Ultrasound guided injections are commonly used to treat the pain and discomfort of runner’s knee. Here’s what you need to know about this popular and highly effective procedure.

What is runner’s knee?

Runner’s knee is the term used for a range of conditions that cause pain around the kneecap (patella). These include: iliotibial band (IT) syndrome, anterior knee pain syndrome, patellofemoral malalignment and chondromalacia patella. Although referred to as runner’s knee, such conditions can have a range of different causes including jumping, cycling, playing football or even walking. Runner’s knee is most common in middle aged women and people who are overweight. IT syndrome is one of the most common causes of knee, thigh and hip pain in runners.

The main symptom of runner’s knee is a dull, aching pain around or behind the kneecap. The pain may be particularly noticeable when walking, climbing stairs, sitting down or standing up, kneeling or sitting for a long time with the knees bent. You may also experience swelling and a popping or grinding sensation inside the knee.

What causes runner’s knee?

Runner’s knee is normally caused by irritation of the soft tissues or lining of the knee or by strained tendons or worn cartilage. Many different factors can contribute to the problem including:

• Weak or tight thigh muscles
• Overuse of the knee
• Trauma or a fracture of the kneecap
• Arthritis
• Dislocation or misalignment of the kneecap
• Not warming up properly before exercise
• Flat feet
• Referred pain from the hip or back

Why might an ultrasound guided injection be recommended?

If you experience pain and discomfort in your knee that does not improve with rest, it is important to get a proper diagnosis as there can be a number of different causes. An imaging scan, such as an MRI scan, will normally be used determine what is causing the pain and your doctor can then recommend the best type of treatment. Ultrasound guided injections of corticosteroids are commonly recommended for people with runner’s knee as they are a quick and effective treatment with low risk of complications.

What are ultrasound guided injections?

Some types of treatment for knee problems involve injecting directly into the knee joint. These include injections of:

• Corticosteroids to relieve pain and inflammation.
• Hyaluronic acid to help lubricate joints and replace the body’s own lost joint fluid.
• Platelet-rich plasma to stimulate the body’s natural healing response.

What are the benefits of ultrasound guided injections for runner’s knee?

In each case, it is vital that the injections are given in the right place so that the drugs or fluids can have optimum effect. In the past, doctors relied on their own knowledge of bones, joints and tendons to direct the needle. However, ultrasound guided injections uses imaging to direct the needle, giving the doctor far greater accuracy and helping to make the treatment more effective as a result.

Evidence indicates that ultrasound guided knee joint injections are 100% accurate compared to 75% accuracy using the doctor’s own judgment. Pain relief is also improved as more of the drug reaches the place it is needed. Doctors report fewer side-effects related to the use of cortisone (such as thinning of the skin) and the risk of complication is lower as the doctor can see neurovascular structures on the computer monitor, which helps them to avoid accidentally damaging these structures.

How do they work?

Ultrasound imaging is used to guide the injection into the correct part of the joint. The doctor can view images on the computer monitor in real-time and can see exactly which part of the joint the needle is in. This enables fine adjustments to be made before the drug is administered.

Joint injections can help patients with runner’s knee to experience relief from symptoms and improvements in movement and flexibility. This enables them to move more freely, which is important for avoiding knee stiffness and for doing stretching and strengthening exercises to support the quadriceps muscles (essential for a return to fitness).

Healing from runner’s knee depends on how serious the injury is and how well you are able to support your own rehabilitation. It is rare to need surgery except in the most severe cases. You can support yourself to avoid runner’s knee by warming up thoroughly before exercising and keeping the thigh muscles strong and flexible. Proper footwear is essential and you should avoid running on hard surfaces like concrete if you can.

If you are interested in finding out more about ultrasound guided injections for runner’s knee, talk to us. We can also advise on diagnosis and treatment of all types of knee pain and sporting injuries.