Pain below the knee cap from running is quite common. Two main types exist. Patella-Femoral syndrome occurs behind the knee cap while patellar tendontits is felt below the kneecap. Running, walking and jumping can be the source of both of these painful and performance-limiting conditions. Proper training and knee care may help prevent and self-manage these conditions.
Anatomy
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The kneecap, or patella, is located in the front of the knee. It is classified as a sesamoid bone because it is embedded in the tendon of the quadricep muscles. The patella increases the tendon's angle, thus increases the leverage the tendon exerts. The quadriceps contract and relax during every stride while walking and running.
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Patella-Femoral Syndrome
Rice University reports, "Patella-Femoral syndrome (PFS) is the most common cause of knee pain in runners." PFS is nicknamed runner's knee. The pain is usually located directly behind the kneecap but may be vaguely located around the patella. The symptoms are described as sharp and dull pain provoked by squatting or walking down stairs. Contributing factors to the development of PFS include excessive hill running, overabundance of distance, muscles tightness in the calves, hamstrings, iliotibilal band, and lateral quadricep, overpronation of the feet and weakness of the medial quadricep.
Patellar Tendonitis
The portion of the quadricep tendon inferior to the kneecap that connects to the shin bone is called the patella tendon. Inflammation of the patella tendon is named patellar tendonitis. Kapi'olani Orthopaedic Associates state this condition is commonly known as jumper's knee. The source of patellar tendonitis include repeated stress on the patellar tendon from jumping, running, walking or cycling. Symptoms include pain and tenderness directly below to the kneecap. This pain may be present during and after exercise and may progress to interfere with activities of daily living.
Preventive measures
Prevention is the best medicine for running injuries. The University of Wisconsin-Madison sports medicine department states the three extrinsic causes of these conditions are sudden increases in exercise intensity, poor warm-up prior to activities and over-training. Eliminate these sources by increasing your training intensity in small increments, spending extra time preparing your body for exercise by warming up thoroughly, and avoid over-training by listening to your body signals. Lessen the intrinsic factors of these conditons by stretching the calves, hamstrings and lateral thighs and strengthening the medial thighs.
Treatment
Apply ice immediately if knee pain should begin during or after exercising. The ice should be used for 20 minutes and always place a towel between the ice pack and your skin. Pay close attention to your body during exercise and throughout the day. Pain, numbness and fatigue are your body's signals to modify your exercise routine. Never self-diagnose and always seek professional advice if the pain persists or worsens.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.