Member Case Study: Anterior Knee Pain

author : AMSSM

comments : 0

My right knee has a pain in the front, just below the kneecap. I walked 24 miles of IM Louisville. No pain while walking but it started immediately when trying to run.

Member Question from Snowboarder

My problem is running off the bike. My right knee has a pain in the front, just below the kneecap. I walked 24 miles of IM Louisville. No pain while walking but it started immediately when trying to run. I can run a 1:44:00 half marathon with no problems and it doesn't hurt while on the bike (the other knee hurts but is fine on the run).

I may be looking into a custom frameset this winter as I have long legs and a short torso. Maybe this will help?
 

Answer from the AMSSM

Anterior knee pain is common among runners and cyclists, and there are many etiologies. Common causes include patellofemoral pain syndrome and patellar tendinopathy. Studies have shown patellofemoral pain syndrome is the single most common cause of anterior knee pain in runners. Overuse, trauma, and anatomical abnormalities are three common causes of patellofemoral pain. Correctly diagnosing the cause of anterior knee pain is important for proper rehabilitation.

Treatment begins with addressing the underlying cause of your knee pain. Changes in your training program, such as the recent initiation of hill training or the addition of certain resistance exercises, may be factors. Shoe fit should be considered, and over–the-counter or custom orthotics may prove useful. If any aspect of your training routine causes your pain to increase, then cross-training or relative rest may help. For example, using an elliptical machine and reducing loading exercises such as squats or lunges may be beneficial. Ice after activity will relieve pain and inflammation. Physical therapy should be strongly considered, as abnormal tracking of the patella, gait pattern, a tight iliotibial band, and quadriceps strength and flexibility are just a few of the physical parameters which may improve in physical therapy. Anti-inflammatory medications and knee braces are often used in treatment of anterior knee pain, though their use is usually not as effective as treating the underlying condition.

Finally, as you have astutely mentioned, the importance of proper bicycle fit cannot be understated. Having a knowledgeable local bike shop work with you and your bicycle can lead to many more miles of happy training!

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date: December 19, 2008