What are the other Names for this Condition? (Also known as/Synonyms)

• Anterior Knee Pain
• Chondromalacia Patella
• PFPS (Patellofemoral Pain Syndrome)

What is Runner’s Knee? (Definition/Background Information)

• Runner’s Knee is a general term that refers to certain medical conditions that cause pain in the front (anterior part) of the knee. These conditions include Anterior Knee Pain Syndrome, Patellofemoral Malalignment, and Chondromalacia Patella
• Runner’s Knee can affect one or both the knees. The condition may cause irritation of the soft tissues surrounding the front of the knee. Other contributing factors include overuse, muscle imbalance, and improper stretching
• The condition mostly occurs in individuals who actively participate in sports; sports that place a lot of stress on the knees such as skiing, cycling, and soccer
• The prognosis of Runner's Knee is usually excellent with appropriate treatment, which usually does not involve any surgery

Who gets Runner’s Knee? (Age and Sex Distribution)

• Individuals of any age, gender, race, or ethnic group may develop Runner’s Knee
• Women are twice as likely to develop Runner’s Knee than men
• Runner’s Knee is mainly seen in athletes who participate in sports that cause excessive pressure on the knees

What are the Risk Factors for Runner’s Knee? (Predisposing Factors)

The risk factors associated with Runner’s Knee include:

• Participation in sports such as skiing, cycling, soccer, or weightlifting
• Increased instability of the knee joint due to attachment of weak muscles and tendons to the knee joint
• Congenital defects involving the knee joint such as trochlear dysplasia (trochlear is a part of the thigh bone, which is abnormal due to a congenital defect)
• Abnormal location of the kneecap bone or patella (termed high patella)
• Loose placement of the kneecap on the knee joint. The patella helps stabilize the knee joint. When the patellar bone is loosely attached, it creates increased instability, resulting in Runner's Knee
• Knock knees (a congenital abnormality), where there is a misalignment of the lower legs. This results in the legs coming too close to each other while walking, causing the knees to knock at each other
• Females who have wide hips have an increased risk of Runner’s Knee
• Lack of training and conditioning before running can increase the risk of muscle and ligament strains in the knee joint

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others. 

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Runner’s Knee? (Etiology)

Some of the common causes of Runner’s Knee (also known as Patellofemoral Pain Syndrome or PFPS) include:

• Improper alignment of the kneecap
• Improper stretching
• Complete or partial dislocation of the kneecap; injury to the kneecap
• Muscle imbalance, muscular tightness, or weakness of the thigh muscles
• Flatfeet
• Repetitive stress on the knee

What are the Signs and Symptoms of Runner’s Knee?

The signs and symptoms of Runner’s Knee include:

• Pain surrounding the kneecap
• Difficulty walking up and down the stairs
• Pain may also occur when kneeling, squatting, and bending the knee

How is Runner’s Knee Diagnosed?

Physicians may use the following tools to diagnose Runner’s Knee:

• Physical examination: Runner’s Knee can usually be diagnosed by a thorough physical examination. During the examination, a physician may check the alignment of the lower leg, kneecap, and quadriceps. In addition to this, complete medical history can aid in arriving at a definitive diagnosis
• X-ray of the knee: An x-ray of the knee is a common method used to diagnose Runner’s Knee. This diagnostic test provides a clear image of the knee, may help determine the extent of the injury, and confirm the diagnosis
• Computerized tomography (CT) scan of the knee: A CT scan takes a series of x-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues of the knee. This then allows the physician to examine the knee and surrounding structures to confirm a diagnosis
• Magnetic resonance imaging (MRI) of the knee: An MRI is a more detailed scan that uses a magnetic field to produce images, which allows a physician to view any damage to the bones and soft tissue to confirm the diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Runner’s Knee?

Runner’s Knee may make it very difficult for an individual to perform even simple daily activities such as walking up and down the stairs.

How is Runner’s Knee Treated?

Both nonsurgical and surgical methods may be used to treat Runner’s Knee, depending on the cause of the knee pain. Conservative, nonsurgical methods usually form the first line of treatment, which include: 

The RICE method is effective for a high percentage of sports-related injuries. RICE is an acronym for Rest, Ice, Compression, and Elevation.

• Rest: Any activity that aggravates the knee condition should be avoided. The physician usually advises individuals to refrain from such activities, until the symptoms improve
• Ice: Applying ice to the knee may help decrease pain and reduce swelling
• Compression: Wearing an elastic compression bandage can help stop additional swelling and loss of blood
• Elevation: Elevating the knee helps to decrease swelling
• Non-steroidal anti-inflammatory medication, such as ibuprofen and naproxen, can help decrease the knee pain
• Physical therapy may help to restore strength, as well as flexibility in the muscles
• Taping the kneecap or wearing a specialized brace during sports participation can provide support for the knee
• Shoe orthotics may also be prescribed by the physician to help relieve pain

Surgical treatment for Runner’s Knee may include:

• Knee arthroscopy: Arthroscopic surgery is a minimally invasive surgical procedure that is used to visualize, diagnose, and repair the knee joint using small instruments. These instruments are inserted through a small incision within the knee
• Realignment of the knee joint: During this surgical procedure, a physician may realign the kneecap to decrease abnormal pressure on the cartilage and supporting structures

How can Runner’s Knee be Prevented?

A few recommendations to help prevent Runner’s Knee include:

• Warming-up prior to exercising
• Correct stretching techniques are recommended before and after an athletic or sports event
• Maintaining a healthy body weight can help prevent abnormal pressure on the knee and other joints
• Wearing appropriate footwear (such as the proper shoe size)
• Maintain strength in the quadriceps and hip abductor muscles, which helps in maintaining balance during any physical activity

What is the Prognosis of Runner’s Knee? (Outcomes/Resolutions)

• The majority of Runner’s Knee cases are successfully treated without surgery. The long-term prognosis is usually good after treatment
• When properly treated, a high percentage of individuals regain their full strength and range of motion in the affected knee

Additional and Relevant Useful Information for Runner’s Knee:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/orthopedc-disorders/