Runner’s Knee

What is Runner's Knee?

Runner's knee, medically known as patellofemoral pain syndrome (PFPS), is one of the most common running injuries, causing pain around or behind the kneecap (patella). This condition occurs when the kneecap doesn't track properly in its groove during movement, leading to irritation of the cartilage on the underside of the patella.

Despite its name, runner's knee doesn't only affect runners - it can develop in anyone who performs repetitive knee-bending activities. The condition typically develops gradually and can significantly impact your ability to run, climb stairs, or perform daily activities involving knee flexion.

What Causes Runner's Knee?

Runner's knee typically develops from a combination of factors affecting how your kneecap moves:

Biomechanical factors:

  • Poor running technique or foot strike patterns

  • Weakness in hip muscles, particularly the glutes

  • Tight IT band, hamstrings, or calf muscles

  • Overpronation or poor foot mechanics

  • Muscle imbalances around the knee and hip

  • Poor core stability affecting overall alignment

Training-related factors:

  • Sudden increases in running distance or intensity

  • Running on hard surfaces or excessive downhill running

  • Inadequate rest and recovery between training sessions

  • Poor or worn-out running shoes

  • Returning to activity too quickly after injury

Structural factors:

  • Kneecap alignment issues (high-riding patella)

  • Leg length discrepancies

  • Previous knee injuries or surgery

  • Joint hypermobility or excessive flexibility

  • Q-angle abnormalities (angle between hip and knee)

Risk factors:

  • Female athletes (higher incidence due to anatomical factors)

  • Adolescents during growth spurts

  • Sudden increase in activity levels

  • Previous history of runner's knee

What Are the Symptoms?

Runner's knee presents with characteristic pain patterns that worsen with specific activities:

Primary symptoms:

  • Dull, aching pain around or behind the kneecap

  • Pain that worsens with running, especially downhill

  • Discomfort when climbing or descending stairs

  • Pain after sitting for prolonged periods ("cinema sign")

  • Grinding or clicking sensations in the knee

Activity-related symptoms:

  • Pain during or after running that may force you to stop

  • Discomfort when squatting or lunging

  • Pain when kneeling or getting up from low positions

  • Stiffness after periods of rest

  • Reduced running performance and endurance

Progressive symptoms:

  • Gradual onset over weeks or months

  • Pain that initially occurs only during activity but may progress to constant discomfort

  • Swelling around the kneecap in some cases

  • Weakness in the quadriceps muscles

  • Compensatory movement patterns affecting hip and ankle

Functional limitations:

  • Difficulty with stairs, particularly going down

  • Reduced confidence during running activities

  • Impact on daily activities like getting in and out of cars

  • Altered running gait leading to other injuries

Struggling with knee pain from running? Given that most injuries we see at our clinic are running-related, we have extensive experience treating runner's knee in athletes of all levels. Our comprehensive assessment includes biomechanical analysis and advanced testing to identify the root cause of your symptoms and create an effective rehabilitation programme.