How can I differentiate runner's knee from other causes of knee pain?
I’m a 20 year old NSF, and I have constant knee pain, even when I'm not running. It hurts even in the morning when I've just woken up. My camp MO said that it was runner's knee which would get better with rest. I am concerned about arthritis, but I was told that I wasn’t in the correct age group, and hence it was unlikely. How can I differentiate runner's knee from other causes of knee pain, and how should I proceed (do I need an MRI scan etc)?
Thank you for expressing your concern about the knee pain you are experiencing. Needless to say, you are not alone and I see many young men in your situation at the Sports Clinic.
As Dr Sean mentions there can be several causes for knee pain and “runner’s knee” is a broad term for pain at the front of your knee. Important things to consider are
1. Swelling to the knee
2. Locking symptoms
3. Instability or giving way
4. Difficulty with stairs
If there are any of these symptoms, there might be something more significant going on.
In your cohort, the commonest cause for pain at the front of the knee is an imbalance of muscles with weakness in some and tightness in others. This often comes from the physical nature of NS and many people are unaccustomed to it, even those who are quite fit.
It may lead to a functional cause of knee pain that is remedied with rehabilitation and running retraining - both of which we can provide you. In most situations and X-ray and ultrasound scan will suffice for investigation but in protracted cases an MRI might be required. The main reason for an MRI is to determine if you need further treatments, rather than establishing a provisional diagnosis.
Probably best to ask your MO to refer you to your closest MSK/Sports Medicine Centre for an initial assessment and treatment. Pending this, you can try some simple quads, hamstring and ITB stretched. Hope this helps.
Assuming there’s no previous trauma (ie. fracture), it's highly unlikely to be arthritis. Arthritis is usually from wear and tear, so usually an older patient would get it. Post-traumatic arthritis can happen, but only if there’s a history of trauma.
At your age group and from what you’ve written, Runner’s Knee would be one of the more common problems. A lot of times there’s a combination of some tendinitis as well, so the pain may not totally go away even at rest.
There are many causes of knee pain, and u would need a thorough knee examination to identify the location and nature of the problem. Tendinitis, meniscal injuries, cartilage injuries, patellofemoral pathology etc can all cause pain. An MRI would also usually be indicated. It would help to exclude other potential injuries. Hope this has been useful!
Dr Sean Ng