Is runners knee permanent?

How do you heel from runners knee?

• I got it from overusing my knee in cross country running up hills. it started to feel better but now i am in soccer and when i jump my knee hurts again. Is the damage permanent and what can i do to help my knee?

• Answer:

  Stephen M. Pribut,a Doctor of Podiatric Medicine answers this question at this website: http://www.drpribut.com/ He states: "At an early stage running should be decreased to lessen stress to this area and allow healing to begin. It is important to avoid downhill running which stresses the patello-femoral complex. Exercises performed with the knee bent should be avoided. When the knee is bent the forces under the knee cap are increased. Many people feel that the vastus medialis muscle works only during the final thirty degrees of extension of the knee. This is the muscle that helps stabilize the knee cap medially and prevents it from shifting laterally and tracking improperly at the patello-femoral joint. The Vastus Medialis Oblique (VMO) and Vastus Medialis Longus (VML) have been shown to be considerably weaker than the Vastus Lateralis (VL) in patients with Patellofemoral Pain Syndrome compared to normals (Makhsous et. al. 2004). Straight leg lifts strengthen the vastus medialis muscles and do not significantly stress the undersurface of the knee cap. They should be done in sets of 10 times on each side. Start with 5 sets of 10 and work your way up to 10 sets of 10. Straight leg lifts are best performed lying on a cushioned but firm surface, with the exercising leg held straight and the non-exercising leg somewhat bent to take pressure off of the back. Lying on a carpet or mat on the floor is a perfect place to perform this exercise. Tight posterior muscles should be stretched. In many cases tight calf muscles or hamstrings lead to a "functional equinous" and make the foot pronate while running or walking. This pronation is accompanied by an internal rotation of the leg which increases the Q angle and contributes to the lateral subluxation of the knee cap. On occasion a tight iliotibial band may contribute to PFPS. “...Straight leg lifts strengthen the vastus medialis and do not significantly stress the undersurface of the knee cap.” If you over-pronate make sure you use shoes that offer more anti-pronation features. Move up a ranking in the amount of stability and pronation control that your shoes offer. If further control of pronation is needed orthotics should be considered. The late George Sheehan, M.D., sports medicine physician and philosopher, was the first to popularize the notion that it was important to look at the foot when runner's knee occurs. It is also important to rule out other knee problems when knee pain occurs in runners and not just lump every pain as "runner's knee". Some authors have suggested that core muscle strength may play a role in this problem. Suggestions for improving core body strenght including gluteal muscles have been made. There is nothing wrong with this suggestion and it may help. Be sure to perform the above exercises first, since they are more specific to the problem being addressed. Orthotics: Orthotics can be a great assist in the therapy of patellofemoral pain syndrome and patellofemoral dysfunction. A variety of studies over the years have shown their effectiveness in treating this in runners. A recent study (Saxena 2003) claimed 76% improved, 2% asymptomatic after previous failed treatment. Orthotics limit the maximum amount of excessive pronation. They also have been demonstrated to reduce the speed (acceleration) of internal tibial rotation. Reducing the speed of internal tibial rotation will reduce the amount of sudden stresses applied to the undersurface of the patella and the need for the VMO ( vastus medialis ) to work so hard in maintaining proper tracking and positioning of the patella. As per Newton's Laws slower motions will require less force to counterbalance them. Treatment Summary: Rest or Relative Rest: Run Less Avoid exercises or activities that require your knees to be bent Avoid running or walking downhill, downstairs or down inclines Do posterior muscle stretches (hamstrings and calf muscles) Do Straight Leg Lifts (Start with 3 sets of 10, work up to 10 sets of 10) Check Your Feet and Shoes, overpronation often contributes to this problem Consider More Stable Shoes (with better anti-pronation features) Orthotics If Needed (OTC or Custom)"