RUNNER'S KNEE (Chondromalacia Patellae) |
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General Information
DEFINITION--Aching pain behind the kneecap. Pain begins and progresses slowly. It appears in healthy, athletically active young people between 12 and 35 years old, and is twice as common in women as in men. This is the most common knee problem for runners.
SIGNS & SYMPTOMS
Soreness and aching pain around or under the kneecap, especially on the inner side. Symptoms worsen after walking or running up ramps or hills, squatting, or jumping up and running.
"Giving way" at the knee (sometimes).
"Water on the knee" (sometimes).
CAUSES & RISK FACTORS
Muscle imbalance or compression at the knee that pulls the kneecap sideways out of normal alignment.
Direct blow to the kneecap.
Injury resulting from extreme flexing of the knee, as in squatting and kneeling.
Congenital abnormal development in the knee.
Overstress of the knee as can occur in any running sport, such as jogging, sprinting, football, basketball or soccer.
HOW TO PREVENT
Strengthen and condition upper leg and hip muscles for maximum strength, flexibility and endurance before you start competition or vigorous physical activity.
Avoid deep squats or activities that compress the kneecap.
Don't use knee wraps for weight-lifting. Wraps increase knee compression.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the knee to rule out fracture. Special views can reveal misalignment or tilting of the patella.
SURGERYSometimes necessary as a last resort. In surgery, cartilage is shaved using an arthroscope (See Glossary). Open-knee surgery may be necessary to realign the kneecap.
NORMAL COURSE OF ILLNESSWith successful treatment, 80% should be able to return to vigorous physical activity. In the remaining 20%, the condition will return if vigorous activity is resumed.
POSSIBLE COMPLICATIONSNon-healing with conservative measures, leading to a need for surgery (a last resort).
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENT
Often none is necessary after diagnosis and prescription of medications and special shoes (sometimes).
Rehabilitation of the quadriceps muscles and hamstrings is sometimes necessary following surgery.
HOME TREATMENT
Rest is essential. Trying to "work through" or "run through" pain worsens the condition.
Don't kneel or climb stairs unless you must.
Apply ice bags for 10 minutes 3 or 4 times a day for 3 to 4 days.
After ice treatments end, apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Your doctor may prescribe orthotic shoe devices, knee straps or braces.
MEDICATIONYour doctor may prescribe aspirin, ibuprofen or other non-steroidal anti-inflammatory medicine.
ACTIVITYWhen pain has subsided, start on quadriceps drills for rehabilitation (see Rehabilitation section). Resume athletic training when the injured leg reaches 75% of the strength of the other leg.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
CALL YOUR DOCTOR IF
You have symptoms of runner's knee that don't improve after resting for 2 or 3 days.
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