Knee Pain

by Ann
(Fort Worth, TX, USA)

I have read a lot about runner's knee and how to get thru it. I have a 16 year old son who runs track/xc and has had knee pain on and off for the past few months. He does pronate and we went back to the running store and got a shoe with more support and that did help some.

He saw a PT and got exercises, and seems to do better when he stretches. He just got a knee sleeve with a strap on it. He seems to hurt most when he is warming up and after he runs, not as much with running.

The thing is that exercises for the quads/hams aggravate his pain, even isometric ones. His pain is general to his knees but concentrated in the medial part of both knees.

He does ice his knees daily, and takes Alleve on and off, but not as consistently as he should.

Answer by Dominique:

Hi there,
Thanks for your question about the knee pain. I am working through a long lasting knee issue myself. I am by no means a doctor, but I can tell what has done the trick for me and finally has got me back to running.

The knee is a complicated part of the body. Lots of "stuff" coming together (told you I wasn't a doctor, so don't expect the technical jargon).

Runner's knee often gets caused by the upper legs getting very tight. If the muscles there are not happy, and they are strong muscles, then they start pulling that knee and basically cause pain there.

I think the treatment with upper leg strengthening and anti-inflammatories sounds like a good first step.

Hearing that he has trouble doing upper leg strengthening exercises and that the pain is mostly there in warm-up and after running could point to upper leg trouble.

If those upper leg muscles are really tight, they will cause knee pain. So in warm up it hurts. Then his legs warm up, the muscles start working better due to increased blood flow and the knee pain subsides.

What I would recommend is good stretching AFTER his running. Also see my Running Stretches-page.

Some self-massage would also help with a foam roller or stick.

What could also help is a visit to an osteopath or getting a sports massage. Considering it is a longer standing issue he may need to get some help to get those muscles loosened up again.

If the problem persists, I'd go get a referral for further tests like an MRI scan. Then they can work out if there is a cartilage issue or not.

Luckily your son is young, meaning that if there is a cartilage problem, they are likely to be able to treat it well (surgery).

Yep, I would do it that way, i.e. good self-massage, stretching after running, seeing an osteopath and getting those muscles loosened up and if all that fails, then get an MRI scan.

Depending on your health plan you can be out-of-pocket a good little amount with that MRI scan, so there needs to be a reasonable expectation that there is indeed a bigger issue. The osteopath should be able to help you make that call as well.

Hope this helps.
Good luck with the treatment of the knee pain.
Kind regards,

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