Runner's knee: pain around the kneecap and what helps

Runner's knee is also called patellofemoral pain. Signs include:

• An ache around or behind the kneecap
• Pain when you squat, go up or down stairs, run or jump
• Pain after sitting for a long time with your knees bent

It usually comes on slowly, without a fall, a twist or a hit.

• Exercises for your hips and thighs. Experts say hip and knee exercises done together work best.
• Doing less of what hurts for now, like running, jumping or deep squats. Then build back up slowly.
• Arch supports (shoe inserts) may help for a short time.
• Pain medicine. Acetaminophen can ease pain. If it is safe for you, a doctor may suggest an anti-inflammatory pill, like naproxen, for a short time.

Anti-inflammatory pills can cause stomach bleeding and kidney problems, and they can raise the risk of a heart attack or stroke. Ask a doctor before you take them if you have stomach, kidney or heart problems. Do not take them if aspirin or any anti-inflammatory has ever given you asthma, hives or another allergic reaction. If you are pregnant, ask a doctor first: these pills can harm the baby, most of all in the second half of pregnancy.

Go to the emergency room or urgent care now for a hot, red, swollen knee, knee pain with a fever, or if you cannot put weight on your leg or your knee looks wrong after an injury. A hot, swollen knee can be an infection in the joint.

Call 911 for chest pain or trouble breathing. Get care the same day for a calf that is swollen, warm or red on one side. These can be signs of a blood clot.

See a doctor in person if:

• You hurt your knee in a fall, a twist or a hit
• Your knee swells up, locks, catches or gives way
• Your kneecap has slipped out of place, or it feels like it slips
• The pain is mostly in your hip or groin, or you limp
• You have back pain that runs down your leg, or numbness or weakness in your leg
• You have pain at night or at rest, weight loss without trying, or a history of cancer
• Your pain has lasted more than 3 months and no one has examined it

If you are in Virginia or West Virginia, you can start a visit online at any time. It is for adults 18 to 49 with an ache around or behind the kneecap that came on slowly, without a fall, twist or hit. Squatting down slowly brings on the pain, and the knee does not swell, lock or give way.

A board-certified physician reviews your answers and sends a home plan: hip and knee exercises, doing less of what hurts for now, arch supports, and acetaminophen. If it is safe for you, the doctor may add a short course of an anti-inflammatory pill.

It is not for people 50 or older, or for anyone with the warning signs above.

Visits start at $59. You see the price before you pay, and you do not need insurance.