E50: Thessaly Test & Joint Line Tenderness for Medial Knee Pain
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In this section of the article, you will learn about the most common knee injuries experienced while running. You will learn about common treatments and rehab exercises.
But most of all, I want you to know you are not alone. Many runners have gone through this before and have come out fine. But with an injury like Runner’s Knee, you must understand one thing:
It is not a major injury in the beginning, but it can and will be the injury that stops you from running permanently if you don’t address the underlying causes.
I have had Runner’s Knee just like you. It was around five years ago.
I was in my prime. 31 years old and the fittest I’ve ever been.
It was a slow progression. I began noticing my symptoms for about a week before I realized and then considered the consequences of my neglect.
What is Runner’s Knee?
Pain felt deep in the knee can be a symptom of Chondromalacia Patella, also known as Patellofemoral Pain Syndrome (PFPS). The meaning of chondromalacia can be broken down to chondro, meaning cartilage and malacia, which means weakening. Runners Knee and Patellofemoral Pain Syndrome are the same condition. I know it’s confusing since the names are different, but think of one as the athletic term and the other as a medical term.
In the past, the term “Runners Knee,” was used to describe pain around the patella or kneecap. Currently, most doctors recognize it as a “catch all, garbage term,” used to describe pain around the kneecap. The term is used so loosely it no longer has value and lacks description of the underlying reason for knee pain around the cap.
Patellofemoral Pain Syndrome is a little bit more descriptive because it indicated the region or location of the irritation. However, it still doesn’t account for the mechanisms causing Patellofemoral pain. We will go into that later…
Let’s start with describing why it’s medically called “Patellofemoral Pain Syndrome.” The region of the knee in question is called the Patellofemoral complex, which is made of the kneecap (aka the patella) and the femur (aka the thigh bone). This region also has ligaments, cartilage, nerves, blood vessels, and tendons. It’s a complex joint when we look into the small parts but by no means is it as complex as the ankle.
The underlying fact that this is a cartilage injury is what makes it the kind of injury that could ultimately keep you from running. Cartilage does not heal as well as bones and muscles do. Cartilage doesn’t have a direct blood flow supply (excluding the outer 1/3 of the meniscus) like other tissues of the body. It gets its nutrients through intermittent compression, pushing out the waste and sucking in the good stuff. Cartilage is just like the rest of your body in that respect.
You eat food and then get rid of the waste. This is no different except think of the cartilage is constipated. It sometimes needs to be squeezed. Constant squeezing however won’t allow for nutrients to come in. This eventually leads to slow cartilage degrade, resulting in Runners Knee. Once you lose it, you lose it. Although with some experimental techniques, regeneration of cartilage is looking more and more possible in the future.
Do you need your cartilage?
Yes, you do. It provides a slick surface for bones to glide on one another. That grinding feeling you have is from the cartilage not being there or it being too soft to do its job.
If you suffer from this condition, you are not alone. In fact, it is the most common reason any athlete will report to a sports injury clinic. It affects up to 30% of all athletes.
What are the symptoms of Runner’s Knee?
Pain that is generally dull and constant
Clicking/popping of the knee upon motion
Swelling of the calf
Bruising of the muscle
Restricted motion
Dull achy pain around the knee cap
Pain walking downstairs
Pain running downhill
“Movie theater sign” (Pain after having the knee flexed for a period of time)
What causes Runner’s Knee?
I hear “overuse” a lot. I’m not going say that is 100% wrong, but I like to point out the obvious. “Why does it only affect one of your knees, then?” you ask. “Don’t you run the same amount of steps with both legs?”
E50: Thessaly Test & Joint Line Tenderness for Medial Knee Pain
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