Diagnosing Runner’s Knee
An MRI is a useful investigation for diagnosing runner’s knee specifically grading the severity since an MRI is very good at looking at cartilage wear and tear. An X-ray can also be used to look for bone damage or signs of misalignment or arthritis.
However diagnosis in runner’s knee is frequently obtained from simply performing a series of questions and a thorough physical examination of the knee and associated structures. Investigations are often only used if the rehabilitation is progressing more slowly than desired.
Grading Of Chondromalacia Patella
Grade 1 The least severe grade is a situation where there is softening of the cartilage.
Grade 2 Indicates softening of the cartilage along with abnormal surface characteristics (the beginning of tissue erosion).
Grade 3 Thinning of cartilage with active deterioration of the tissue.
Grade 4 The most severe grade and indicates exposure of the bone with a significant portion of cartilage deteriorated. This bone exposure means there is bone-to-bone rubbing at the knee.
Treatment Of Runner’s Knee
When treating chondromalacia patella or runner’s knee the rehabilitation process generally focuses at creating better tracking of the kneecap during quadriceps contraction. In the acute stage ice and anit-inflammatory medications may be useful but this is normally only for a brief period of time if at all. As a rule resting from the aggravating activities is necessary whilst undergoing rehabilitation and retaining cardiovascular conditioning can be achieved via swimming and cycling which put less load on the kneecap.
Your physiotherapist will most likely look to train selective strengthening of the inner portion of the quadriceps muscle to help normalize the tracking of the patella but also looking at strengthening the core and deep hip rotators. Footwear changes may be indicated as well as taping/bracing of the patella and stretching exercises around the knee and hip. The whole purpose of physiotherapy rehabilitation for runner’s knee is to help improve muscle strength and the balance of such around the knee to help prevent knee misalignment ultimately normalizing patella tracking and reducing pain.
What’s The Prognosis With Chondromalacia Patella?
Generally patient’s should have a rapid and full recovery with this condition and it is also worth noting that runner’s knee is not considered to be a precursor to developing future osteoarthritis.
If the condition fails to respond to conservative treatment such as rest and physiotherapy then surgical correction of knee alignment is considered but this is very much a last resort and in my opinion it is relatively uncommon to reach this point. If surgery is considered it is typically arthroscopic surgery to examine the joint and determine whether there’s misalignment of the knee and then if indicated a common surgical procedure used is a lateral release which serves the purpose to release tension of structures on the outside of the knee to help the kneecap track more evenly. Other surgical options may involve smoothing the backside of the kneecap, cartilage grafts, or relocating the insertion of the tendons associated with the patella.
Prevention Of Runner’s Knee
Preventative work around strengthening the inner portion of the quadriceps muscle to help normalize the tracking of the patella combined with hip stability and flexibility work would be simple ways for those at risk of developing runner’s knee to reduce their chances of developing this type of anterior knee pain. You can also help reduce your risk by managing your weight, maintaining a healthy body weight can help take pressure off the knees. And reducing ongoing stress to your knees by keeping high impact activities to a minimum and wearing knee-pads if you have to spend regular or extended time leaning on your knees on hard surfaces will also play a roll in reducing the likelihood of developing runner’s knee.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Treating Runner’s Knee should consult his or her general practitioner or physiotherapist or suitably skilled practitioner.