How To Beat Runner’s Knee

The most common running injury is not what you think it is.

Patellofemoral pain syndrome — otherwise known as anterior knee pain and runner’s knee — is the most common running injury, accounting for roughly 20 percent of all running injuries.

The main symptom is pain below the kneecap that is generally mild at first and experienced only during running but becomes progressively more intense during running and also increasingly felt at rest if training continues.

Many theories about the nature of the damage underlying the pain have come and gone. The reason behind this revolving door of proposed etiologies is that, unlike other injuries such as knee meniscus damage, there is no obvious structural abnormality associated with PFPS, whether the joined is examined by x-ray, MRI or surgical arthroscope. Recently this reality has lead orthopedists to a new view of PFPS in which pain itself — or, more specifically, chronic stimulation of pain nerves in the knee — is understood as the essence of the injury. Any of a number of varieties of relatively minor tissue degradation, such as inflammation of the synovium, a pouch that contains the knee’s lubricating fluid, may underlie this pain nerve stimulation. But because these breakdowns are relatively minor and hard to identify, they need not be targeted. It’s the pain itself that must be targeted.

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