Knee Assessment

“Runner’s Knee” (a.k.a. Patellofemoral Syndrome) refers to when the cartilage of the kneecap has become irritated from excessive compression force (i.e. overloading the knee cap). Common symptoms include:

• Dull achiness around kneecap joint
• Pain with squats, walking stairs, and/or running (especially downhill)
• Pain while driving or remaining seated with the knee bent
• Note: If there is swelling around the knee joint as well as a clicking or catching sensation, it may indicate a meniscus issue, which would be treated differently.
• CAUSES OF RUNNER’S KNEE

• More common in men, ages 15-30 years old, especially in jumping sports.
• Patellar Tendinitis: an acute, inflammatory condition where the patellar tendon gets acutely overloaded beyond the tendon’s capacity. There may be microtears in the tissue that cause it to be inflamed and painful.
  • Dull achiness/sharp pain below the knee cap – pain with squats, walking stairs, and/or running (especially downhill)
  • Tender to touch the tendon
  • Pain happens instantly and gets worse with activity; and after aggravation, pain may linger.
• Patellar Tendinosis: chronic degeneration of the tissue due to persistent tensile overload (strains), where the tendon is not inflamed, but has not fully healed and is thus in a chronically weakened state. By definition, over three months is considered chronic.
  • Dull achiness below the kneecap – pain with squats, walking stairs, and/or running (especially downhill)
  • Pain may take some time to come on, or pain may happen initially when running and then seem to alleviate as you run
• CAUSES OF PATELLAR TENDONITIS/OSIS

“IT Band Syndrome” is a common condition in runners (c. 22%), especially women, that results from too much friction and/or compression force during knee flexion (bending). Symptoms include:

• Pain can be sharp and radiate up the side of the leg from the knee
• Pain with squats, walking stairs, and/or running (especially downhill)
• Progressing pain while running a longer distance
• CAUSES OF IT BAND SYNDROME

• Patella (Kneecap): Embedded in the quadricep tendon, the kneecap is used for leverage and shock absorption (with each running step, the impact force is 7-11 x your body weight). Cartilage helps protect the patella bone while also reducing the friction of movement.
• IT Band: On the outside of the knee and thigh is the long fibrous band called the Iliotibial band (IT Band), which attaches to the hip muscles (Tensor Fasica Latae and Gluteus Maximus) at the top and inserts right below the outside of the knee joint at the bottom. The function of the IT Band is to help stabilize the hip and knee during loading.
• Patellar Tendon: on the lower part of the kneecap is the patellar tendon, which attaches the kneecap to the shin bone (tibia). The purpose of the tendon is to help transmit tensile forces from the quadriceps.