Runners knee, the knee is a hinge joint, it includes the articulation between the tibia and femur (leg and thigh) and the patella (knee cap). The most common knee problems in running is called the patellofemoral  syndrome. This consists of the quadriceps, knee cap and patellar tendon. For many years runner's knee was considered to be chondromalacia of the patella. This essentially means a softening of the cartilage of the knee cap. Cartilage does not have the same blood supply that bone do, it relies on intermittent compression to squeeze out waste products and then allow nutrients to enter the cartilage from the synovial fluid of the joint. During running certain mechanical conditions may predispose you to a mistracking knee cap. Portions of the cartilage may then be under either too much or too little pressure and the appropriate intermittent compression that is needed for waste removal and nutrition supply may not be present. This may result in cartilage deterioration, which at the knee usually occurs on the medial aspect or inner part of the knee cap. All patello-femoral pain though may not be caused by this mechanism, although uneven stresses across the joint are believed to play an important role in the development of pain  in this area. The symptoms of runners knee include pain near the knee cap usually at the inner portion and below it. Running downhill and sometimes even walking down stairs can be followed by pain. Patellofemoral pain syndrome is often caused by the kneecap not tracking smoothly in its femoral groove. The symptoms are aggravated when the knee is bent since increased pressure exists between the joint surface of the knee cap and the articular surface of the femur. This increase in force over-stresses the injured area and leads to pain. Factors that increase what is known as the "Q angle” increases the chance of having runners knee. Many times adding to the strong lateral pull of the bulk of the quadriceps is a weak vastus medialis (VMO). This is the portion of the quadriceps that helps medially stabilize the patella. It runs along the inside portion of the thigh bone to join at the knee cap with the other three muscles making up the quadriceps. Some of the mechanical conditions that may contribute to this include knock knees, weak Vastus Medialis , weak Quadriceps Muscles, tight Hamstrings or calf muscles, excessive pronation of the feet . If you suffer from this condition you should visit a Podiatrist and have your gait assessed, you may benefit from custom made orthotics.









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