hi guys! lately i’ve been getting knee pains after about 45 mins to an hour of running. but i specifically feel the pain when its downhill (steep or slight) only. if its flat or uphill, i’m totally fine with it. does anybody know what this knee injury is and what remedies i should take? does this have anything to do with old running shoes as well? appreciate any help. thanks!
Not a weird injury…I was just diagnosed with a Patella Tracking issue. Check out this info: Patellar Tracking Disorder - Topic Overview What is patellar tracking disorder?
Patellar tracking disorder occurs when the kneecap (patella) shifts out of place as the leg bends or straightens. In most cases, the kneecap shifts too far toward the outside of the leg, although in a few people it shifts toward the inside.
Your knee joint is a complex hinge that joins the lower leg bones (tibia and fibula) with the thighbone (femur). The kneecap is held in place in the front of the knee joint by tendons on the top and bottom and by ligaments on the sides. A layer of cartilage lines the underside of the kneecap, helping it glide along the groove at the end of your thighbone.
The kneecap can shift or rotate off track if the groove is too shallow or if the cartilage is damaged. Ligaments, tendons, or muscles that are too loose or too tight may also lead to a misaligned kneecap.
See a picture of the knee joint
. What causes patellar tracking disorder?
A patellar tracking disorder is usually caused by several problems combined. The shape of the patella; too tight or too loose muscles and tendons in the leg, foot, or hip areas; and overuse may lead to patellar tracking disorder. See a picture of the muscles and tendons related to patellar tracking disorder.
Also, a severe blow to the inside of a healthy knee can knock a kneecap out of alignment or, in extreme cases, dislocate it. Symptoms of a dislocated kneecap include the knee looking misshapen like a bone is out of place, not being able to bend or straighten the knee, knee swelling, and severe pain.
Sometimes patellar tracking problems run in the family. If you have a family member with knee pain, you may want to take preventive measures, such as strengthening your thigh muscles. What are the symptoms?
If your kneecap is out of alignment, you may have discomfort or pain, especially when you go down stairs, sit for a long time, stand up from sitting, or squat. This kind of pain, also known as patellofemoral pain, may be caused by patellar tracking disorder.
You also may feel a popping, grinding, slipping, or catching of the kneecap when you bend or straighten your leg. Or you may feel that your knee is buckling or giving way, as though the knee suddenly cannot support your body weight. How is patellar tracking disorder diagnosed?
Some knee problems can be hard to tell apart. Your doctor will ask questions about your past health and carefully examine you to rule out other conditions. Some of the questions might be: When and how did the pain start? Did it start on its own with no direct cause? Or was the pain caused by injury, overuse, or some other problem with the knee? The doctor will also feel and move your knee as part of the physical exam. Patellar Tracking Disorder - Topic Overview (continued)
You may also have imaging tests such as X-ray, CT scan, and MRI. How is it treated?
You can try home treatment if your knee is not swollen, dislocated, giving way, or causing you severe pain. Take a break from activities that cause knee pain, like squatting, kneeling, running, and jumping. Put ice on your knee, and use pain medicines you can buy without a prescription.
As your knee pain starts to decrease, begin stretching and strengthening your leg. Strengthening your thigh muscles can help keep the kneecap stable. Your doctor or physical therapist can help you plan an exercise program specifically for your condition. You will probably start with one or two exercises and add others over time. It is important to closely follow the instructions from your doctor or physical therapist.
Knee pain can be a slow and frustrating condition to heal. But most people with pain from patellar tracking disorder gain relief with a few months of treatment and without surgery. As a rule, the longer you have had this problem, the longer it will take to get better.
Most people can gradually return to their previous activity level if they: Avoid movements that make symptoms worse. Do specific stretches and muscle-conditioning exercises. Lose excess weight. Tape or brace the knee, in some cases. Learn the best way to perform a sport, and wear the right shoes or equipment.
Surgery is usually not necessary for patellar tracking disorder. It is most often used when dislocation happens many times and other treatments have not worked. There are many types of surgery that can realign the kneecap and correct the tracking problem in some people. You and your doctor can decide which surgery is best for you.
How can patellar tracking disorder be prevented?
You may be able to prevent patellar tracking disorder and related knee pain. Avoid activity that overloads and overuses the knee. Stretch your legs and hips well, both before and after activity. Cycling and swimming are especially good activities. Stay at a healthy weight to reduce stress on your knee joints. Patellar Tracking Disorder - Symptoms
Symptoms of patellar tracking disorder can include: A dull ache under, around, and/or at the outer edges of the kneecap. This is often made worse by using the stairs (especially going down stairs), sitting for long periods, and squatting. A popping, grinding, slipping, or catching of the kneecap as the knee bends or extends. A grinding or popping sensation may develop before painful symptoms start or may not occur at all. If you have kneecap popping or grinding without pain, see the Prevention section of this topic for stretching and strengthening exercises. Swelling of the knee, in some cases. The knee buckling or “giving way,” as though the knee suddenly won’t support your weight.
Knee pain has many causes. If you have knee pain when squatting, standing up from a sitting position, descending stairs, or while sitting, you may have patellar tracking disorder. However, other conditions cause symptoms similar to those of patellar tracking disorder.
If the pain is on the “outside” of your knee, that’s a classic symptom of Iliotibial (IT) Band syndrome, aka Runner’s Knee.
I’m not a doctor, but what everyone has always told me (and what has worked for me so far) is to (a) drastically reduce volume, (b) do lots of IT band stretches (google), and (c) see a doctor, or a chiropractor who specialized in Active Release Techniques.
I have my appointment with the chiro on Thursday 
I’m not a doctor but have experienced similar pain, most noticeable when running downhill. I have been trying to shorten my downhill stride and not heel strike as much. Trying to let the muscles absorb the shock.
It may just be wishful thinking but it seems to be working. I’m also wearing a lighter, neutral shoe and try to run as though I’m barefoot when running.
hi rahzel,
i feel the pain “inside” the knee cap. definitely not an ITB pain.
thanks!
Not a weird injury…I was just diagnosed with a Patella Tracking issue. Check out this info: Patellar Tracking Disorder - Topic Overview What is patellar tracking disorder?
Patellar tracking disorder occurs when the kneecap (patella) shifts out of place as the leg bends or straightens. In most cases, the kneecap shifts too far toward the outside of the leg, although in a few people it shifts toward the inside.
Your knee joint is a complex hinge that joins the lower leg bones (tibia and fibula) with the thighbone (femur). The kneecap is held in place in the front of the knee joint by tendons on the top and bottom and by ligaments on the sides. A layer of cartilage lines the underside of the kneecap, helping it glide along the groove at the end of your thighbone.
The kneecap can shift or rotate off track if the groove is too shallow or if the cartilage is damaged. Ligaments, tendons, or muscles that are too loose or too tight may also lead to a misaligned kneecap.
See a picture of the knee joint. What causes patellar tracking disorder?
A patellar tracking disorder is usually caused by several problems combined. The shape of the patella; too tight or too loose muscles and tendons in the leg, foot, or hip areas; and overuse may lead to patellar tracking disorder. See a picture of the muscles and tendons related to patellar tracking disorder.
Also, a severe blow to the inside of a healthy knee can knock a kneecap out of alignment or, in extreme cases, dislocate it. Symptoms of a dislocated kneecap include the knee looking misshapen like a bone is out of place, not being able to bend or straighten the knee, knee swelling, and severe pain.
Sometimes patellar tracking problems run in the family. If you have a family member with knee pain, you may want to take preventive measures, such as strengthening your thigh muscles. What are the symptoms?
If your kneecap is out of alignment, you may have discomfort or pain, especially when you go down stairs, sit for a long time, stand up from sitting, or squat. This kind of pain, also known as patellofemoral pain, may be caused by patellar tracking disorder.
You also may feel a popping, grinding, slipping, or catching of the kneecap when you bend or straighten your leg. Or you may feel that your knee is buckling or giving way, as though the knee suddenly cannot support your body weight. How is patellar tracking disorder diagnosed?
Some knee problems can be hard to tell apart. Your doctor will ask questions about your past health and carefully examine you to rule out other conditions. Some of the questions might be: When and how did the pain start? Did it start on its own with no direct cause? Or was the pain caused by injury, overuse, or some other problem with the knee? The doctor will also feel and move your knee as part of the physical exam. Patellar Tracking Disorder - Topic Overview (continued)
You may also have imaging tests such as X-ray, CT scan, and MRI. How is it treated?
You can try home treatment if your knee is not swollen, dislocated, giving way, or causing you severe pain. Take a break from activities that cause knee pain, like squatting, kneeling, running, and jumping. Put ice on your knee, and use pain medicines you can buy without a prescription.
As your knee pain starts to decrease, begin stretching and strengthening your leg. Strengthening your thigh muscles can help keep the kneecap stable. Your doctor or physical therapist can help you plan an exercise program specifically for your condition. You will probably start with one or two exercises and add others over time. It is important to closely follow the instructions from your doctor or physical therapist.
Knee pain can be a slow and frustrating condition to heal. But most people with pain from patellar tracking disorder gain relief with a few months of treatment and without surgery. As a rule, the longer you have had this problem, the longer it will take to get better.
Most people can gradually return to their previous activity level if they: Avoid movements that make symptoms worse. Do specific stretches and muscle-conditioning exercises. Lose excess weight. Tape or brace the knee, in some cases. Learn the best way to perform a sport, and wear the right shoes or equipment.
Surgery is usually not necessary for patellar tracking disorder. It is most often used when dislocation happens many times and other treatments have not worked. There are many types of surgery that can realign the kneecap and correct the tracking problem in some people. You and your doctor can decide which surgery is best for you.
How can patellar tracking disorder be prevented?
You may be able to prevent patellar tracking disorder and related knee pain. Avoid activity that overloads and overuses the knee. Stretch your legs and hips well, both before and after activity. Cycling and swimming are especially good activities. Stay at a healthy weight to reduce stress on your knee joints. Patellar Tracking Disorder - Symptoms
Symptoms of patellar tracking disorder can include: A dull ache under, around, and/or at the outer edges of the kneecap. This is often made worse by using the stairs (especially going down stairs), sitting for long periods, and squatting. A popping, grinding, slipping, or catching of the kneecap as the knee bends or extends. A grinding or popping sensation may develop before painful symptoms start or may not occur at all. If you have kneecap popping or grinding without pain, see the Prevention section of this topic for stretching and strengthening exercises. Swelling of the knee, in some cases. The knee buckling or “giving way,” as though the knee suddenly won’t support your weight.
Knee pain has many causes. If you have knee pain when squatting, standing up from a sitting position, descending stairs, or while sitting, you may have patellar tracking disorder. However, other conditions cause symptoms similar to those of patellar tracking disorder.
wow! this information is great. thanks for all the details.
So is it a problem if you have that horrible grinding sound (my spying career is definitely over!), but no pain? Or is it a harbinger of things to come?
worn out shoes might be not providing enough cushioning, since the force of impact is stronger on downhills. check your form, though. that’s where you can do the most damage running downhill. make sure that your lead foot is not getting in front of you causing you to land on an extended leg with all of your force. that will just kill the knees. i try to lower my body a bit so it becomes impossible for that leg to fully extend and try to keep my foot landing under me with my body moving over it as i push off. landing on a leg with some bend in it acts as suspension and relieves the impact. also, increase your leg turnover and use a little more kick behind. these things will shorten your stride and keep your legs more under you, instead of in front of your body. last, use forward lean to control your speed…lean more to speed up, less to slow down. on long, steep downhills i tend to raise my elbows a bit to use my arms for balance. just some things to try out on the next run to see if they help.