Q Ive had knee pain for a few months now. My GP has explained that the patella has moved out of line and that I am experiencing bone grinding on bone when I run. Now its got worse, but my GP is in no hurry to refer me to a specialist, saying that at my age (50) I should know better. Surely my running career cant be over?A Your problem might not be the kneecap running out of line. It could be related to your patellar tendon, which runs directly below the kneecap. You need to establish if there is any tenderness under the kneecap on this tendon. If so, then massaging the tender area will help it has to be quite deep. If there is no tenderness then the problem may be related to the kneecap, which is difficult to diagnose in this type of situation. The treatment for this is quite specialised, and you really do need to see a qualified physiotherapist. If this simply is not available then trying to take the pressure off the kneecap may help. To this end you can make sure that you are wearing appropriate running shoes by visiting a specialist retailer.
You could also try shoe inserts, best recommended by a podiatrist or physiotherapist. There are some good non-prescription orthoses available try calling Medisport for advice on AOL orthotics (0161-678 0233). This may well be enough to take the pressure off your knee.
In addition to this you could benefit from training in a gym and performing knee-strengthening exercises. Do not, though, perform leg extensions see the gym staff for help.
Martin Haines, sports medicine consultant