Unfortunately, runners frequently suffer from injuries, and the knees constitute one of the areas that are more commonly affected (followed by the feet and the ankles, the hips, the Achilles tendon and the calf).
Runners’ most frequent injuries are the patellofemoral syndrome or patellar chondropathy, the iliotibial band syndrome, the plantar fasciitis, the patellar tendinitis and the Achilles tendinitis.
Considering that the patellar chondropathy is the most common injury for runners, this article will explain everything you need to know about it.
Even though in this article we refer to this injury as patellar chondropathy, it is important to point out that it has many other names, though they always refer to the same pathology: chondromalacia patella, patellofemoral syndrome and even “runner’s knee”.
The patellar chondropathy is a pathological state of the cartilage located on the posterior surface of the patella, and which provokes pain all along the knee.
The knee is one of the most important and complex joints in the body (anyone having suffered from injuries in them know their relevance).
The knee is made up of the joining together of two important bones, the femur and the shinbone, and of a small bone called patella (or kneecap), which lies on the anterior surface of the joint and extends along the femoral trochlea during the flexion and extension of the knee.
Basically, the lower part of the patella extends along the bones that make up the knee as you flex and extend it.
When the knee is fully extended, the patella is located above the femoral condyles, and as it is flexed, the contact between the joint surfaces of the patella and the femoral trochlea increases, and the areas of patellofemoral contact change.
Behind the patella, there is a cartilage, the function of which is to avoid two bones from touching directly, in order to prevent their erosion and to allow the joint to move.
The name of this injury derives from the cause of the pain: the patella rubs the cartilage that is located on the posterior surface of the patella and damages it.
Runners frequently complain about feeling pain on the anterior surface of the knee. The pain increases when doing certain activities, such as: running on uneven terrains or going down stairs. The pain is also more intense when flexing the knee for a long time, as when sitting down.
This is accompanied by a feeling of friction and snaps when flexing and extending the knee and by a feeling of lack of stability, that runners describe as “my knee is failing”.
This pathology may be originated by different factors:
– Repeated traumatisms, like those occurred during a race.
– External hyper pressure caused by a muscular imbalance (between the external and the internal vastus). This provokes a lateral displacement of the patella during the flexion and pain when it places itself on the external condyle.
– Insufficiency of the muscles involved in the extension of the knee, the quadriceps.
– An abnormally high patella.
– Excessive trainings with multi jumps.
– A Q angle bigger than the normal angle (it is the angle formed between the femur axle and a vertical line along the patella and the patellar tendon) that causes the lateral displacement of the patella while standing on it.
– Foot pronation.
– Retraction of the iliotibial band.
– Pelvic blocking, pelvic anteversion.
– Genu valgum (knock-knee).
The treatment for this injury is important to run without pain (and perform the rest of your daily activities).
During the acute phase of this injury, it is normal to have anti-inflammatory and analgesic therapies prescribed by a physician.
For that purpose, ultrasound, electro stimulation and massage therapy (especially in the quadriceps and the tensor fascie latae) and cryotherapy are usually applied.
Moreover, it is important to guarantee the functional economy of the knee, avoiding to carry weight during the flexion and extension of the knee and going up and down stairs, and moderating the amount of sport done.
During the chronic phase, strengthening quadriceps and hamstrings, under the supervision of a physiotherapist regarding how to do the exercises, exercising in a reeducation pool and performing proprioception exercises are techniques that may help you.
Taking into account the great amount of possible causes (and their combination), it is important to prevent patellar chondropathy.
A specific program of muscular strengthening for the muscles involved in the flexion and extension of the knee is vital for many runners to prevent and treat the patellar chondropathy.
Apart from that, stretching and massaging these muscles are also valid alternatives.
flickr photo by anieto2k http://flickr.com/photos/anieto2k/6014515732 shared under a Creative Commons (BY-SA) license