Treatment or rest for 'runner's knee'?

It's the classic runners' dilemma. Do you see a sports physician when your knee starts to twinge, or simply rest up until it's better?

Knee pain without underlying damage tends to get better eventually. But for many athletes, waiting is not an option. Sports injury clinics are full of runners having their knees strapped up, testing expensive orthopedic insoles, and learning quadriceps-strengthening exercises.

The question is, does any of this do any good? A new study suggests a tailored exercise program may help relieve knee pain, but doesn't necessarily speed a full recovery.

The study recruited young people age 14 through 40, with pain around the kneecap that didn't have an obvious physiological cause. This type of knee pain is very common in runners, cyclists, and other athletes.

Half the recruits followed a six-week program designed for them by a physical therapist, including exercises to strengthen muscles and improve balance and flexibility. The others were instructed to rest up.

After three months, the people who'd followed the exercise program reported less pain, and more ability to use their injured knee. But they were no more likely to say they'd recovered from their injury. That could be because the pain had reduced, but it hadn't gone altogether.

After a year, people were still reporting somewhat less pain in the exercise group than the rest group. But all the other outcomes were about the same, including whether people were recovered and how well they could use their knee.

What you need to know. If you want to see quicker improvements to your pain and ability to use your knee, exercises may help. If you're happy to wait and let nature heal, the outcome is likely the same in the long run.

--Anna Sayburn, patient editor, BMJ Group

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