Dealing with knee pain as an avid runner.
– Magdalena Cadet, M.D. – Rheumatologist
“Spring is officially here in NYC and the weather is starting to get nicer. Some runners have been loyal to their outdoor regimen and managed to brave the cold during the winter season. Some of us who are not fans of the frosty weather took a little hiatus, but now it is time to get back to the GRIND! My love of running ignited when I attended Georgetown University and I decided to pick up this form of exercise after I gained more than the “Freshman 15” pounds. I was getting adjusted to a schedule at college that didn’t involve daily ice skating or ballet practices and we can all remember late night snacking during those college years. I found running a stimulating sport where my priority was focused on improving endurance and speed while trying to maintain good joint function and prevent injury. This activity also served as a peaceful outlet as my mind escaped from the day’s reality. I loved running by the amazing Lincoln and Jefferson Memorials as well as the other famous sites in Washington D.C. when I was younger. In NYC, running through Central park and down the West Side highway by the Hudson River has become one of my favorite activities. As I have begun to slowly start my running routine again this season, I’ve noticed some aches and pains that are creeping in. With repetitive running and other aerobic exercise during the last thirty years, there have been periods in my life where I have complained of knee pain. Sometimes it may just be a simple runner’s injury, but we all still need to pay attention to our bodies and explore the causes for knee pain.” – Dr. Cadet
Look for these symptoms in your knees:
• Stiffness in the knee
It is very important to seek medical attention when:
• there is significant swelling or fever with the knee pain
• the knee can’t support the body’s weight
• if the knee locks up and doesn’t relax
• if falls occur from the knee pain
After a complete history and physical examination by a specialist, some of the common reasons for knee pain may include:
• Chondromalacia Patellae – This condition also known as patellofemoral syndrome results from softening or irritation of the smooth cartilage under the knee cap which can result in the knee cap rubbing against the thigh bone with movement pain. Younger individuals may complain of pain on top of the knee, especially runners. Pain may be noted when climbing and descending stairs or with squatting, kneeling, and standing up from chairs after prolonged sitting.
• Ligament injuries of the anterior cruciate ligament tear (ACL), posterior cruciate ligament (PCL) and medical collateral ligament (MCL) often occur in younger individuals who are involved in athletics.
• Meniscal Tear – The meniscus is an important part of the knee cartilage by distributing a person’s body weight across the knee joint. Runners may have decreased ability to move their knees or hear a “popping” or “clicking” noise in the knee. Meniscal or cartilage tears can be seen in both older and younger patients.
• Bursitis (prepatellar) – This often occurs in individuals who often kneel for their occupation or are involved in tasks, which involve kneeling for a significant period, like cleaning or getting your little one to crawl. There is a small sac of joint fluid of the kneecap and fluid can accumulate to cause pain and swelling.
• Patellar Tendonitis – It is referred to as “jumper’s knee”. The patellar tendon is located over the front of the knee and may become inflamed with overuse and may result in pain. This condition often occurs in people who engage in sports like running, soccer, volleyball, and basketball.
• Baker’s or Popliteal Cyst – Knee pain may arise from swelling that occurs in the back of the knee. Sometimes the cyst or swelling may become so large that the cyst ruptures and causes significant pain in the knee and calf. A baker’s cyst may be a sign that there is an underlying problem, such as osteoarthritis, rheumatoid arthritis, or meniscal tear.
• Osteoarthritis – It is often referred to as “wear and tear” arthritis, since the cartilage which cushions the joints breaks down with aging and results in the bones of the joint rubbing together. This breakdown of cartilage may cause knee pain, swelling, and stiffness lasting less than thirty minutes.
• Rheumatoid Arthritis is a debilitating arthritis associated with inflammation, joint destruction, and possibly involvement of other organs in the body.
• Post Injury or Trauma Arthritis can result in knee pain from cartilage damage, ligament tears or bone fractures.
• Gout- a type of arthritis linked to an increase of a substance in the body called uric acid. When there is a large buildup of uric acid in the body, crystals form and may settle in the joint causing severe pain, redness, and swelling at first. Pseudogout, which is often found in women in their mid-forties to sixties, can result from an accumulation of calcium crystals in the body and cause knee pain.
• Hip conditions like Iliotibial (IT) Band Syndrome may also sometimes refer pain to the knee. This specific condition which is often seen with runners and cyclists can cause pain on the outside of the knee with overuse of the band of connective tissue (iliotibial tendon) that extends from the outside thigh to the knee. When the band tightens and rubs across the hip bone, inflammation may occur.
It is very important for the physician to consider other conditions such as an infection (septic arthritis) or a neurologic condition if these other causes are not suspected. It is very important for you to clearly tell their physician the details of their knee pain in order for a complete evaluation to be initiated.
Here are some SIMPLE MEASURES that may help with knee pain.
• Avoid tasks that involve kneeling or squatting for several hours, lifting heavy objects, excessive climbing stairs or prolonged walking!
• Scale back on engaging in sports that require repetitive direct impact on the knee joint such as basketball, soccer, or excessive running. Participating in stationary cycling for up to 15 minutes a day may be a better alternative to these high impact sports. This may be difficult to do for some of us but it may be time to try that Soul cycle or Fly Wheel class!!
• Keeping the knee relaxed and avoiding overextension may also help with knee pain.
• Sometimes massaging the knees by slowly rotating the knee cap or patellae can be beneficial.
• If the pain is due to an overuse syndrome or an acute injury, try resting the joint first for a few days to weeks. Avoid the activity that aggravates your knee pain. Heat and Ice are often initially recommended to decrease the initial inflammation and swelling.
REMEMBER “RICE”: Rest, Ice, Compression, & Elevation
For any female or male who is overweight and imposes a risk of developing knee osteoarthritis or a ligament/cartilage injury, weight loss and lifestyle modification is necessary. For every pound that an individual is overweight, additional excess weight and force is applied to the knee joint. “Now that I’m in full swing of my running regimen and half marathon training as some of you may be, I’ll be making a solid effort to pay attention to my knees. I’ll keep you posted on the training and stay tuned for my next blog on different treatments and exercises for knee pain. Keep that knee strong and fit!” – Dr. Cadet
If you are interested in learning more about Dr. Cadet, please feel free to email or call one of our offices for a consultation. She would be more than happy to discuss your condition and treatment options for an individualized treatment plan. www.OsteoCenterNY.com