Intermittent knee pain when running and kneeling


Q: I am 23 year old, active male, I have been suffering knee pain in the inside of my joint, this pain occurs when i'm running, I can run about 1km before it kicks in. the pain is dull and increases when i move the joint within its normal range of motion. I cannot remember a specific injury to the knee in question ( my right knee) although i did take a fall and injured my left knee in a twisting motion. since then i have had this trouble. I also feel pain when i kneel down and after long periods of inactivity. i have been experiencing this for about 2 months. do you have any ideas as to what may be the problem?


A:    I suggest you avoiding overstress on the knees, it is very important before to do any exercise or straining physical activity to have an initial warm-up and stretching of the muscles, also when you start an exercise routine the demands have to be progressive and gradual, and the time and days that you dedicate to exercise must be consistent and regular to avoid injuries. There is a very well described entity in the medical literature called: Overuse Syndrome, which can affect any part of the body that is over stressed with movements or activities in a repetitive way, including occupational, recreational, and habitual activities. Repetition is part of the definition of overuse injury. The concept is that overuse injury is associated with repeated challenge without sufficient recovery time, and this is true for Body Building, Running, Jogging or any other sport or activity in which you exceed the guidelines and your own limits or capacities. One of the most common causes of knee pain in persons of your age group: Patellofemoral syndrome or Chondromalacia patella. The pain typically is located behind/under the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (e.g, running, during squats, bicycle, ascending/descending stairs or pendants). Pain may be worsen by sitting with the knee flexed (“indian style”) for a long period of time, such as while watching a movie, hence leading to the terms "theatre sign" and "movie-goer's knee." The causes are diverse: Overuse (repetitive use or activity), overloading, and misuse of the patellofemoral joint. The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises and pain control with TENS, ultrasound, ice packs after exercises), anti-inflammatory medication (i.e.: “Aleve”, “Advil”), education  so  you understand which activities avoid because those can aggravate patellofemoral syndrome. Also, and very important, remark the need for extended adherence to the exercise regimen. The physical therapist should educate you about a home exercise program Allow time for these conservative measures (e.g.: exercise program) to have an effect , usually 4-6 weeks is adequate for some resolution of symptoms.

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