Many plastic surgeons, like Toronto-based Dr. Pirani, have been using Botox or Dysport for many years in the treatment of cosmetic concerns. Botox is a favoured type of cosmetic procedure, because it is effective, non-invasive, and is also temporary. While we have known the benefits of Botox in a cosmetic sense, it seems the other benefits are still coming into light. One of these other uses is to treat runners who are experiencing knee pain. 


Lateral patellofemoral overload syndrome (LPOS) is a condition that commonly affects runners as well as other athletes, including cyclists and other active people. With LPOS, patients experience inflammation and a sharp pain in a specific area, normally the front and the side of the knee joint. This can prevent athletes from competing and even staying active, since it can take many days or weeks to recover. 

The condition is even worse when an athlete has not given themselves time to properly rest, instead pushing themselves harder, making the recovery period take even longer. It is estimated that one in five female athletes and one in eight male athletes suffer from LPOS. This is the condition that researchers were using Botox on to treat.

What is Botox/ Dysport?

Both Botox and Dysport are neurotoxins that are placed using an injection into troubled muscles or areas of the body. The solution causes temporary paralysis that is localized to the muscle that receives the injection. Essentially, the medicine will relax an overly worked area, such as a knee, giving it some release while giving you a chance to strengthen up your other muscles.

Botox works well for wrinkles, because it temporarily immobilizes the muscles that are causing the wrinkles, leaving you with smooth skin. The same thing applies for LPOS, relaxing overly worked muscles to give other muscles a chance to strengthen.

The Injection

The initial study that was performed with the use of Botox used 45 patients who had been diagnosed with LPOS and who had not responded to physiotherapy treatment. The injection itself was placed in the front and the outside of the hip. The hip is the injected area, because patients have been shown to overuse the hip in particular, which can cause pain and injury further down the leg.

In some cases, the knee might be directly injected, or the gluteal muscles. It all depends on the muscle that they are trying to target to ease your suffering. Several injections may be used, but that is specific to the situation, so it is not a one-injection works for all kind of thing.

The Results

After the study, it was discovered that more than two-thirds of the patients did not require additional treatment beyond the injection. Some physiotherapy following the injection is encouraged to help you build up the muscles around the area that is causing the most discomfort. Otherwise, following physiotherapy, most patients reported that they did not need any further treatment. The patients also reported that they were pain-free even five years after having received the injection into their muscle.

The patients who still needed additional treatment did also experience relief from the injection, but their case was too severe to not require further intervention to relieve the pain. 

Bottom Line

Botox injections for LPOS have been shown to be the last option for many athletes before exploring surgery. Surgery would completely remove them from a sport for an unknown amount of time. The injections, however, are non-invasive with a quick recovery time as the other muscles are strengthened. Hopefully this is an option we will be seeing more of in the future.