What is runner’s knee?

Runner’s knee is a general term that can be applied to several different injuries in relation to overuse of the knee, resulting in pain around the kneecap. Orthopaedic surgeon Mr Alex Chipperfield tells us more about the medical conditions that fall under runner’s knee.

The specific medical conditions that this term covers include:

• Patellofemoral pain syndrome
• Chondromalacia patella
• Iliotibial band syndrome
• Plica syndrome

What are the symptoms of chondromalacia patella?

Chondromalacia Patella (CMP) is inflammation of the underside of the patella (kneecap), with softening and in some cases fragmentation of the cartilage.

The kneecap cartilage is a shock absorber and allows the kneecap to glide smoothly over the thigh bone during knee movements. When this cartilage is damaged the kneecap no longer moves correctly - it can catch, lock, jar and cause pain.

Common symptoms include pain at the front of the knee. This is generally brought on by prolonged sitting or repetitive knee flexion. Pain can also be experienced in activities that excessively load the front of the knee, such as rising from a seated position and climbing stairs.

Runner’s knee vs jumper’s knee – what’s the difference?

Runner's knee refers to a cluster of conditions that can cause pain around the front of the knee, generally associated with how the kneecap moves.

Jumper’s knee is a specific chronic inflammatory condition affecting the patellar tendon that attaches the kneecap to the shin bone (for more information on this condition, see Mr Chipperfield’s previous article).

What is the treatment for chondromalacia?

Treatment depends on how far gone the condition is. The key is whether or not the cartilage has begun to fragment and wear away.

If the cartilage is preserved, then a strict regime of RICE (Rest, Ice, Compression, Elevation) can help, along with anti-inflammatory medication and physiotherapy. In these cases, it is important to allow the symptoms to completely resolve before resuming the activity that caused it.

Once the cartilage is damaged, the treatment becomes more difficult. The above regime can help settle acute inflammatory flare-ups but the movement of the patella will remain abnormal due to roughening of the formerly smooth surface of the kneecap cartilage.

There is currently no proven way of regenerating this cartilage, but there is plenty of research into this area. Currently the only surgical option available (besides joint replacement) is a keyhole procedure known as chondroplasty - this involves smoothing down the surfaces and sealing them off. The aim is to allow better movement and prevent further fragmentation.

Results of chondroplasty are variable, and success is by no means guaranteed. It is reserved as a “last resort”.

How soon can I get back to running?

It is recommended that you wait until the symptoms have completely resolved before restarting running. This can be frustrating in the short term but is beneficial in the long term.

Do you suffer from knee pain? Visit an orthopaedic surgeon such as Mr Alex Chipperfield for a checkup.