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The Weekend Warrior

Still running around with knee pain?

Knee pain can be a daunting issue that prevents you from life activities and enjoying your body to your fullest. Continuing to move around on a painful knee can do you more harm than you think.

The knee is composed of three real joints the patellafemoral (the knee cap), the actual knee joint itself (tibiofemoral), and a smaller joint (Tibiofibular, which we won’t really talk about in this piece). There’s some interesting characteristics about these joints that I should disclose. The knee is NOT a hinge. There is some small rotation that occurs at this joint when you bend and straighten the knee. Allowing and even assisting in the knee’s small yet important rotation is the knee cap (patella).

The Runner’s Knee:

Understanding the biomechanics will help explain what commonly is believed by most medical professionals as “Runner’s Knee.” This is a loose diagnosis at best. Any pain in the knee area due to walking, running, and climbing stairs is usually called a runner’s knee.

There are about 5 different reasons in my mind that can cause pain in the knee during movement or weight-bearing activities: nerve pain, knee cap pain, knee tendon pain, knee joint pain, and knee fat pad pain.

So it is really important that we get the correct diagnosis.

In most cases, the knee pain is due to a condition called chondromalacia which means the softening of cartilage most often seen at the knee cap. Knee cartilage only softens for one reason—it is being underused.

Now that doesn’t make sense because seemingly your knee is most likely overused.

So here is my explanation, the knee cap is pulled by muscles from higher up that make your knee track laterally or to the outside. The outside half of your knee cap gets overused and the inside half gets underused thus causing the cartilage softening.

The pain you probably feel isn’t necessarily the cartilage but the friction from tracking differently. So restoring the ability of the knee cap to track more evenly will help you extend your knee’s life.

Increased torques at the knee and knee cap doesn’t just come from using it. The real cause is from the foot, the ankle, and the hip. These three joints can make your knee and knee cap experience excess torques of 7-21 times your body weight. Ouch!

Correcting the TRUE limitations or misalignments at the hip and foot/ankle are necessary for you to keep a healthy knee over a long time, well after your knee feels better from treatment.

Disclaimer: *Please seek professional guidance if you have limitations or questions to these suggestions and do at your own risk*

  • Prevention and Remedies

  • Maintain Flexibility and stretch your calves and hip flexor muscles

  • Strengthen your Gluteus muscles with crab or side-to-side walking (much like how a basketball player would guard someone)

  • Ice after your workouts or runs

Seek Physical Therapy to correct some of the more prevalent mechanical dysfunctions

When to Seek Immediate Attention: There’s a number of reasons that your knee pain can develop. My recommendation is that if your knee pain worsens over a 2 week period. If you experience swelling, bruising, redness, and warmth in conjunction or by itself please seek some medical attention. If you can’t put weight on your leg and /or you heard a snap I’d say it’s a pretty good reason to go the Emergency Room.

Keep Reviving and Thriving!

Your friend,

Dr. Justin Lin

Doctor of Physical Therapy

Specialties in Chronic Pain and Sports Medicine


Dr. Justin is #1 in Yelp Physical Therapy for Orange County

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