I have pain in the upper part of my tibia and the side of my knee after I run (rarely do I notice it while running). I feel the pain when walking during the day after a morning run or while sitting for longer periods of time. I think this is "runner's knee" and I've tried resting and stretching to no avail. I'm wondering who I should see for help - a chiropractor?

While I have nothing against chiropractors, I think your best first stop is with a physician. Your primary care physician should be able to examine you and decide whether this is likely a problem with your muscles, ligaments, cartilage, or bones.

The usual approach to knee pain that is related to overuse is to encourage some rest along with an anti-inflammatory medication for a period of a few weeks to see if it results in improvement. If you return to running, icing your knee after a run might also help, as might an elastic knee brace to remind you to go easy on the knee. Avoiding hard running surfaces and wearing shoes with good arch supports can also help. And, it might turn out that your days of regular running are best put behind you -- to be replaced with other sports such as swimming or biking. Dscussion of your symptoms and evaluation of your running technique with a trainer may help. In addition, physical therapy can sometimes help both with rehabilitation and with running technique, especially if you have a therapist that is knowledgeable about sports injuries.

However, if you are not getting better with some of these interventions, or if your doctor suspects a mechanical injury that might need surgery, then an MRI scan of the knee will be needed to further evaluate it.

I hope this overview gives you an idea of the many things that could be wrong with your knee and the rationale for starting your evaluation with your primary care physician.

Best of luck, and please let us know what happens.

Dr. Mike Potter

-- Michael Potter, MD, is an associate professor at the University of California at San Francisco Medical Center.

First published March 29, 2005
Last updated October 31, 2007
Copyright © 2005 Consumer Health Interactive