Condition, Runner's Knee

What is a Runner’s Knee? Symptoms, Pain, Causes & Treatment

What is Runner’s Knee or Patellofemoral Pain ?

Patellofemoral pain is a general term that includes several possible diagnoses and symptoms that can be experienced by runners and non-runners alike. It is a common cause of knee pain in runners. The term “runner’s knee” may be used when the person is not a runner or has been diagnosed with other conditions. Patellofemoral Pain Syndrome (PFPS) is a condition that affects the areas around and below your kneecap, including the patella and femur. PFPS occurs when the tissues in this area become too tight or rub together too much, usually from repetitive motions such as going up and down stairs or going for a long run.

Runner’s knee is more prevalent among women than in men, according to research by Harvard Medical School; women of middle age especially are at larger risk, likewise people who are overweight.

What Are The Symptoms of Runner’s Knee?

Most times the symptoms of Patellofemoral Pain (Runner’s Knee) develop gradually. Although the symptoms of the runner’s knee might look like symptoms of other health problems or conditions; it is important to talk to your healthcare provider for a proper diagnosis. Here are the symptoms of Patellofemoral Pain (Runner’s Knee): 

  • The pinnacle of a runner’s knee is a dull severe pain behind or around the patella or kneecap; especially where it is joined with the lower part of the femur or thighbone.
  • You may feel pain when you are walking, squatting, climbing or coming down from stairs, running, kneeling, standing or sitting down, and when you sit for a long time with the knee bent.

Other symptoms include popping and swelling or grinding in the knee

  • Also, you may hear clicking sounds of the kneecap when you straighten or bend your knee
  • Kneecap is too tender to touch
  • Pain increase even when you do your usual sport, activity, or routine
  • Reduced strength in the thigh muscle if symptoms are left untreated

Causes of Runner’s Knee?

Several things could bring Patellofemoral Pain, they include; 

Bone Overuse: Doing a lot of high-stress exercises and bending of the knees frequently, like plyometrics and lunges can irritate the tissue in and around the kneecap.

Direct Hit on The Knee: If a person falls or receives a direct hit on the knee, it could cause immediate Patellofemoral Pain.

Bones are not lined up (malalignment): This is when the bones from your hips to your ankles, are not in their original and correct position. This can exert too much pressure on a certain spot, such that your kneecap cannot move smoothly through its groove. This misalignment can cause Patellofemoral Pain.

Problems With Your Feet: Problems like hypermobile feet, a situation when the joints in and around the feet move more than they should do; flat arches; overpronation, a situation where the foot rolls inward and down when you step can cause great pain. Because these problems change the way you walk, they can cause Patellofemoral Pain

Unbalanced or Weak Thigh Muscles: The big muscles in front of your thigh which are known as quadriceps keep the kneecap in place when you bend or stretch the joint. If this muscle is weak, unbalanced, or tight, the kneecap might not stay in the right spot; thus, causing Patellofemoral Pain.

Chondromalacia Patella: This is a condition where the cartilage beneath your kneecap breaks down. This breakdown can cause disruption when the kneecap is supposed to be fully functioning; thus, this Patellofemoral Pain happens.

Surgery: Knee surgery, especially repairs to the anterior cruciate ligament using your patellar tendon as a graft can lead to having Patellofemoral Pain.

Other causes of Patellofemoral Pain are:

  • Having a tight kneecap that is too high in the knee joint
  • Tight hamstrings
  • Poor foot support
  • Tight Achilles tendons
  • Arthritis
  • Inadequate stretching before exercise
  • Improper equipment use or improper sports training procedure
  • Playing on hard surfaces

Risk Factors of Runner’s Knee

Factors that can increase the risk of having Patellofemoral Pain include:

Sex: According to research, women are twice more likely than men to have Patellofemoral Pain. This is because women’s wider pelvis increased the angles where the knee joints meet

Age: Patellofemoral Pain is usually related to young adults and adolescents, this is because they are more likely to be vibrant and energetic; thus, they tend to overuse their bones. Also, women in their mid-age are at higher risk. In older people, knee problems are commonly caused as a result of arthritis.

Sports: People that engage in sports that involve running and jumping are at higher risk of having a Runnner’s knee. This is because their activities tend to exert extra pressure and stress on their knees, especially when they try to increase their training level

Bodyweight: Individuals who are overweight are at higher risk also. This is because their body weight automatically exerts excess pressure and stress on their knees, especially when they stand or walk.

Flat Feet: People with flat feet might be at higher Patellofemoral Pain, as they exert more stress and pressure on their knee joints.


How is Runners Knee Diagnosed?

Because the symptoms of a runner’s knee look like other conditions, it is necessary to have a proper diagnosis, to have the proper treatment.

 To diagnose a runner’s knee, the doctor will ask you questions about your symptoms and pains; and then proceed to do a physical examination. During the physical examination, you will be required to move your leg and knees in certain ways to check for stability and determine the motion range.

In some critical or confusing cases, the doctor might require some imaging tests like X-rays, MRI scans to confirm the diagnosis and rule out other probability


How can I Prevent Runners Knee?

To prevent a runner’s knee, the following precautions should be ensured:

  • Use proper insole if you have problems that may cause a Runner’s knee
  • Avoid running on hard surfaces
  • Keep healthy weight
  • Wear quality footwear
  • Keep the muscle in your thigh is limber and strong with regular exercises
  • Ensure your shoe has enough support
  • Before any workout, ensure you warm-up
  • Don’t change your workout routine suddenly; do it gradually
  • Immediately the sole of your shoe loses its shape or it is worn out, get a new pair
  • Use a knee brace during a workout when necessary
  • When running, lean forward with your knees bent
  • Use proper training equipment and ensure proper training techniques

How Do I Treat Runners Knee?

For most people, Runner’s knee gets better on its own with time and little treatment to ensure a speedy recovery. To treat a runner’s knee, the following treatment procedures can be ensured:

RICE Protocol

The RICE protocol involves the following procedure

Rest your knee as much as possible, so as not to make the injury worse. Avoid activities like running, lunging, standing for too long, sitting too long with your knees bent, and squatting.

Icing your knee to ease swelling and pain; you can try this for 15 to 20 minutes every 3 to 4 hours for about 4 to 5 consecutive days, or until the pain is minimized or gone.

Wrap your knee to reduce swelling. Use a patellar strap, elastic bandage, or sleeves to give it the needed support

Elevate your legs, using a pillow when you sit. You can also lie and elevate it on the wall.


You can get over-the-counter painkillers or anti-inflammatory medications (NSAIDs), such as ibuprofen and acetaminophen to reduce the swelling and pain. These drugs should not be taken for long to avoid increasing the risk of gastrointestinal issues

Physical Therapy

Working with a professional and qualified therapist can help minimize the swellings and pain, and also speed up recovery time. The therapist may recommend massage, using a brace, stretches and exercises, and patella tapping.


If all the above treatments have been tried and there is no positive result, the doctor may suggest surgery as it is the last option. Surgery is usually done with an arthroscope, a camera in a thin tube, and light. The arthroscope is inserted into the knee with the aid of the light and camera, and the damaged cartilage is removed.

This procedure can relieve tension and increase mobility. Severe cases may require operations on the knee to redirect the patella.

Conclusion on Runner’s Knee

Patellofemoral Pain or a Runner’s knee can be very frustrating; you should see the doctor for proper diagnosis immediately you start feeling pains in your knee.

Photo by Nicolas Hoizey on Unsplash