medications especially if you have other health issues and take other prescriptions.
After reducing the pain, the rule of physical therapy comes on to restore the full strength of your joint and the bulk of thigh muscles which allow more range of movement.
Your doctor may recommend knee braces for you to provide extra support to your knee joint and reduce knee pain after running.
Surgery is the last option and if you have a tear or if your kneecap needs to be realigned when the cartilage is damaged.
2- Iliotibial (IT) band syndrome
Common knee injuries that cause knee pain after running and tenderness on the lateral aspect of the knee due to overuse and repetitive flexion and extension of the knees.
The iliotibial band is superior to the joint line and inferior to the lateral femoral epicondyle.
Iliotibial band syndrome occurs when the IT band becomes inflamed and irritated which increases friction outside the knee when bending causing pain.
Causes of IT band syndrome
1- repetitive walking up and downstairs, wearing high heels, or sitting for long periods with bent knees.
2- Lack of flexibility.
3- Weak abdominal, gluteal, and hip muscles.
4- Arthritis.
5- Weak extensors and flexors of the knee.
6- Weak hip abductors.
7- Flat feet.
Diagnosis and treatment of iliotibial band syndrome
Diagnosis
1- The doctor can diagnose iliotibial band syndrome by complete history, symptoms, and physical exams.
2- Clinically, your doctor will ask you to do certain exercises to see strength, stability, and pattern of movement.
3- Your doctor will assess the alignment of your pelvis and the tightness of the IT band.
4 -Some cases may require an ultrasound, X-ray, or MRI scan.
Treatment
1- Nonsteroidal anti-inflammatory drug (NSAIDs).
2- RICE.
3- Strengthening exercises for your muscles.
4- Daily stretch.
5 Chronic cases may need corticosteroid injection and surgery.
3- Patellar tendinitis (the jumper's knee)
This is inflammation of the patellar tendon which connects the kneecap with the shinbone and it’s a common cause of knee pain after running.
Usually, pain occurs between the kneecap as you begin the physical activity and if it is left untreated, the pain will worsen and start to interfere with playing your workout and then daily activity.
Causes of patellar tendinitis
1 -Overuse due to repetitive stress on the patellar tendon.
2- Inflammation and weakness of the tendon.
3-Muscle imbalance: unequal strength of the muscles so the stronger muscles pull harder on the patellar tendon causing tendonitis.
4-Chronic illness especially that disturbs the blood flow to the knee joint such as kidney failure, autoimmune disorders such as rheumatoid arthritis and lupus, and metabolic diseases such as diabetes.
5-Running and jumping.
Diagnosis and treatment
Diagnosis
1- Clinically, the doctor will apply pressure on the knee joint to determine the site of the pain,
The pain of the patellar tendonitis is located in front of the knee just below the kneecap.
2- The doctor may need to do an x-ray to exclude other knee problems.
3-Ultrasound will be useful also because it gives an image of the knee joint and tears of the patellar tendon.
4-MRI gives more details about the knee joint and patellar tendon.
Treatment
1-Pain reliever such as ibuprofen and naproxen sodium to reduce knee pain after running.
2- physical therapy such as
Stretching exercises to reduce muscle spasms and lengthen the muscle tendon.
3- Strengthening exercises.
4- Patellar tendon strap which disturbs the pressure away from the tendon and helps your knee pain to relieve.
5-Iontophoresis is a method of therapy that involves spreading corticosteroids on the skin and using a device that delivers a low electrical charge to push medications through your skin.
6-invasive methods such as corticosteroids injection to relieve knee pain and platelets rich plasma injection which help new tissue formation and help the healing of the tendon
7-Surgery, If all the previous methods of treatment fail, surgical debridement of the patellar tendon is the next solution.
4- bursitis of the knee joint
Bursae is a small fluid-filled sac that is located near the Knee joint, when this sac becomes inflamed and irritated, it causes bursitis which is a common cause of knee pain after running.
It's more common on the shoulders and elbow but also occurs on the knee and heel, the affected joint becomes swollen, red, stiff, and painful.
Causes of knee bursitis
1- repetitive motions that create pressure on the bursae around a joint such as basketball, extensive kneeling, and lifting something over your head several times.
2- Trauma to the affected joint.
3 - Inflammatory arthritis such as rheumatoid arthritis, gout, and infection.
4- Daily activities which require repetitive movements such as carpet laying, tile setting, gardening, painting, and playing a musical instrument.
5 -With the progress of age, bursitis becomes more common.
Diagnosis and treatment
Diagnosis
1- Medical history.
2- Imaging such as X-rays or MRI.
3 -Laboratory such as blood tests or an analysis of fluid from the inflamed bursa to determine the cause of your joint inflammation and pain.
Treatment
1- RICE.
2- If inflammation is the cause of bursitis, your doctor will prescribe antibiotics
3- Physical therapy and exercises to strengthen your muscles.
4- A corticosteroid drug injected into the bursa to relieve pain and inflammation.
5- Assistive devices such as a walking cane and other devices to reduce pressure on the affected joint.
6 -Surgery to drain the inflamed bursae.
5- Meniscus tear
It's one of the most common knee injuries that occur when you do any activity forcefully, especially when putting your full weight on it, which can lead to a torn meniscus.
Torn meniscus cause knee pain after running, swelling, popping sensation, feeling your knee giving away and difficult to do the full extension of your knee.
Causes of torn meniscus
1- Forcefully twist or rotate your knee, such as aggressive pivoting, kneeling, deep squatting, or lifting something heavy can sometimes lead to a torn meniscus.
2- Wear and tear of the knee when aging.
3- Athletes, especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball.
Diagnosis and treatments
Diagnosis
1-Clinically, your doctor will move your knee and leg into different positions, watch you walk, and ask you to squat to help identify the cause of your signs and symptoms.
2-Imaging such as x rays or MRI.
3- Arthroscopy is a device that contains light and a small camera to transmits an enlarged image of the inside of your knee onto a monitor and surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee to trim or repair the tear.
Treatment
1- RICE is enough to relieve the knee pain after running caused by a torn meniscus.
2- Medications such as naproxen and ibuprofen.
3- Surgical repair may be required in some complicated cases.
Summary
Knee pain after running is a common problem and most knee injuries can be treated easily with rest, ice, and over-the-counter medication but if your pain persists for a long time, you need to see your doctor.
By.dr.Fatma Ragab
Read more: knee support
Read more: knee support
Read more: knee support
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