While long runs may predispose athletes to “runner's knee,” other pathologies can also cause pain. Runner’s knee (also referred to as anterior knee pain or chondromalacia patella) causes symptoms in the front of the knee around the kneecap. A variety of causes may be implicated, including lower-extremity muscle imbalance, flat feet, and/or kneecap misalignment. It is worsened by running, kneeling, and squatting.
Prevention is the best treatment and involves the use of proper footwear, proper running form, and regular stretching. When runner’s knee does occur, the good news is that it often responds well to conservative treatment such as rest, physical therapy, and anti-inflammatory medications.
Meniscal tears, on the other hand, cause pain that usually localize to the medial (inner) or lateral (outer) side of the knee, depending on the location of the tear. The meniscus is a wedge-shaped structure that functions as a shock absorber in the knee and also plays a stabilizing role. While meniscal tears may also cause pain with bending, squatting, and running, they can cause other symptoms not typically associated with runner’s knee, such as swelling, locking, and giving way.
Depending on the location and size of the tear, a meniscus injury may also respond well to conservative treatments. However, if the pain persists and/or the tear is causing mechanical symptoms, arthroscopic surgery to cut out or repair the torn meniscus may be required.
Dr. Joshua Dines is an orthopedic surgeon and a member of the Sports Medicine and Shoulder Service at Hospital for Special Surgery. He is a team doctor for the U.S. Davis Cup tennis team, an assistant team physician for the New York Mets, and a consultant for the Los Angeles Dodgers.