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Ester Marsh: If you’ve got knee pain, plenty of culprits could be to blame

One of my colleagues asked me some questions about knee pain since many people jumped back into exercise maybe a bit too hard too quickly after being off due to COVID-19.

I figure it’s a great column for this week.

Many things can cause knee pain but here are some of the most common overuse injuries. Remember, a doctor needs to diagnose your problem to be sure.

Some overuse problems of the knees:

Patellar tendonitis: Also called “jumpers knee,” athletes such as basketball and volleyball players often struggle with this when they have knee pain. This tendon connects the knee cap to the shin bone so the pain is below the knee. Typically there is inflammation due to overuse of the tendon. If it is an overused tendon with no inflammation it is called patellar tendinosis. Instead of inflammation, there are microscopic tears and thickening of that tendon. Pain will start after an activity and will continue when injury progresses. Strength and flexibility exercises are important to prevent this and there are braces called infrapatellar straps to support that tendon and improve stability. Many times you see basketball players wear this strap below the knee.

Runners Knee: Pain around or behind the knee cap gets worse when bending, going down stairs or down hill, along with possible swelling. When doing research on this, iliotibial band syndrome is another name for it. Runners knee is the bruising near the bottom of the knee cap. It can be caused by incorrect tracking of the knee cap when running, over pronation (rolling the foot inward), inappropriate running shoes or an excessive increase in the training load (too much too soon). This injury is often misdiagnosed with condromalacia patella, which is the deterioration of cartilage in the knee joint or damage to the back of the knee cap.

Iliotibial band syndrome: Another name for runners knee, pain is typically located on the outside lower part of the knee, below where the IT band attaches to the tibia (shin bone). However, pain can go all along your illiotibial band up the side to your hip. Imbalance and overuse is another reason why people (not only runners) struggle with IT band syndrome. Strength and stretching exercises are also key to prevent or recover from this.

Bursitis of the knee: The bursa is a small sac filled with fluid on the outside of the knee cap. Also called pre-patellar bursa (most common bursa with knee bursitis) pre-patellar bursitis is the inflammation of the bursa and causes pain, swelling and the feeling of heat. This bursitis is also known as “popeye” knee. The swelling can be severe right on top of the knee cap.

Again, it is important for a doctor to diagnose these because some can be caused by an infection and antibiotics would be needed to help heal.

If you are dealing with knee problems, check if you are doing too much too soon.

Are you stretching enough? Is there an imbalance of the muscles? Is your footwear appropriate?

Rest and ice are always good to perform if any knee issues arise and to help prevent knee pain. After a long and hard workout, lift your legs up and “strap” a couple of ice packs on your knees while enjoying a good book or TV program. Anti-inflammatories such as aspirin and ibuprofen will help with the inflammation if needed.

Make sure you check with your doctor first and that you are not allergic to these over the counter medicines of to be sure there isn’t anything else going on. Early detection/prognosis by a doctor, physical therapy and proper exercises and listening to your body can help your recovery to strong healthy knees.

Ester H Marsh is Health and Fitness Director JF Hurley family YMCA.

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