Runners of all levels, from 5k-er’s to marathoners, contact Prolotherapy offices in a panic because they have developed knee pain or “runner’s knee”, also known as patellofemoral pain syndrome or chondromalacia patella. Thankfully Prolotherapy is the perfect cure for the underlying cause of runner’s knee.

Definition of runner’s knee

The patella, or kneecap, is covered on its backside with the thickest layer of articular cartilage of all the joints in the body. Runner’s knee or chondromalacia patella occurs when this cartilage deteriorates or erodes. The softening or wearing away and cracking of the cartilage under the kneecap results in pain and degeneration. The cartilage becomes rough and prevents the kneecap from gliding smoothly over the knee.

Causes of runner’s knee

• Injury and/or overuse: Knee pain from running is one of the most commonly seen overuse injuries. About half of overuse injuries affect the knee joint in some way. Runner’s knee is one of the most common overuse injuries that we see among runners, but also among other athletes participating in sports requiring a lot of running, such as soccer, football, lacrosse, or tennis. With overuse or injury, the cartilage behind the kneecap erodes or deteriorates and runner’s knee or chondromalacia patellae occurs. An abnormal alignment between the patellae and the femur can result, which leads to a clicking or crunching in the joint when it is fully extended. Runner’s knee or chondromalacia patella affects one out of every 5,000 people. The good news is that cartilage can be regenerated with Prolotherapy treatments!
• Malalignment:  If your bones are not tracking completely correctly, then the stress to the knees from running will not be distributed properly. The good news is that tracking problems can be alleviated with Prolotherapy injections.
• Weak thigh muscles or hamstring muscles: Weak muscles on either side of the thigh create an imbalance in strength and puts stress on the knee joint. Working to strengthen these areas is somewhat helpful, but often Prolotherapy is needed to actually cure the problem.
• Old shoes: if a runner has been running without pain, but all of a sudden develops a new knee pain, it’s often time to change shoes. Most runners know that the life of a pair of running shoes is typically only about 300 miles.
• Foot problem/weak feet or ankles: Pronation, supination, or other foot problems may also contribute to runner’s knee. Sometimes correcting the underlying foot/knee problem is what needs to be addressed first.

Symptoms of runner’s knee

As chondromalacia patellae develops, runners may experience pain behind or around the patella (knee cap), especially where the thigh and the knee meet; the runner may also experience pain when he/she bends – such as with walking, squatting, kneeling, running, or even sitting; pain going down hill or down stairs is often more painful than flat/upward; runners may experience swelling, popping, and/or grinding as well.

 

Runner’s knee treatments

Here is what the medical literature has to say about conventional treatment options including surgery:

“Chronic disabling patellofemoral (PF) pain and instability can have significant effects on patient function and lifestyle. Although the management of PF pain has improved greatly, there is still a category of patient who tends to have recalcitrant symptoms, which are difficult to manage. The patient often bounces from practitioner to practitioner, physiotherapist as well as surgeon, for some relief of symptoms. However, often the underlying source of the pain is not well understood, so treatment can aggravate the symptoms.”¹

“Patellofemoral instability affects activities of daily living and hinders athletic participation. Over the past 2 decades, more attention has been paid to medial patellofemoral ligament (MPFL) reconstruction for the treatment of recurrent patellar dislocations/subluxations. Numerous techniques have been reported; however, there is no consensus regarding optimal reconstruction…A total of 164 complications occurred in 629 knees (26.1%). These adverse events ranged from minor to major including patellar fracture, failures, and clinical instability on postoperative examination, loss of knee flexion, wound complications, and pain. Twenty-six patients returned to the operating room for additional procedures.”²

Athletes, in general, are more eager for surgery than patients who suffer from degenerative disease. The reason being that they believe surgery is the fastest way back to the game. Some even resort to drastic surgery where the patella is removed in order to remove the pain. This sometimes does relieve the pain, but at a significant cost to the body. The strength to extend the knee is reduced by about 30 percent, and the force exerted in the knee is increased. There are a host of other risks associated with surgery. The athlete must realize that with each procedure and each shaving or cutting of tissue, NSAID (non-steroidal anti-inflammatory drug) prescription, or cortisone shot, the odds of developing long-term arthritis are greatly increased. The key to keeping the knee strong is to stimulate the area to heal, not to cover up the pain with a cortisone shot or NSAID. Even worse is to eliminate the painful area by shaving or cutting. This just delays the pain for a few years until the remaining tissue becomes degenerated. The best approach for the athlete is to stimulate the area to heal. The best way to do that is with Prolotherapy.

Prolotherapy for runner’s knee

Prolotherapy, Platelet Rich Plasma Therapy and Stem Cell Therapy help chondromalacia patellae or patellar tracking problems because the pain-producing structure is generally the patellar tendon or the musculoskeletal support around the patella. Prolotherapy for chondromalacia involves intra-articular (inside) injections as well as injections on the outside of the knee, stimulating the growth of many musculoskeletal structures around the patella. Prolotherapy gives tissues the resources and growth factors they need to heal. It is for this reason the knee gets stronger and the pain of chondromalacia is relieved.

A number of Prolotherapy research papers exist on curing knee pain, like that of runner’s knee. Comprehensive Prolotherapy injections, whether dextrose, Blood Platelets, Stem Cells, or other growth factors are a less complicated and invasive procedure. A summation of an article on articular cartilage regeneration found in the Journal of Prolotherapy is as follows: “Prolotherapy improved the pain and function in five knees with osteoarthritis. All five degenerated knees showed evidence of articular cartilage regeneration in their standard weight-bearing X-rays after Prolotherapy. It is suggested that before and after X-ray studies can be used to document the response of degenerated joints to Prolotherapy.”³

Prolotherapy’s success rates for knee pain and runner’s knee is extremely high. For more information contact us.

 
1. McConnell J. Management of a difficult knee problem. Man Ther. 2012 Jun 27. [Epub ahead of print]

2. Shah JN, Howard JS, Flanigan DC, Brophy RH, Carey JL, Lattermann C. A Systematic Review of Complications and Failures Associated With Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation. Am J Sports Med. 2012 Jun 7. [Epub ahead of print]

3. Hauser RA, Cukla JJ. Standard Clinical X-ray Studies Document Cartilage Regeneration in Five Degenerated Knees After Prolotherapy. Journal of Prolotherapy. 2009;1:22-28.