Why do my knees hurt after or while running?
Running, a highly addictive activity, is largely beneficial. Unfortunately, with each impact , large mechanical forces pass through the foot systems , through the lower leg, knees, thighs, hips, and back . The knees are the most commonly injured part of the body when running. It is a very complex joint with a number of delicate structures. It could therefore be said that they are the most susceptible part of the body to injury when running. Up to 26% of running-related injuries occur in them. 1
The most common causes of knee pain and something about them
The feeling of pain can come suddenly , for example, with meniscus damage , muscle tear , ligament or tendon rupture. Such injuries are referred to as acute and you need to see a doctor immediately. The majority of knee injuries are chronic injuries that occur over a longer period of time , the pain worsens over time and so their diagnosis and then recovery can take a long time. Their order is given according to how often they occur.
Classification of running knee injuries by location of pain
| Place of pain | Name of injury | Duration of treatment |
| Anterior segment of the knee - behind the patella | Patellofemoral syndrome (runner's knee) | weeks to months |
| Outer side of the knee | ITB Syndrome | 6-8 weeks |
| Front of the knee - below the patella | Patellar tendinopathy (jumper's knee) | 12 weeks |
| Suddenly at a moment according to the injured party | Meniscus rupture | months |
Patellofemoral syndrome - what is runner's knee?
It is chronic and the most common knee pain in runners .
Where does runner's knee hurt?
The pain is localized in the anterior segment of the knee directly behind the patella .
Why does runner's knee occur?
The main cause is long-term overuse of the knee in the patella area. Running , stairs , jumping , squatting and other repetitive movements with bending and extending the knee can be the cause.
Is anyone predisposed?
The vast majority of people affected by this condition are athletes who overuse their knees. However, some people are more susceptible . This pathology is more common in women , people with gait disorders , people with unstable patellas or weak thigh muscles .
How long does it take to treat runner's knee?
The duration depends on how early the syndrome is caught. Mild cases can recover in a few weeks , while more severe cases can take months or even years. It is important to return to training gradually and without pain.
How to treat runner's knee?
Ideally, it is a good idea to be examined by an orthopedist who can prescribe medication, aids and rehabilitation. As medication, you can get anti-inflammatory analgesics to relieve pain and inflammation, or corticosteroids. You don't have to avoid orthoses either. However, the most important thing is physiotherapy . You need to give your knee some rest to regenerate , but at the same time stay moderately active and it is not easy to find the right amount. You have to gradually and gradually put weight on your leg, but even then the pain should never get worse . As long as it doesn't hurt, you can gently stretch and stretch your knee, and even start squatting on it over time. 2, 3
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Iliotibial band syndrome (ITB syndrome) - what is it?
This syndrome is one of the most common causes of chronic knee pain . It is a painful pathological change in the structures around the knee.
Where does ITB syndrome hurt?
The pain in this injury occurs on the outside of the knee . It is where the iliotibial band , which is a fibrous extension of several muscles in the buttocks and thigh, attaches. The pain typically occurs with bending the knee and may be present during or after activity.
Why does ITB syndrome occur?
Many factors lead to the development of pain. The main cause is the repeated friction that occurs when bending and straightening the knee . Certain changes occur at the site of friction, to which the abundantly innervated attachment of the iliotibial tract responds with pain. The influence of inflammation or enlargement of the bursa cannot be ruled out.
Is anyone predisposed to ITB?
People with a shortened and very tight iliotibial band or weak leg extensors are predisposed . Together with risk factors such as many walking, running and cycling kilometers, iliotibial band syndrome develops.
How long does it take to treat ITB syndrome?
As always, it is individual, but the pain typically goes away after 6-8 weeks of rest . Returning to training should look like you start with running shorter distances , on the flat and always with at least a day of rest between runs . Only after 3-4 weeks without pain will we increase the distance, intensity and run up and down hills.
How to treat ITB syndrome?
Unfortunately, treatment does not work immediately. It is necessary to give the injury rest and gradually start to put weight on it after the pain has gone. Ice is also effective. Stretching the iliotibial tract or massaging it with a massage roller is also effective. Anti-inflammatory drugs or corticosteroids are only given in case of severe inflammation. Of course, surgery is the last resort if the situation does not improve even after 6 months of rest. 4, 5
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Meniscus tear - what is it?
A meniscus tear is a very unpleasant acute injury . It involves a partial or complete tear of the fibrocartilage that normally prevents friction between the femur and shinbone.
Where does a torn meniscus hurt?
The pain typically comes on suddenly when moving at the moment of meniscus damage. Then it hurts for a relatively long time when trying to put weight on it. The pain is more pronounced on the side of the knee where the meniscus was injured. Often the injury is accompanied by swelling .
Why does a meniscus tear occur?
The meniscus usually ruptures when it is overloaded during sports . Typically, during an awkward impact , an uncoordinated take-off while running, or perhaps when squatting with heavy weight.
Is anyone predisposed to a meniscus tear?
A meniscus that is already degeneratively altered by overuse is more likely to be torn or torn, making long-time runners more susceptible to injury .
How long does it take to treat a meniscus tear?
Unfortunately, the treatment of a torn meniscus takes a long time, months .
How to treat a meniscus tear and when to have surgery?
There are different approaches, depending on the severity and whether you are willing to undergo surgery. It is necessary to discuss your situation with a doctor who will present the options to you. It is possible to let the meniscus heal conservatively . This requires at least 3 months of rest , the possibility of injections to promote healing. There are then 2 surgical solutions . Either remove the meniscus arthroscopically , which was popular before, or stabilize the meniscus arthroscopically and let it heal . Stabilization of the injured meniscus is shown in studies to be the best option with the highest chance that the athlete will return to running . 6, 7, 8
Source: www.alleviatepainclinic.com
Patellar tendinopathy - what is jumper's knee?
It is a chronic injury to the tendon that attaches the thigh muscle to the tibia through the patella.
Where does jumper's knee hurt?
Patellar tendinopathy typically causes pain in the front of the knee , more specifically below the kneecap (see image below).
Why does jumper's knee occur?
The patellar tendon is extremely stressed during take-off and prolonged overuse is one of the main factors for the development of tendinopathy. The greatest degree of change occurs on the posterior side of the tendon. The tendon thickens but loses its mechanical properties .
What factors contribute to the development of jumper's knee?
Poor foot posture , high weight , and weakness of the thigh muscles are risk factors that contribute to the development of patellar tendinopathy.
How long does it take to treat jumper's knee?
In most cases, with proper treatment, the pain disappears completely after 12 weeks .
How to treat jumper's knee?
The first and very effective treatment option is rehabilitation , surgery is not recommended for this injury. Relative rest is necessary, with absolute rest the tendon would atrophy, but with too high a load the tendon will not heal. A private physiotherapist will advise you on a specific rehabilitation exercise program or a doctor will prescribe rehabilitation. 9, 10
Source: www.complete-physio.co.uk
Resources:
- Francis, Peter et al. "The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location and Specific Pathology: A Systematic Review." Journal of sports science & medicine vol. 18,1 21-31. 11 Feb. 2019
- Gaitonde, David Y et al. "Patellofemoral Pain Syndrome." American family physician vol. 99.2 (2019): 88-94.
- Petersen, Wolf et al. "Patellofemoral pain syndrome." Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA vol. 22,10 (2014): 2264-74. doi:10.1007/s00167-013-2759-6
- Hadeed, Andrew. and David C. Tapscott. "Iliotibial Band Friction Syndrome." StatPearls , StatPearls Publishing, 23 May 2023.
- Khaund, Razib, and Sharon H Flynn. "Iliotibial band syndrome: a common source of knee pain." American family physician vol. 71.8 (2005): 1545-50.
- Beaufils, P, and N Pujol. "Management of traumatic meniscal tear and degenerative meniscal lesions. Save the meniscus." Orthopaedics & traumatology, surgery & research : OTSR vol. 103,8S (2017): S237-S244. doi:10.1016/j.otsr.2017.08.003
- Kopf S, Beaufils P, Hirschmann MT, Rotigliano N, Ollivier M, Pereira H, Verdonk R, Darabos N, Ntagiopoulos P, Dejour D, Seil R, Becker R. Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc. 2020 Apr;28(4):1177-1194. doi: 10.1007/s00167-020-05847-3. Epub 2020 Feb 13. PMID: 32052121; PMCID: PMC7148286.
- Snoeker, Barbara AM et al. "Risk factors for meniscal tears: a systematic review including meta-analysis." The Journal of orthopedic and sports physical therapy vol. 43.6 (2013): 352-67. doi:10.2519/jospt.2013.4295
- Schwartz A, Watson JN, Hutchinson MR. Patellar Tendinopathy. Sports Health. 2015 Sep-Oct;7(5):415-20. doi: 10.1177/1941738114568775. Epub 2015 Jan 23. PMID: 26502416; PMCID: PMC4547110.
- Muaidi, Qassim I. “Rehabilitation of patellar tendinopathy.” Journal of musculoskeletal & neuronal interactions vol. 20,4 (2020): 535-540.
Image sources:
- https://www.socalhip.com/wp-content/uploads/2022/01/Patellofemoral-Pain-Syndrome.png?fbclid=IwAR0n1_8u4ijobqf8mZMemsfNju5cyNGv7emRsN4gVbesNi7695vClJ2NzLY
- https://www.levitas.cz/2018/02/bezecke-koleno-iliotibialni-syndrom-itb-syndrom/
- https://www.alleviatepainclinic.com/blog/meniscal-tears/
- https://complete-physio.co.uk/patella-tendinopathy-also-known-as-jumpers-knee/
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