Common Knee Injuries From Running

AdventHealth and Rothman Orthopaedics are joining forces to lead in pioneering research and innovative care in Central Florida. Together, we’re transforming the field of orthopedics. This article originally appeared on RothmanOrtho.com.

Over 28 million people in the U.S run weekly. Ask anyone who has been doing it for a long time and they’ll likely all tell you the same thing: going for a run can be extremely freeing. The wind is at your back, your destination is what you make it to be, and everything comes naturally. But while it may feel like a simplistic motion, there are a number of muscles, tendons, and nerves working together to make it all happen. And unfortunately, a minor breakdown of one of those parts can make the whole experience feel more restrictive than freeing.

It’s not unusual for athletes to sustain injuries without direct trauma, and that’s especially true for injuries pertaining to the knees. In fact, about 40% of all running injuries involve the knee in some way, a majority of which are usually a result of wear and tear. Fortunately, taking preventative steps now can lead to healthier joints in the future. That’s why Rothman put together this compilation of some common knee injuries from running, as well as how to handle them.

Runner’s Knee

Medically known as patellofemoral pain syndrome, runner’s knee is an orthopedic condition that negatively affects the tissues, nerves, and bones of the kneecap. Pain from this injury generally comes as a consequence of worn-down cartilage rubbing against soft tissue. This unnatural friction causes irritation and soreness, making normal tasks feel like hard work. The injury tends to comes as a result of activities that involve repetitive bending or stress to the knee. Patients often report discomfort after extended periods of rest with their knees bent, or after hearing a popping/cracking sound in the knee, accompanied by inflammation.

Common causes for runner’s knee include:

• Overuse and/or repetitive stress
• Conditions like chondromalacia patella, which causes cartilage under the knee to deteriorate and soften, bringing inflammation and pain to the knee joint
• Structural deformities in the legs, such as patellar malalignment. This causes the muscles in knees and legs to be weak and/or imbalanced.

Preventative measures for this condition often involve a reduction in athletic intensity. Even a mere change in technique can go a long way in limiting the wear and tear on knee cartilage. By taking shorter strides while running and keeping their knees slightly bent, studies have shown that runners can reduce unnecessary pressure on their joints by up to 30%.

Similar to other soft-tissue injuries, runner’s knee can become a long-term issue without proper diagnosis and care in the early stages. Dr. Christopher Dodson of Rothman Orthopaedics says “continued activity may advance this condition, causing increased severity of symptoms and structural damage.” That’s why it’s important to get medical guidance on the issue as soon as possible.

Patients can temporarily minimize their discomfort through the use of anti-inflammatory medications, as well as use of the RICE method. In some cases, an orthopedic specialist may advise temporarily wearing a runner’s knee brace to allow for the knee to stabilize and recover. For more severe cases, surgery may be needed to fully repair the affected joint.

Jumper’s Knee

Similar to runner’s knee, patellar tendonitis (or jumper’s knee) is a condition that is well-known to affect those who routinely run long distances. Patients who suffer from jumper’s knee experience inflammation of the tendon that connects the kneecap to the shinbone. This inflammation brings about aches and discomfort when running, jumping, or walking - any action that requires the bending and straightening of the leg. The pain can be temporary or long-term, but always requires some sort of treatment to restore its natural state.

Common causes of jumper’s knee include:

• Unbalanced leg muscle strength
• Repetitive stress to the knee
• Misaligned leg, feet, and ankle structure
• Physical activity on hard playing surfaces
• Chronic diseases that can weaken or deteriorate the tendon (among other soft tissues) over time

To properly determine whether the pain is a bone fracture or a soft tissue problem, diagnosis requires a combination of MRI’s, X-rays, and ultrasounds. Jumper’s knee should be handled seriously because of the nature of the injury. If not handled properly, the inflamed tendon can go from worn-down to torn, causing worse damage and potentially limiting normal, everyday function.

Patellar tendonitis treatment requires a conservative use of the affected tendon for a temporary amount of time. This reduction in activity is often complemented with a stretching regimen, under advisory of an orthopedic specialist. Patients will also be encouraged to strengthen their leg muscles in an effort to make themselves less susceptible to jumper’s knee in the future. Multiple diagnoses of patellar tendonitis lead to surgical intervention in order to fully repair the affected tendon.

Iliotibial Band Syndrome

As the most common cause of lateral knee pain in runners, iliotibial band syndrome (also known as ITBS) has affected more than its fair share of athletes. The IT band serves to stabilize the knee and allow it to move, flex, and extend without pain. It’s a thick, tough and fibrous tendon that runs from the hip to the tibia on the outermost part of the leg.

Frequently caused by overuse, those with ITBS can expect to see symptoms such as:

• Pain on the side of the knee that worsens when running
• Swelling along the femur or below the knee
• Discomfort when the knee is bent at a 45-degree angle

ITBS treatment comes in many forms, and Rothman orthopedic specialist Dr. Steven Cohen directs patients to be proactive when they notice symptoms related to ITBS. “When identified early, this condition can be effectively addressed using iliotibial band exercises, iliotibial band stretches, and other non-surgical treatment methods.”

Aside from these targeted physical therapy exercises, Rothman also offers Orthotics to assist in correcting the patient’s gait, which can prove to be the culprit for the appearance of ITBS in the first place. For more serious and ongoing circumstances, surgery may be recommended to help runner’s get back to their pre-injury state of physical activity.

Osteoarthritis

Degenerative joint disease (also known as osteoarthritis) is the most common chronic condition relating to joint pain in the U.S., affecting nearly 27 million Americans. It stems from a result of overuse and generally affects the hips, knees, ankles, and foot joints. Runners suffering from osteoarthritis have worn down the cartilage that allows for comfortable movement. When cartilage wears away, bone will rub against neighboring bone, causing severe pain and discomfort, as well as limiting the range of motion in the affected area. More often than not, patients diagnosed with osteoarthritis have some sort of predisposition to the condition.

Symptoms of degenerative joint disease often include:

• Discomfort or pain in the groin, thigh, or knees
• A limited range of motion
• Stiffness in the affected joints
• Consistent trouble sleeping at night (in severe cases)

The first step for treatment is getting an accurate diagnosis from an orthopedic specialist, who will be able to properly determine the best method for recovery. While there are many conservative treatment measures, those diagnosed with osteoarthritis should expect to undergo surgery if they want to fully rehabilitate the worn down cartilage.

Here for Your Whole Health

Have you heard? We've joined forces with Rothman Orthopaedics, one of the nation’s top orthopedic programs, to create a groundbreaking, comprehensive specialty network that is the new gold standard in quality, innovation, research and whole-person care.

This visionary partnership will expand the possibilities for world-class treatment for a variety of orthopedic services, including joint replacement, fracture care, reconstruction of the knee, shoulder, elbow and hand and treatments for arthritis and osteoporosis. Together, our leading-edge providers comprise a powerhouse of innovation focused on developing new treatments and widening accessibility to top-level care while raising the bar for orthopedic excellence.

Learn more at TransformingOrtho.com.