Runner’s Knee (Patellofemoral Pain Syndrome): Causes, Symptoms, and Treatment
Runner’s Knee, or Patellofemoral Pain Syndrome (PFPS), is one of the most common causes of knee pain, affecting both athletes and non-athletes alike. It occurs when pain develops around or behind the kneecap (patella) due to issues with how the kneecap moves against the femur.
If you experience knee pain when running, squatting, climbing stairs, or even sitting for long periods, this guide will help you understand why it happens and how physiotherapy can help you manage and prevent it.
What is Runner’s Knee (PFPS)?
Runner’s Knee is a non-traumatic knee condition that develops due to increased stress on the patellofemoral joint—the area where the kneecap glides over the femur. Unlike ligament injuries or meniscus tears, PFPS does not involve structural damage but rather irritation due to mechanical overload.
PFPS is primarily influenced by movement patterns, muscle imbalances, and training errors, making it highly responsive to physiotherapy-based rehabilitation.
Who is at Risk of Runner’s Knee?
PFPS can affect anyone, but it is particularly common among:
- Runners & Cyclists – Repetitive knee flexion-extension can overload the joint.
- Active Individuals & Athletes – Jumping, squatting, or sudden increases in activity levels may contribute.
- Office Workers & Drivers – Prolonged sitting with bent knees can cause discomfort.
- Women & Adolescents – Hormonal and anatomical factors, such as wider hips, may increase the risk.
What Causes Runner’s Knee?
Runner’s Knee is multifactorial, meaning several factors contribute to knee pain. Key contributors include:
- Overuse & Sudden Activity Changes – A rapid increase in running or exercise volume can overload the knee joint.
- Quadriceps Weakness – Weak quadriceps fail to stabilise kneecap movement, increasing stress.
- Hip & Glute Weakness – Poor hip control alters knee alignment, leading to excess strain
- Tight Muscles – Reduced flexibility in the calves, hamstrings, or quadriceps can contribute to altered biomechanics.
- Poor Movement Mechanics – Knees collapsing inward (valgus) during squats or running can exacerbate joint stress.
Important: Runner’s Knee is NOT due to knee damage but rather improper loading and movement dysfunction, making rehabilitation highly effective.
Common Symptoms of Runner’s Knee
- Pain around or behind the kneecap, often worsening with activity.
- Pain when squatting, running, climbing stairs, or sitting for long periods (“movie sign”).
- Clicking or grinding sensations (crepitus) in the knee.
- No significant swelling or instability, unlike ligament injuries.
How to Treat Runner’s Knee
The good news? Runner’s Knee is highly treatable! Most people recover well with a combination of exercise therapy, movement modification, and progressive loading.
1. Physiotherapy & Strength Training (First-Line Treatment)
- Quadriceps Strengthening – Exercises like straight-leg raises, step-ups, and terminal knee extensions help stabilise the knee.
- Hip & Glute Strengthening – Strengthening the glute medius and glute max improves knee control.
- Functional Training – Squat, lunge, and running drills enhance movement mechanics.
Key Message: Strengthening the quads, hips, and calves is crucial for long-term Runner’s Knee recovery!
2. Activity Modification & Load Management
- Reduce high-impact activities (e.g., excessive running, deep squats) temporarily while allowing recovery.
- Avoid prolonged sitting with knees bent for extended periods.
- Adjust running or cycling form to optimise biomechanics.
3. Pain Management & Recovery Strategies
- Short-term relief: Ice or heat therapy can help with pain management.
- Foam rolling & soft tissue release: Quads, IT band, and calves may benefit from self-massage.
- Orthotics & Footwear Adjustments: If foot mechanics contribute, proper shoes or orthotics may help.
What About Surgery or Injections?
- Surgery is not recommended for Runner’s Knee, as it is a biomechanical issue, not a structural problem.
- Cortisone injections are generally ineffective since PFPS is not an inflammatory condition
How Physiotherapy Can Help
At Personal-Physio, we take an evidence-based approach to PFPS rehabilitation, offering:
- Personalised Strength Programmes
- Movement & Running Assessments
- Hands-on Treatment for Pain Relief
- Education on Activity Modification & Prevention
With the right rehab approach, you can overcome Runner’s Knee and return to pain-free movement!
Final Thoughts: Managing Runner’s Knee Long-Term
- Runner’s Knee is not caused by damage—it is a mechanical issue that responds well to rehabilitation.
- Exercise therapy is the best treatment—with a focus on quads, hips, and movement mechanics.
- Most people recover fully—but gradual progression is key to prevent recurrence.
Struggling with knee pain? A physiotherapy assessment can identify contributing factors and create a personalised recovery plan!
Book a Consultation at Personal-Physio !
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