Dr. Jacqueline Gerhart: What Is Causing My Knee Pain While Running?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Reader: There are many causes of knee pain. To narrow them down, it's best to note where the knee pain is, what brings the pain on, and if there was any injury associated with it.
Because you are a runner and are relatively young, you likely have an overuse injury. Overuse injuries happen to people who perform repetitive motions, such as a warehouse worker lifting boxes or a pitcher throwing a baseball. The warehouse worker is continually bending and lifting - and may be lifting incorrectly - causing repetitive strain on the back or knees. The pitcher is continually rotating his shoulder to throw, causing a "wear and tear" injury on that joint.
In the same way, when a runner continually lands on the pavement in a repetitive motion, their knee and hip joints are under stress and strain. Sometimes this motion is more than the natural cushioning of our joints can bear.
Osteoarthritis, the most common type of arthritis, is an overuse injury. It is caused when the cartilage that cushions the ends of our bones deteriorates over time. The cartilage becomes rough, and eventually completely wears down, causing very little space and cushioning in the joint. It usually causes pain, tenderness, stiffness, loss of movement and flexibility, bone spurs, and sometimes a grating sensation, which progressively worsens over time.
While it is possible you are experiencing arthritis at age 30, you likely have a different type of overuse injury called patellofemoral stress syndrome. "Patello" refers to the patella, which is your knee cap. "Femoral" refers to the femur, which is your upper leg bone. So "patellofemoral stress syndrome" literally means a stress or overuse injury between your upper leg and knee cap.
The injury involves the cartilage under your patella. From overuse, misaligned bones or injury, this cartilage gets damaged, causing pain and grinding. Since you feel sensations of grinding or creaking in the top of your knee, and because it improves with less activity, chances are your diagnosis is patellofemoral stress syndrome.
Patellofemoral stress syndrome is common in runners, in young adults and in people with wider hips. Since women have wider hip structures than most men, patellofemoral stress syndrome is more common in women. Additionally, people who are overweight or who have weak quadriceps muscles are at increased risk.
To prevent patellofemoral stress syndrome, be sure to do quadriceps exercises. The quadriceps muscle is partly responsible for keeping the patella in place and allowing it to track properly. Also, if you are overweight, consider doing non-weight-bearing activities first, like swimming or cycling, and then easing in to jogging.
Be sure to warm up for at least five minutes before running, and stretch afterward to promote flexibility. If you are just starting an exercise program, remember to do it gradually. If you experience pain in other joints or notice your knee pain is worsening, see your primary care provider. He or she will be able to suggest exercises and pain-management practices to help get you back to your activity.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 03/06/2012