Pain in the knees most frequently affects people who are active and participate in sports because of the repetitive motion necessary for biking, running, or jumping.
In fact, a third of all sports injuries are knee related.
In this article, I will discuss two frequent problems which affect the knees, patellofemoral (kneecap) pain and iliotibial (IT) band syndrome. Both of these problems start slowly with the repeated use of the knees either in an improper fashion or in someone with a misaligned knee. These particular disorders are rarely caused by an accident, which tend to affect the ligaments or the meniscus around the knee instead. I will not be discussing osteoarthritis of the knee in this article, but I will write about it in the future.
Kneecap pain is characterized by the irritation of the cartilage of the knee between the kneecap and the femur (thigh) bone.
The pain, which can be infrequent and sharp or recurring and chronic, is located around the kneecap in the front of the knee. In the beginning, the pain usually starts after the activity 
has finished, but if the problem isn’t treated, the symptoms usually worsen and the pain can be present during the activity as well. Some people report cracking in their knees. A good indication of this particular disorder is the movie theater sign. Someone with this problem will have pain at the kneecap when they are sitting somewhere without enough space to stretch their legs, such as the cinema. Another symptom could be an episode where the knees buckle or give out unexpectedly. Generally, this pain arrives when the joint has been over-utilized, like when an exercise program increases in intensity too quickly, or when there is a problem in the alignment between the kneecap and the thigh bone. Repeatedly going up and down stairs, running uphill, kneeling frequently, and doing sports which require a lot of jumping can also cause this type of pain. Bikers should be sure to adjust their seat correctly, as a bike seat which is too low often causes this type of knee pain.
Iliotibial band syndrome appears after the long-term practice of repeatedly flexing and extending the knee.
Bikers and runners are particularly at risk. For bikers, a seat which is positioned too high is
often the cause of this knee pain. Irritation and inflammation is caused by the repeated friction between the long iliotibial band on the outside of the knee and thigh, and a protuberance of the femur (thigh) bone at the knee. An alignment problem of the knee is almost always the cause. Otherwise, it can be caused by a lack of suppleness of the IT band and the muscles near the hip and buttocks that attach to it. With this syndrome, the pain will be on the outside of the knee. In some cases, there can also be a hip pain as well. The pain increases with physical activity and when the heel touches the ground.
An injury to the knee which is left untreated can degenerate into a chronic pain.
The healthy side of the body will also often over-compensate for the injured side, which can also create its own biomechanical problems in the body. It is important to consult a doctor to get a precise diagnosis for the knee pain and to start treatment as quickly as possible before the symptoms worsen.
As is often the case, the longer one waits to start treatment, the harder it becomes to heal.
Treatment options to consider for these particular problems should include: acupuncture, sports therapy, kinesiology, osteopathy, and physiotherapy. Acupuncture can relieve the inflammation at the beginning of the injury and help diminish the pain. Physiotherapy and acupuncture often work well together to help correct structural misalignments in the ankles, knees, and hips, which can contribute to the problem. A physiotherapist should be able to suggest the best stretches to do, as any treatment for knee pain will work best in conjunction with proper stretching at home.
The best prevention for sports-based injuries like these is proper stretching before and after exercising.
I know that no one likes to hear it, but the older we get, the more important stretching becomes. Getting my patients to take their health in their own hands is an important part of my practice and I encourage you all to get active and start stretching this spring.
