3 Reasons Why Your Runner's Knee is Not Getting Better

Does this sound like your knee?

It's Monday morning and you completed a long run this weekend.  As you walk (or hobble) down the stairs, you feel a deep dull pain along your knee cap each time you bend it.  At work, you squirm in your seat because the pain starts coming back after you've been sitting with your knee bent for a while.  You start to notice you're avoiding squatting down and lunges because they hurt.  

As the week goes on, the knee pain slowly improves until your next long run.  Everything starts back up all over again.  You've tried stretching, foam rolling, icing and braces.  None of the self-treatment options seem to work.  It feels better if you take ibuprofen, but you know it's wrecking your stomach and raises your blood pressure.

If this story sounds familiar, you probably have Runner's Knee.  

Also known as Patellofemoral Tracking Syndrome, Runner's Knee occurs when the patella (or kneecap bone) does not glide nicely along the femur (or thigh bone).  If the angle is off, ever so slightly, it creates pressure along the joint which results in inflammation and pain over time.  As a sports chiropractor in Bloomingdale IL, I treat Runner's knee and get to see lots of patients who have struggled with knee pain for months or years. 

Based on my clinical experience, here's 3 reasons why your Runner's Knee isn't getting better:

Reason #1:  Runner's Knee is NOT an overuse injury

There's a common misconception that Runner's Knee is simply an overuse injury and if you reduce your milage or rest for a few weeks it will go away.  Although you will feel better if you stop the aggravating activity, the mechanical pressure will continue along your kneecap and eventually everyday activities will bother it too like walking or going down stairs. 

To fix the problem, you need to remove the mechanical issue.  Avoiding use of your knee does not fix the problem.  You need to figure out why your kneecap joint is creating friction when you move it.

Reason #2: Ice, NSAIDs and cortisone injections help Runner's Knee feel better, but don't really solve the inflammation issue

Icing, NSAIDs (ibuprofen, naproxen etc) and cortisone injections help turn down your body's natural inflammation and healing response.  This reduces the number of "pain chemicals" you produce and your knee feels better -- just like magic.  But as your knee warms up or the medication/shot wears off, you are right back to square one. 

A research paper in the journal Radiology recently reported that cortisone injections can actually worsen knee problems and increase your risk of degeneration or needing a knee replacement.  We think this occurs because inflammation is part of your body's natural healing response.  If you turn this off, you turn off your body's ability to repair.  This speeds up the rate at which your knee falls apart.

Reason #3: You (or your doctor, chiropractor or PT) are treating your knee, but not fixing the cause of your knee pain.

It's human nature to be want to treat the place that hurts.  But in the case of knee pain, the cause of the mechanical pressure is rarely due to the knee joint itself.  It's a relatively simple "hinge."  It bends and extends -- that's about it.  When things are not moving well in your core, hip and foot, it changes the angle of how the kneecap moves over your femur, causing Runner's Knee.

If your health care team has been massaging, stretching or strengthening your knee, it's likely to feel better temporarily and then the pain will come back because the real root cause is in your core, hip or foot.  Identifying the root cause during the examination process is key to rapid relief and long-lasting results with Runner's Knee.  By taking this approach, most of my patients experience relief within the first couple of visits and full resolution within 6-8 visits -- half of the time it takes with the traditional "knee-focused" approach.

One of my favorite exercises to help prevent Runner's Knee is the Side Bridge with Hip Abduction.  It really gets the lateral side of your core engaged along with your outer hip, which helps keep your femur (and kneecap!) in optimal alignment.  Try adding this exercise to your daily routine and work your way up to 6 reps on each side.