By Jaclyn Lim for Health Xchange, with expert input from the Orthopaedic Sports Service, Department of Orthopaedic Surgery at Singapore General Hospital (SGH), a member of the SingHealth group

If you are an avid runner, you might be familiar with a painful condition known as runner’s knee. Also known as patellofemoral pain syndrome, runner’s knee is a general term that refers to a sharp pain, swelling or discomfort behind or around the kneecap that acts up after a run.

“Runner’s knee is the most common overuse injury among runners,” says Associate Professor Paul Chang Chee Cheng, Senior Consultant and Director, Orthopaedic Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital (SGH), a member of the SingHealth group. In Singapore, up to 50 per cent of runners suffer from runner’s knee.

Such knee pain tends to strike runners because of the repeated stress and impact across the knee during a run, which can lead to the degeneration or damage of the cartilage beneath the knee cap. “But runner’s knee is not merely a runner’s ailment – it can affect athletes who engage in other sports like biking and jumping too,” clarifies A/Prof Chang.

There are also other reasons which contribute to runner’s knee, such as weak thigh muscles, flat feet, bone malalignment (caused by conditions like bow legs or knock knees) as well as a direct trauma to the knee, like a fall. Tendinitis which affects the soft tissues around the knees can also cause pain after running.

SYMPTOMS

You may have runner’s knee if you have:

– A sharp pain behind or around the kneecap
– A sharp pain when you bend your knee, such as when you are walking, squatting, kneeling, or running
– A swollen knee
– Popping or grinding sensations in the knee

If you have been experiencing these signs and symptoms of runner’s knee, it would be wise to get your knees checked by a sports physician or an orthopaedic surgeon. “Depending on the severity of the symptoms, you may need to go through tests like an x-ray, magnetic resonance imaging (MRI) and computed tomography (CT) scan,” says A/P Chang.

TREATMENT

When injured, you should always allow some time for recovery. However, it’s best to start correct exercises early before muscle weakness sets in.

The best way to treat runner’s knee is to take a short break from the activity that has been causing the pain. “Joggers who need to avoid putting weight on their knee can temporarily consider another sport like swimming or gym-training instead,” suggests A/P Chang. However, seeking professional advice on shoes, training regime and running technique is essential before going back to running.

If you have a swollen knee, applying ice packs to the area for a few minutes, every few hours, will help to alleviate the pain. Alternatively, use a knee guard to lend extra support or elevate your swollen knee with a pillow.

Your doctor might also prescribe anti-inflammatory painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve the knee pain. Stretching and strengthening exercises may also help.

However, in severe cases, surgery to remove the damaged cartilage or to realign the kneecap may be useful, says A/P Chang.

HOW TO PREVENT RUNNER’S KNEE FROM RECURRING

Even after you’ve healed, consider taking some preventive measures to stop runner’s knee from acting up in future.

WEAR THE RIGHT RUNNING SHOES. Be sure to do your research and buy a pair of running shoes that suit your feet. Don’t pick shoes solely based on aesthetics and branding; consider the cushioning (air, gel or wedge) and match it to your exercise needs. If you have flat feet, the solution may be as simple as getting custom-made arch supports.

STRETCH, STRETCH, STRETCH. Based on a UK study, doing stretching and strengthening exercises before training sessions can help to reduce the incidence of anterior knee pain (AKP) in recruits. So consider doing stretching and strengthening exercises to improve flexibility and prevent muscle tear.

DON’T BE OVERZEALOUS IN YOUR TRAINING ROUTINE. Never increase your running mileage or switch terrains suddenly. A/Prof Chang explains: “Your body will need time to adapt to the longer distances or change in running terrain to prevent runner’s knee.”

GET PROFESSIONAL ADVICE on your running style, technique and frequency and distance of runs.

TRY OTHER SPORTS. Cross-training (biking or swimming) will allow your knee and body to recover between long runs.

Cutting-edge medical technology – including minimally-invasive surgery – and the expertise of specialists make the Department of Orthopaedic Surgery at Singapore General Hospital (SGH), a member of the SingHealth group, a premier referral centre for spinal surgery, joint replacement and ankle and foot surgery, and the treatment of musculoskeletal tumours, trauma and sports-related injuries.

Reproduced with permission from SingHealth’s Health Xchange, Singapore’s first interactive health and lifestyle resource portal. For more information, visit www.healthxchange.com.sg.

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