By Michael G. Pingicer, M.S., L.Ac.
One of the most common aliments for any athlete is knee pain, as I know all too well from personal experience. I played soccer as a child and teen as much as I could in all types of weather. I loved it. Indoors, outdoors, in snow, in hot humid weather - I was there. In soccer, the knees are utilized for running and for maneuvering the ball. There is a lot riding on healthy knees for soccer players to be successful. I began to get knee pain my junior year of high school from all the years of playing. All the MRIs and x-rays told the doctors nothing. They couldn't find any tears or breaks in the bones, cartilage, tendons, or ligaments. "Runner's knee" was the diagnosis. They prescribed physical therapy and rest, but I wanted to play. So, I played through the pain using my own adrenaline and desire. I used ibuprofen and ice after games as temporary stopgaps that only slightly touched the pain until I found acupuncture later in life. Now I can play pain free.
Why is it called Runner's Knee?
The name is a bit of a misnomer because this type of knee pain can occur in anyone, but frequently occurs in runners and athletes (whose activities usually involve some running). Many types of athletic movement can particularly stress the knee due to the repetitive, high-impact action of the leg with the ground and the twists and turns that are taken at high speeds. Knee pain can also result from jobs that require a lot of walking, or from a person being overweight.
What is Runner's Knee?
A very common form of knee pain is patellofemoral pain syndrome or "runner's knee," as it is more commonly known. The pain is usually in the front of the knee and it usually results from the patella (kneecap) rubbing against the femur (thighbone) causing pain, hence the name: patellofemoral pain syndrome. Commonly, there may also be some breakdown of the cartilage that is behind the kneecap causing more friction between the kneecap and the thighbone, or there could be some improper tracking of the kneecap over the femur causing increased friction and pain. These last two problems are common, but not always necessary to have patellofemoral pain syndrome.
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What are the symptoms?
The main symptom of patellofemoral pain syndrome is knee pain, especially when sitting with bent knees, squatting, jumping, or climbing stairs. You may also experience occasional knee buckling, where the knee suddenly and unexpectedly gives way and does not support your body weight. A catching, popping, or grinding sensation when walking or with knee movement is also common1.
What are the treatments?
1. Biomedical treatment
Biomedical treatment of runner's knee is usually as follows:This is a bit discouraging as it involves avoiding something in your life that could be giving you some sense of pleasure, such as sports, or just day to day walking, which is practically impossible to avoid. It involves taking pain medication that has an impact on your body. The physical therapy is the most promising of the treatments because it typically involves stretching the tight muscles and strengthening the weak muscles that may be pulling the patella out of alignment causing the pain. Surgery should always be and usually is a last option unless there is something seriously wrong. Patients should always get a second opinion whenever surgery is advised.
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2. TCM Treatment
There is a saying in traditional Chinese medicine (TCM) that "when there is stoppage, there is pain and when there is free flow, there is no pain" (bu tong ze tong tong ze bu tong). In this context, "stoppage" means the inhabitation of the free flow of qi/blood through the acupuncture channels resulting in pain2. The goal of acupuncture is to increase circulation of qi and blood in the channels in order to promote free flow and reduce pain.
Qi and blood stagnation and stoppage can come from many different factors in TCM. Some of these factors are due to the elements of the environment. Have you ever known someone whose knees become painful in the cold and rain and another person whose knees become painful in the heat and dryness? These mean something diagnostically in TCM, and a skilled practitioner can adjust treatments accordingly. Pain can be exacerbated by certain lifestyle circumstances or choices such as too much movement or not enough movement. For example: Does your pain feel better with rest or with movement? Either answer means something in TCM. There are many different diagnoses of pain in TCM, and a skilled practitioner will be able to diagnose your pain correctly and treat accordingly.Acupuncture treatment for runner's knee is a great option because it is drug free, kills pain, improves circulation, and releases tight muscles. The acupuncture needles are one of the only tools that can access the area between the patella and the femur, improving circulation to this area that does not have much blood flow. Chinese medicine also utilizes herbs internally and externally. Herbs can relieve pain and improve circulation to the area. The inclusion of herbs in treating knee pain can exponentially increase the recovery.
Research proves acupuncture is as effective as prescription pain killers for knee pain.
In a blinded study analyzing the effectiveness of acupuncture in treating patellofemoral pain syndrome, 75 patients were randomly selected to receive acupuncture treatment or to not receive acupuncture treatment3. Individualized acupuncture treatment was administered twice weekly for 4 weeks, and patients were followed for 1 year to evaluate how their pain progressed. After 1 year, the acupuncture group reported less pain overall than the group that did not receive acupuncture. This is also promising because it shows that acupuncture treatments have long-term effects.
In my practice, I treat a lot of athletes from the weekend warrior to the professional. There are many aches and pains that come up all over the body, but knee pain comes up more frequently. I have seen great results treating runner's knee when acupuncture is used in conjunction with some strengthening exercises, stretching, and certain Chinese medical massage techniques.
Juliette Aiyana, L.Ac.
Aiyana Acupuncture & Chinese Herbs
41 Union Square West, Suite 519
New York, NY 10003
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I feel like my old struggle to feel at a comfortable weight has finally ended! The weight loss acupuncture, nutritional program and herbs have made a huge difference for me! The changes also resolved fatigue and gave me more energy which fueled my exercise program. For me, it was never about losing a huge amount of weight, but more about maintaining a comfortable and healthy weight (and not starving myself) so after three months I do not feel a sense of up and down at all - but rather comfortable and at a balanced weight where everything fits nicely and I feel absolutely great! Thanks so much, Juliette!"
- Mary S, Female, Age 45