Wednesday, March 16, 2011

Runner's Knee

Recently, one of the players on my fantasy basketball team missed a few games due to "Runner's Knee". Yesterday I got an e-mail from my local running group, Runner's Edge of the Rockies, reminding everyone that Spring trail season has begun. I thought this would be a good time to discuss a little bit about Acupuncture, Active Release Technique and how they can help Runner's Knee.


What is Runner's Knee? Commonly referred to as Patellofemoral Syndrome, Runner's Knee isn't always a  singular condition, rather a term used to describe a number of disorders with different causes that all create the same relative discomfort. Some of the most common disorders leading to this type of injury are:
  • Overuse.
  • Direct trauma to the knee.
  • Misalignment. 
  • Problems with the feet.
  • Weak thigh muscles. 
While most commonly seen in runner's, this condition can affect anyone.  Repeated bending of the knee can irritate the nerves of the kneecap. Overstretching tendons may also cause the pain of Runner's Knee. If any of the bones are slightly out of their correct position -- or misaligned -- physical stress won't be evenly distributed through the knee joint. This can cause pain and damage to the joints. Sometimes, the kneecap itself is slightly out of position. Uneven tension from the Quadriceps muscles can lead to uneven tracking of the patella over the tibiofemoral joint. Runner's knee can also result from flat feet, also called fallen arches or overpronation. This is a condition in which the impact of a step causes the arches of your foot to collapse, thus compromising the mechanics of the foot and ankle, increasing the stress on the the knee joints.

The type of pain associated with Runner's Knee can vary depending on it cause. Commonly we see; A diffuse ache/pain behind or around the kneecap, especially at the junction of the femur and patella. Pain that's worse when walking downstairs or downhill. Mild swelling. Popping or grinding in the joint. Pain is easily recreated with movement (e.g. walking, bending, running).

 Treatment Options for Runner's Knee:
  • Firstly, the common acute protocol of R.I.C.E should be applied. Rest, Ice, Compression, and Elevation should help alleviate most symptoms.  
  • Secondly, if this is a frequent occurrence, have an assessment.  Go to your doctor, chiropractor, movement specialist, family physician, and have the joints evaluated for mechanics and strength.  Some advanced imaging may be necessary in complex cases. 
  • Thirdly, evaluate your options for recovery.  Runner's Knee is typically non surgical and can become a chronic exercise in pain management.  Long term use of anti-inflammatory medications is often not advised.  Here is where Acupuncture and Active Release Technique can benefit you.
Acupuncture can use a combination of Tendinomuscular Meridian treatments (TMM) and Trigger Point activation to alleviate symptoms. TMM treatments are very straight forward and quite often extremely effective.  TMM theory is not overly complex but understanding it involves a fairly intimate understanding of the different types of energy (qi) in the body and how it flows.  Look back in the next few days for a more in depth explanation of TMM.

Understanding trigger points and correctly identifying the muscle groups is another key to getting results.

Trigger points in the Vastus Medialis refer pain to the front and inner side of the knee. Since trigger points in other muscles can produce similar pain patterns, a tip off to the Vastus Medialis is if the patient also mentions weakness in the thigh and knee area, including buckling of the knee. Also, Vastus Medialis trigger points cause deep pain in the knee joint, leading to the common misdiagnosis of knee-joint inflammation.

Vastus Lateralis is the largest of the quad group and can create multiple pain sites along the lateral thigh, from the pelvic area all the way to the knee joint.  Vastus Lateralis is also the only quad muscle whose trigger points can cause pain behind the knee.  An easy test to identify this muscle is pain in the knee and difficulty with flexion/extension after sitting for a period.

Rectus Femorus trigger points often occur on the more proximal end of the muscle yet refer pain to the front of the knee, much like Vastus Medialis.  Careful palpation will help distinguish which muscle is involved. 


Active Release Technique is a set patented soft tissue techniques designed to treat muscle, fascia, tendon and nerve disorders.  A qualified ART practitioner can assess the muscles, tendon and nerves involved in the affected area and choose from over 500 techniques to treat the injury.  ART treatment are often immediately effective and can resolve acute and chronic issues with equal success.

Stop by our Denver office for a Free 15 minute Acupuncture consult and let us help you stay on your feet!!

So now that you are armed with all this new info, Happy Running !

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