Strengthening Exercises:Muscle weakness or imbalance is one of the first things physical therapists check for when evaluating knee pain. Such an imbalance can be the source of pain. In addition to specific muscle strengthening of the muscles that support the knee (quads, hamstrings, calf), building core strength improves overall stability which may reduce the risk of injury.

The balance of quadriceps to hamstring strength is not 1:1; but closer to 3:2. In general healthy hamstrings can lift 60 – 80% of what healthy quads can do.
More about Conditioning Exercises.

Flexibility:Athletes who are less flexible than average may benefit from flexibility exercises. This is more critical in athletes involved in stop and go sports or those that require quick cuts and turns. Improving flexibility in the quadriceps, and the hamstrings are helpful. For specific stretching

1.Optimize your technique. If you’re involved in a sport or activity on a regular basis, it’s important to have the best technique possible so that proper movement patterns are trained.

2.Listen to your body. If your knees hurt, or you feel fatigued, don’t be a hero — take a break. You’re much more likely to injure yourself when you’re tired.

3.Baby your knees. Wearing proper gear for knee-sensitive activities can help prevent injuries. Use kneepads when playing volleyball or laying carpet and buckle your seat belt every time you drive. Most shattered kneecaps occur in car accidents.

4.Make sure your shoes fit well. A well-fitting shoe helps you maintain stability. Choose footwear that’s appropriate for your sport. Running shoes aren’t designed for pivots and turns, for instance, but tennis and racquetball shoes are.

5.Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. That doesn’t mean you have to stop being active, but it does mean being smart about when and how you work out. If your knees ache after jogging or playing basketball or other sports that give your joints a real pounding, consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.

6.Get strong, stay limber. Because weak muscles are a leading cause of knee injuries, you’ll benefit from building up your quadriceps and hamstrings, which support your knees. Try knee extensions, hamstring curls and leg presses to strengthen these muscles. Balance and stability training helps the muscles around your knees work together more effectively. And because tight muscles also can lead to injury, stretching is important. Try to include flexibility exercises in your workouts.

7.Keep extra pounds off. Maintaining a healthy weight is one of the best things you can do for your knees — every extra pound puts additional strain on your joints, increasing the risk of ligament and tendon injuries and even osteoarthritis.

Knee pain is slowly becoming common among larger portion of the population. Knee pain is a matter of concern among people of various age groups especially older individuals. Your knee pain treatment should aim towards removing the cause of the knee pain rather than just covering up the pain. Your doctor should identify the root cause of your knee pain and should work toward uprooting the cause of the problem.

Nutritional supplements:To improve the joint’s mobility and decrease knee pain from arthritis, nutritional supplements like glucosamine and chondroitin may be used. Both of these are naturally occurring substances found in cartilage. Glucosamine is thought to promote the growth of new cartilage and repair damaged cartilage while chondroitin is believed to inhibit cartilage-destroying enzymes and promote water retention, improving the elasticity of the cartilage. Talk to your physician before taking these supplements.

Non-steroidal anti-inflammatory drugs:Temporary pain can be alleviated by reducing the inflammation of the tissue in the knee. Non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended to decrease the inflammation associated with arthritis. Aspirin, ibuprofen and ketoprofen are over-the-counter NSAIDs which reduce inflammation and swelling along with prescribed NSAIDs available through your physician.

Most medication that falls in the anti-inflammatory category also has analgesic effects, says William Bargar, MD, director of the Joint Replacement Center with Sutter General Hospital in Sacramento, Calif., and a spokesman for the American Academy of Orthopaedic Surgeons.

The main over-the-counter drugs are acetaminophen (Tylenol and other brands) and non-steroidal anti-inflammatory drugs (or NSAIDs), including aspirin (such as Bayer), ibuprofen (Advil, Motrin), and naproxen (Aleve). These can help with simple sprains or even arthritis.

Dr. Bargar points out that even though knee pain-relieving medication is available without a prescription, you should use care when taking it. Be sure to follow the instructions for any medication and read the warnings.

“What you also have to watch for is that some of these over-the-counter drugs are sold as ‘arthritis strength,’ and that means they are larger doses. For example, too much arthritis-strength Tylenol can damage the liver,” he says. “Ibuprofen can cause gastrointestinal damage, such as ulcers and bleeding, if you take too much. You have to be careful about overdoing it with over-the-counter drugs for knee pain.” Another option to try is glucosamine and chondroitin sulfate, which are oral supplements believed to relieve the pain of osteoarthritis. Side effects can include headache, upset stomach, and skin reactions. The American Academy of Orthopaedic Surgeons reports that these supplements might help you during the earliest stages of knee pain caused by osteoarthritis, but it can take up to two months of consecutive use to notice any relief. Be sure to tell your doctor you are taking the supplements, because they can interfere with other medication.

Topical Medications:Some prescription topical creams contain an NSAID that is absorbed through your skin directly to the area where it is needed. The amount of drug absorbed by the bloodstream is minimal, eliminating or significantly reducing the side effects associated with oral NSAIDs. Because some medication still gets into the bloodstream, if you are taking oral NSAIDs for knee osteoarthritis you may have to reduce the dosage of your medication.

Corticosteroids:In severe cases of knee osteoarthritis, where mobility is severely restricted, corticosteroids (steroids) can be injected into the knee joint for quick relief that can last from weeks to months to years. Steroid medications have powerful anti-inflammatory properties but also can have serious side effects. Used too frequently, they can actually lead to more cartilage degradation. In knee osteoarthritis, corticosteroids are not given orally because the side effects outweigh the benefits.

Commonly referred to by the acronym P.R.I.C.E., self-care measures for an injured knee include:

1. Elevation. Because gravity drains away fluids that might otherwise accumulate after an injury, elevating your knee can help reduce swelling. Try propping your injured leg on pillows or sitting in a recliner.

2.Compression. This helps prevent fluid buildup (edema) in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that’s lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.

3.Ice. A staple for most acute injuries, ice reduces both pain and inflammation. Some doctors recommend applying ice to your injured knee for about 20 minutes three times a day. A bag of frozen peas works well because it covers your whole knee. You can also use an ice pack wrapped in thin fabric to protect your skin. Although ice therapy is generally safe and effective, don’t leave ice on longer than recommended because of the risk of damage to your nerves and skin.

4.Rest. Taking a break from your normal activities reduces repetitive strain on your knee, gives the injury time to heal and helps prevent further damage. A day or two of rest may be all that’s needed for minor injuries. More severe damage is likely to need a longer recovery time.

5.Protection. The best way to protect your knee from further damage depends on the type and severity of your injury. For most minor injuries, a compression wrap is usually sufficient. More-serious injuries, such as a torn ACL or high-grade collateral ligament sprain, usually require crutches and sometimes also a brace to help stabilize the joint with weight bearing.

Knee pain treatment exercises can help control your knee pain. Strengthening and stretching your quadriceps and hamstrings will both improve and protect your knee. The exercises prevent stiffness and make your knee less vulnerable to injury, according to thephysiotherapysite.co.uk. Do the exercises several times daily to get the best results. Check with your doctor prior to starting any exercise program to avoid injury.

Straight Leg Lift:Straight leg lifts help strengthen your quadriceps, or thigh muscles, according to the American Academy of Orthopaedic Surgeons. Lie on your back to do this knee pain treatment exercise. Bend your healthy knee while keeping your injured leg straight on the surface. Tighten your abdominal muscles to keep your lower back firmly against the floor. Tighten the thigh muscles in your painful leg. Slowly lift your straight leg 12 inches off the floor. Hold this position for five seconds. Slowly lower your leg back to the original position. Repeat this exercise five times. Make certain you do not arch your back during this exercise. You also do not want to use a sudden, jerking motion to lift your leg.

Water Walking:Walking in water can help your knee pain. Walking is good for your body, but walking in water places less impact on your joints. The water’s natural buoyancy supports your body weight, which helps diminish your knee pain. Water provides 12 times the resistance of land-based exercises, which also helps you strengthen and build muscle, according to the Arthritis Foundation. Get into waist or chest-deep water. Walk as you would on land. Stand upright with your shoulders back. Bend your arms slightly and keep your chest lifted. Make certain your feet touch the pool’s bottom to avoid any injury. Tighten your abdominal muscles to avoid straining your back. Slowly stride forward at your own pace. If walking in shallow water, walk across the width of the pool. Relax for 10 seconds when you reach the opposite side. Walk back to your original starting point. Repeat this exercise five times. If you are walking in chest-deep water, walk the pool’s perimeter. Hold onto the pool’s side with your hand, if desired. The deeper the water, the more intense your workout.

In addition to asking about your pain — its location, what it feels like, when it started, what makes it seem better or worse — your doctor may inquire about your exercise program, sports you play or used to play, and any previous injuries to your knee joint. During the physical exam, your doctor is likely to inspect your knee for swelling, pain, tenderness, warmth and visible bruising; check your range of motion; and perform a number of maneuvers to evaluate the integrity of the structures in your knee.

One of these maneuvers, the Lachman test, helps detect injuries to the ACL. In the Lachman test, your knee is bent at a 30-degree angle and your doctor gently moves your lower leg forward at the knee. If your lower leg moves freely without reaching a firm endpoint, you’re likely to have a torn ACL. Other maneuvers assess the PCL, tendons and menisci.

These tests may not be accurate in some instances — when movement in your knee is restricted by swelling or by contracted muscles in the back of your leg, for example. In that case, your doctor may order a magnetic resonance imaging (MRI) test or another imaging test to aid in the diagnosis.

Unlike an X-ray, which isn’t useful for viewing ligaments, tendons and muscles, an MRI can help identify injuries and damage to soft tissue. MRI uses a powerful magnet to create 3-D images of the inside of your knee. Generally, no special preparation is needed for this test; however, if you’re bothered by confined spaces, be sure to let your doctor know. He or she may be able to send you to a facility with an open MRI machine, which allows you to see outside of the machine, or you may be prescribed a mild sedative for the test.

1.Computerized tomography (CT) scan. This specialized X-ray, which creates cross-sectional images of the inside of your body, may help diagnose bone problems and detect loose bodies.

2.X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.

If your doctor suspects an infection, gout or pseudogout, you’re likely to have blood tests and sometimes arthrocentesis, a procedure in which a small amount of fluid is removed from your injured joint with a needle and sent to a laboratory for analysis.

Radiological examination:

1.X-Ray of knee may show a fracture, osteoarthritis changes and punched out lesion of gout and pseudogout

2. MRI may be indicated to diagnose torn menisci or other conditions

3.Bone survey at times may be indicated

Urine tests

1.Urinalysis for blood, sugar and protein

2.24 hour urinary uric acid, if suspect gout

3.Blood tests

4.Full blood count, ESR and CRP

5.Renal function tests and Electrolytes

6.ASO titre, if suspect rheumatic fever

7.Arthritis screen depending on suspicion including Rheumatoid factor, ANA and ENA antibodies, HLA-B27

8.Uric acid (marker of gout)

9.Coagulation profile

10.Blood cultures, if fever

11.Lyme disease serology

12.Iron studies, if suspect hemochromatosis

Physical examination

1.Full physical examination looking for signs of systemic disease that can predispose or present with joint pain – e.g. rash and pitted nails of psoriasis; Raynaud’s phenomenon of rheumatoid arthritis; doughnut-shaped rash of Lyme disease; butterfly rash of systemic lupus erythematosus; abdominal tenderness of ulcerative colitis and Crohn’s disease; heart murmur of rheumatic fever or subacute bacterial endocarditis.

2.A systematic examination of the affected knee looking for signs of inflammation, deformity, swelling, disordered stability and reduced range of motion – e.g. tenderness and warmth indicates inflammation; redness of the skin over the joint indicates gout, pseudogout, rheumatic fever or septic arthritis.

3.Inspect the knee with the person walking, standing and lying.

Call Your Doctor If:

1.You still have pain after 3 days of home treatment

2.You have pain, swelling, numbness, tingling, or bluish discoloration in the calf below the sore knee

3.You have a fever, redness or warmth around the knee, or significant swelling

4.Your knee is deformed or misshapen

5.Your knee buckles, clicks, or locks

6.You have severe pain, even when not bearing weight

7.You cannot bear weight on your knee

Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Or, certain medical conditions, including arthritis, gout and infection, may be at the root of your knee pain.

Many relatively minor instances of knee pain respond well to self-care measures. More-serious injuries, such as a ruptured ligament or tendon, may require surgical repair.

Although every knee problem can’t be prevented especially if you’re active you can take certain steps to reduce the risk of injury or disease.

The knees are the most easily injured part of the body. The largest and most complicated joint, the knee is used for everything from standing up, sitting, to walking, running, etc. It’s a weight-bearing joint that straightens, bends, twists and rotates. All this motion increases your risk of acute or overuse knee injuries.

Acute knee injuries (including torn ligaments and torn cartilage) are often caused by twisting the knee or falling. Sports that involve running and jumping and sudden stopping and turning, such as soccer, basketball, volleyball, tennis, and baseball, as well as contact sports such as football, wrestling, and hockey increase the risk of an acute knee injury.

The knee is a joint that has three compartments. The thigh bone (femur) meets the large shin bone (tibia) forming the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third compartment, called the patellofemoral joint.

The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (cruciate ligaments). These ligaments provide stability and strength to the knee joint.

The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for motion and absorbs the load of the body above the knee when standing. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. Below the kneecap, there is a large tendon (patellar tendon) which attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.

Knee pain is the most common musculoskeletal complaint that brings people to their doctor. With today’s increasingly active society, the number of knee problems is increasing. Knee pain has a wide variety of specific causes and treatments.

The knee joint’s main function is to bend and straighten. The knee, more than just a simple hinge, however, also twists and rotates. In order to perform all of these actions and to support the entire body while doing so, the knee relies on a number of structures including bones, ligaments, tendons, and cartilage.

Running is a wonderful sport for building fitness and endurance, but serious exercise without proper strength and conditioning can lead to something known as “runners’ knee”. This injury, caused from the continued stress and impact on the knees, is common in a number of sports especially in the younger generation. Though the pain of runners’ knee isn’t typically intense or excruciating, it can be nagging and leave athletes on the sideline for a while. Following are several very good runner’s knee exercises.

As an athlete, whether you participate in running or snowboarding, ballet or volleyball, it is important to have strong muscles and take great care to avoid runners’ knee. Unfortunately, many athletes don’t ever take into consideration how important their knees are or how easily they can injure them. However, it is important to note that the stronger the legs, the easier the impact will be on the knees.

Runners’ knee is often believed to be caused by poor knee tracking, or the way the kneecap slides over the thighbone. If the muscles in the thigh are weak or imbalanced, the knee tracking will be improper, therefore leading to runners’ knee.

Runners Knee Exercises Tips:

1.Knee Bend:Along with the exercises, it is of vital importance, that you also incorporate stretches in your workout schedule. This is one of the runners knee stretches. For this stretch, lie flat on your stomach. Keep both the legs stretched out. Now start bending your one leg towards your buttocks, while you keep the other leg straight. You will notice, that it is difficult to touch your leg to the buttocks, this because of tightness in the quadriceps. Do this stretch at least 5 times, change sides and repeat with the other leg. After you are done it with both the legs, single leg at a time, do the same stretch with both the legs simultaneously.

2.Single Leg Dip:This is one of the knee exercises to strengthen the knee and quads. For this exercise you will need to support yourself on either side. You may make use of chairs as props. Lift your right leg of the ground, as you balance yourself well on the left leg. Now start lowering yourself, by pushing all your weight into the heel of the left leg. Initially you will not be able to lower yourself beyond a few inches, but with practice you will be able to go far down, as though you were squatting with single leg. An important instruction is not to let the knee of the left leg go beyond the toes.

3.Wall Squat:This is one of the most wonderful, compound quad exercises for runners. Face your back towards the wall. Keep a distance of about two feet between your feet and the wall, but rest your buttocks on the wall. Slowly start sliding down on the wall, till you come to a position, as though you were sitting on a chair. While you do this do not forget to tighten your abdominal muscles and also squeeze your buttocks. Hold the position for a minimum of 5 to 7 seconds. Slowly return back to the starting position and ensure that this exercise is repeated 15 times.

4.Standing Leg Raises:Standing leg raises are similar to leg raises. In this exercise you will need to take support. You can hold on to a window pane for support. We will start with the right leg first. Lock the knee of your right leg, while the knee of the standing leg is soft. Lift your right leg off the ground and remember to flex your toes as you do this. Keep lifting it about 6 inches at a time. Like I mentioned in the leg raises, hold for 5 seconds in each position. While retuning back to the starting position, lower the leg 6 inches at a time. This exercise is to be done 10 to 15 times on each leg. Change sides and repeat the same on the left leg.

5.Leg Raises:This is one of the simple knee exercises, which can be done at home as well. Lie with your back on a mat and stretch both your legs in front of you, initially. Now bend your left knee and let the foot rest on the floor. Slowly start lifting your right leg off the floor, six inches at a time. The most important instruction is to keep your right knee locked as you do this. Every time you lift the knee hold in the same position for at least 5 seconds. Lift the knee to the maximum. While coming down, lower the knee 6 inches at a time, but do not forget to hold for 5 seconds. Do this exercise on each of your leg 10 to 15 times. The advanced version is to add ankle weights for the exercise. For more information, read exercises for a bad knee.

6.Use Good Running Shoes:If you have flat feet which can lead to excessive pronation then use appropriate running shoes which can correct this. Also, make sure that your shoes have enough support and discard them once they lose their shape or the sole becomes worn or irregular.

7.Take it Slow:If you are going to increase the intensity of your workout, do it slowly and gradually. Abrupt increases set you up for injury.

8.Stretch:Always stretch before and after physical activity. This maintains the elasticity of your muscles preventing undo strain on your lower joints.

9.Strengthen your Thigh Muscles: Make sure to keep your thigh muscles strong. Regularly stretch and strengthen them. If you don’t, your body will depend on the strength of your knee, which can result in knee injury.

10.Lose Weight: If this applies and you are overweight, establish a healthy diet and exercise program.

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Rest is a key component of the rehabilitation phase. Sufferers should only engage in low impact activities such as swimming, and make sure that they stretch thoroughly before commencing any exercise and use a knee brace if necessary. Wearing the correct footwear that is designed to support the feet and align the body is also recommended to make sure that you’re not putting any excess weight on the knee at an angle that will cause or aggravate the condition.

Check with your local running store (or physiotherapist) if you suspect that you have a foot strike problem. Then buy the appropriate shoes to correct this. I also like to wear cushioning shoes for marathon training, but this is a personal choice and might not suit everyone. If you frequently run on paved roads, try to pick a flatter area where possible. Even the sidewalk is preferable although it is often a harder surface. Running tracks in gyms are usually banked, so try to avoid these as much as possible.

Although speedwork is often called for in more advanced marathon programs, it can be a major contributor to knee problems. If you decide to do this as part of your training, go for the longer (slower) intervals rather than the short bursts of fast running. Most of us can run a successful marathon without including any formal speedwork in our training.Hill work is a great way to improve your leg strength and aerobic capacity, and should be part of your marathon training. However too aggressive an approach, and going too fast on the downhill, can be very detrimental to your knees. This is where the ‘listen to your body’ advice comes in. If you have been strengthening your quads, and you are wearing the right footwear you are probably OK. Just ease off the moment you start to feel any discomfort.

1.Formulate a training programme that progresses gradually and has sufficient rest involved too.
2.Avoid overdoing exercises. Anything over done is bound to cause trouble, so know the limits of your body.
3.Do not indulge in running downhill excessively, as it applies more pressure on the joints.
4.If you are running on unpaved roads, try to run on the flattest stretch, to minimize the shock.
5.Remember to choose the right shoes for running, as they play an important part in maintaining the health of your legs and feet.
6.It is important to do warm up and stretches properly, before running. In order to strengthen and protect hamstring, quadriceps and calf muscles, stretching is necessary. While stretching, remember to hold each stretch for around 30 seconds and then loosen up slowly. You could repeat this 2 to 3 times a day.

Runners Knee Prevention Tips:

1.Watch Your Body Weight:The more weight you carry on your frame, the more load you put on your knees. If you are overweight and looking to lose weight through running, you should have a professional trainer put together a program for you that will reduce your risk of injury.

2.Stay Hydrated:Water is necessary for so many bodily functions. Dehydration is asking for injury. Hydrate before, during and after your run.

3.Stop Before You are Tired:Do not run to exhaustion. Do not even run until you’re tired. When you get fatigued, your fine motor control is one of the first things to go. As such, your motions become sloppy and you start to lack muscle control of your joint motion. This is an injury waiting to happen.You need to keep complete control of your body with your muscles. Stop and rest when you need to.

4.Do Not Run With Weights:Avoid ankle weights or heavy shoes. The extra weight at your extremities will put a much greater load on your joints. A weight on your ankle can easily put force that’s 10 to 20 times greater on your knee (depending on the speed you run).

5.Wear Good Shoes:Good shoes are so important. But what is good for one person is bad for another. It is worth the effort to find a store with an educated staff that will take the time to fit a shoe not just to your foot, but to your stride.

6.Let Your Knees Move Correctly:Be careful with your running posture, especially if you run on a treadmill. If you concentrate too hard on placing one foot in front of the other, you might run with your knees hinging in to straight of a line. Your stride has a side-to-side element to it. In other words, you should kick out to the side and let your feet splay out a little.If you run on a thin treadmill, you might be forced into an extreme case of this, causing a lot of knee problems as a result. The fix? Vary your running surfaces or get an extra wide treadmill.

7.Vary Your Running Surfaces:Get off the treadmill and try the open road. Or, if you are a road runner, try an indoor track or just vary your running path.By varying your running routine, you will vary your stride and foot strike. This reduces the repetition in the repetitive stress injury. It also keeps the muscles at the joints balanced.

Avoid trauma or abnormal stress on the knee. Keep the leg muscles strong and flexible, especially the quadriceps and the hamstrings.

The condition is common and concerning the American population alone, there are about 40 million people who are afflicted by the complaint. The injury is popularly characterized by the deterioration or degeneration of the patella or the cartilage portion that is situated at the rear of the kneecap. The term runner’s knee has been further used simply because the disorder typically affects a lot of runners.

Studies show that one in every five runners is afflicted by this knee problem in a period of 12 months. Other individuals who are really prone to this knee injury include the soccer players, cyclists, tennis players, rowers, and those rugby players. Basically, their sports submit the knees to constant and severe stress. Thus, it is important to be acquainted with the runners knee treatment.

The pain brought about by runner’s knee is so excruciating that you will feel annoyed and bothered. The pain may subside for a few days but eventually, it will reoccur. If the damage gets so severe, it may mean the permanent inability to play your sport or engage in the strenuous activities. Don’t allow yourself to succumb to early retirement in the use of your knees. Address such concern at once before everything gets too late!

The Top Causes of Runner’s Knee:Through time, experts have unraveled the top causes of runner’s knee. Even if you are not a runner, you can be prone to the condition provided that you qualify for the following causes.

Overexertion or overuse:The prolonged and hectic use of the knees without intervals can cause the damage to the cartilage. Take note that any physical activity such as training or work out that is done without pausing can wear out the cushioning effect of the cartilage and therefore cause the pain in the kneecap.

Regardless of the cause, the good news is that minor to moderate cases of runner’s knee should heal on their own given time. To speed the healing you can:

1.Get arch supports for your shoes.These orthotics which can be custom-made or bought off the shelf may help with flat feet.
2.Practice stretching and strengthening exercises if your doctor recommends them.
3.Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs ( NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects, like an increased risk of bleeding and ulcers. They should be used only occasionally, unless your doctor specifically says otherwise.
4.Elevate your knee on a pillow when you’re sitting or lying down.
5.Compress your knee. Use an elastic bandage, straps, or sleeves to give your knee extra support.
6.Ice your knee to reduce pain and swelling. Do it for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain is gone.
7.Rest the knee. As much as possible, try to avoid putting weight on your knee.

Severe cases of runner’s knee may need surgery. A surgeon could take out damaged cartilage or correct the position of the kneecap so that stress will be distributed evenly.

The first step to promote healing is to decrease the number of miles run by at least thirty percent. This allows the knee to rest so that faster healing can take place. Instead of running on uneven outdoor terrain, it can be helpful to switch over to a treadmill or elliptical machine until the symptoms improve. Downhill runs should be avoided as well as leg squats which can put excessive strain on the knees. Footwear with good arch support and cushioning is important for faster healing and prevention of future knee problems. Sometimes runner’s knee arises from excessive pronation of the feet which can be corrected with appropriate running shoes. Having a professional help with the selection of shoes can ensure that the foot is properly cushioned and supported. In some cases, an orthotic may be needed.

Runner’s knee is frequently caused by weak quadriceps muscle, and strength exercises that focus on these muscles can help to correct the problem. There are a variety of DVD’s designed for quadriceps strengthening available online. These exercises can also help to prevent future problems with runner’s knee when done on a regular basis.

To relieve the discomfort of runner’s knee immediately after running, an ice pack can be applied to the sore knee which helps to reduce inflammation. Anti-inflammatory medications may offer additional benefit.

Self Muscle Massage

1) When using self muscle massage on Runners Knee, keep in mind that you need to work on two parts: a) what actually hurts- your Quads and b) what is causing the problem.

2) In the last post on PFS, we identified several restrictions that may lead to a shortened stride and decreased push up. They include:

a) decreased hip extension(this means you want to work on your hip flexors and glutes)

b) decreased knee extension (this means you will want to work on the hamstring and gastroc muscle)

c) decreased ankle mobility (this means that you will want to work on the calf and foot)

3) When working on the Quad itself, start easy and above the knee cap. Work your way closer to the joint as symptoms allow.

4) If you are unsure where the restriction may be, start with the most likely candidate- the hamstrings and calf. The majority of PFS patients that I see have extremely tight calves and hamstrings.

5) Ice following soft tissue work, especially the quad. This will help decrease pain and inflammation. 10-15 minutes is all you need.

Runners Knee Treatment

Arthroscopy and Lateral Retinacular Release: If the knee-tracking problem is caused by excessive lateral pull (kneecap pulls toward outer side of knee), cutting the tight lateral ligaments to reduce the amount of pull can rectify the problem.

Surgery:Surgery for Runners Knee should be a last resort, after an exercise program to correct muscle imbalances has been given a fair trial. It may be necessary if there are significant structural abnormalities.

Proper Foot Wear: Shoes with an arch support to control over pronation, shoes with adequate cushioning in sole to help absorb shock. Orthotics may be required for those with severe over pronation. See Knee Pain, Overpronation, and Footwear. High heels throw your body forward and increase the pressure underneath your kneecap. Limit the time spent wearing high heels.

Knee Brace:A Patellar Stabilizing Brace helps keep the kneecap in the middle of the patellofemoral groove. This may be helpful when the muscles than support the knee are still weak. A knee brace can take some stress off the knee and help relieve pain. Wearing a brace does not replace the strengthening exercises that correct the root of the problem. Braces help some people more than others. (Wearing them during sports has not been shown to reduce knee injuries) They are expensive, and some people find them hot and bulky. Patellar stabilizing braces must be fitted properly to be effective. Not all knee braces are created equally. Ask a doctor or physical therapist whether or not knee braces are appropriate for your situation.

Knee Taping : Taping is used to realign the kneecap and hold the kneecap in place. Although knee taping has not been scientifically proven to help stabilize the knee joint, it has been shown to significantly reduce pain. The relief is usually immediate. There are different techniques that a physical therapist (physiotherapist) can show you. The tape can be irritating the skin.

Exercise: Exercises, particularly exercises to strengthen and stretch the quadriceps (front thigh muscles) and hamstrings (muscles of the back of thigh). The exercises emphasized in the majority of cases are those that strengthen the quadriceps particularly the inner division of the quadriceps. This usually is very effective. Spending a few minutes, a couple of times a day on these muscles and gradually working up to 20 minutes per day are sometimes all that is needed. Be patient. It can take several weeks to notice an improvement. See Knee Exercises page.

NSAIDs : Non-steroidal anti-inflammatory drugs such as Aspirin or Advil, as recommended by your doctor. See Medications.

Icing: Applying Ice to the knee, especially after exercise may reduce pain and swelling. Don’t ice for over 20 minutes at a time to prevent frostbite. Elevating the knee above the level of the heart while icing helps in reducing the inflammation.

Rest : (not total rest) Temporarily avoid activities that cause extra stress on the knees such as squatting/kneeling or high impact activities like running until the pain subsides. Swimming or low-impact activities such as working out on an elliptical trainer are fine. Avoid squatting/kneeling as a bent knee causes extra pressure between the patella and femur. Avoid leg presses where you support your weight with a bent knee. Straight leg lifts are safer. As you get stronger, partial squats are ok

Diagnosis of runner’s knee begins with a history and physical exam. Joint X-rays are usually normal. The healthcare provider may do an arthroscopy. The provider inserts a small, lighted tube into the joint and examines it.

First, you can reduce the pain and inflammation by icing your knees immediately after running. Take an anti-inflammatory like ibuprofen or aspirin after running. Work on strengthening your quad muscles, which will help support and stabilize your kneecap. You can do simple exercises, such as forward lunges. Stretching your hamstrings and IT bands can also help.

Make sure you have the right kind of running shoes for your foot type. Also, make sure you’re not running in worn-out shoes. You should replace your shoes every 300-400 miles. You may also want to consider buying over-the-counter arch supports. If you’re still experiencing pain, you may need to see a doctor about getting

The doctor will perform a physical examination. The knee may be tender and mildly swollen, and the kneecap may not be perfectly lined up with the femur (thigh bone).

When you straighten your knee, a grinding sensation may be felt below the kneecap. Pressing the kneecap when the knee is straight may be painful.

X-rays are usually normal, although a special x-ray view of the kneecap may show signs of arthritis or tilting.

ometimes chondromalacia is not cured by conservative therapy, and it may be determined that surgery is needed for definitive treatment. By looking into the knee with an arthroscope, the surgeon can assess the damage done to the cartilage. He or she can also assess the mechanics of the joint to ascertain if there is an anatomic misalignment that could be corrected.

One common misalignment is due to abnormal tracking of the patella (tracking is simply the movement of the patella as the knee moves) caused by tight tissue on the outside (lateral) of the kneecap. For this problem, a procedure known as a lateral release can be performed. The lateral release involves cutting the tight lateral ligaments to allow for normal position and tracking of the patella. If this is not sufficient to correct the misalignment there is more extensive surgery that can be performed.

Pain, typically diffuse pain, in front, around or beneath the kneecap. More pain and/or feeling of joint instability after climbing stairs, jumping rope, running, or after a period of sitting.

There is extra pressure between the kneecap and thighbone when the knee is bent at a right angle as when sitting. The kneecap is pressed towards the femur. If there is already irritation of the cartilage on the underside of the kneecap, discomfort or pain results. Even sleeping in a curled up position can cause pain when the condition has flared up. Contracting the quadriceps, as when going up or down stairs, also causes increased compression of the knee joint.

Sometimes after activities that have activated the quadriceps, it feels the knee is being pulled to one side. Sometimes a clicking, cracking or crunching sound is heard when the knee is bent or straightened. This is the kneecap slipping back into the groove.

An X-ray or MRI of the knee can show if there is damage to the cartilage or if the patella is displaced or tilted. A tilted patella may be correctable with exercise if the tilt is caused by a muscle imbalance.

Symptoms Of Runners Knee:

1.Swelling in the knee.
2.Pain occurs initially when running downhill then progresses to all running.
3.Knee pain on the sides of the kneecap, particularly with deep knee bends or prolonged sitting.
4.Knee pain below the kneecap.

Notice pain around the outer side of the knee. Sometimes, people panic and think there might be a possible tear on the meniscus or knee cap. Or you might think you have strained a muscle. Consult with your physician to confirm the IT band syndrome diagnosis. Preferably, go to an orthopedic doctor.Experience difficulty using your knee when walking up or down the stairs. Often it hurts more to step down than to go up.

Examine your knee for swelling. There will be some along the side of the knee. A vein might become more prominent than it was before, or a group of little veins anywhere on the leg might become swollen.Spot that your walk has become a limp. It will feel like something is dragging your leg along. There will be pain behind your knee cap and pressure all along the side of your leg up to your hip.Notice that you are more tired than you would be normally. The pain on the side of your leg will span from the top of your hip to your knee and will make you fatigued. You will be working more to perform daily routine activities and you will want to rest more. In fact, you will want to just lie down.

Since we are not blessed with x-ray vision a way of diagnosing runner’s knee is by looking for the distinct symptoms. Individuals ailing from runner’s knee tend to experience pain beneath or on the sides of the knee cap, also there is a grinding or cracking sound when the knee is flexed resulting from the under surface of the kneecap rubbing against the knee joint. Other symptoms include pain after running uphill and swelling at the knee.

Unlike that of arthritis the degeneration caused from runner’s knee can be reversed. Treatment of runner’s knee is dependent on age, gender, and medical history; however the first and most obvious treatment of runner’s knee would be to stop running, not permanently just long enough to give your knee time to recover.

• The use of non-steroidal anti-inflammatory medication can also help to reduce the pain and swelling.

• Keep legs elevated as much as possible and also try sleeping with a pillow between legs.

• Avoid lifting weights as this increases tension on the knees and will only worsen the condition.

• Strengthen quadriceps muscles through various exercises such as squatting.

• Applying ice to shin area.

If symptoms persist then you should consult your physician as surgery might be required.

As is always the case prevention is better than cure. Proper stretching and warming up before physical activity and cooling down afterwards can reduce one’s risk of getting runner’s knee. Other preventative practices includes, avoiding running downhill and on rugged uneven surfaces, also when undertaking a new training programme do so in gradual progressive steps.

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