Runners Knee – A guide to your knee pain

Julia Truong
by Julia Truong
HELP! My knee hurts!
It’s that time of the year again, where we bring out the ol’ Asics Kayanos, put on the Dri-FIT shirt and shorts, and pop in the Bluetooth air pods. Whether you’ve signed up for a fun run, run ultra-marathons, or even just enjoy running around the block, you’ve probably fallen victim, or know someone dealing with Runner’s knee
If you, or someone you know is currently experiencing the pain of Runner’s knee, then you’re probably frustrated. You want to return to what you love doing but every time you try to up the intensity, the pain just flares up! 
Don’t worry, we’re here to help. Below are answers to some of the most frequently asked questions we get from our patients about Runner’s knee. Scroll down and have fun reading!

What is Runner’s Knee? 

Runner’s knee isn’t a specific type of injury, but rather a broad term used to describe the pain associated with the kneecap. Health professionals commonly refer to it as patellofemoral pain syndrome, or PFPS
Runner’s knee, or PFPS causes pain on the front of the knee, around and under the kneecap. Pain tends to be worse with activities such as squatting, kneeling, sitting with knees bent, climbing stairs, and running. The pain can develop relatively slowly, over months or even years. 
PFPS can affect anyone who participates in activities that places repeated stress on the knee joint. For example, running, skiing, and hiking, just to name a few. 

What causes Runner’s knee?

Runner’s knee is brought on from repetitive and excessive strain to the knee joint. The pain can be caused by irritation of the tissues around the kneecap but can also be inflammatory in nature. When the level of stress to the tissues surrounding the kneecap goes beyond its usual tolerance, runner’s knee can occur.
Runner’s knee can happen to anyone, but it’s often contributed to by other factors including the following: 
  • Overuse or excessive training  
  • Trauma to the kneecap
  • Running biomechanics
  • Weak or tight iliotibial band, hamstrings, gastrocnemius, quadriceps, hip abductor muscles
  • Foot biomechanics or weakness

What are the signs and symptoms of Runner’s Knee?

How do I know if I have runner’s knee? Well, you would likely be experiencing one, or more, of the symptoms below –
  • Dull, aching pain around or in the kneecap
  • Pain is especially noticeable when you run, walk, kneel, squat, sitting on or standing up from a chair, going up or down a flight of stairs
  • Possible tenderness around kneecap 
  • Possible grinding, clicking, rubbing sound when moving, straightening or bending the knee
  • Knee may feel unstable or weak after sitting for a long time, participating in an aggravating activity 

Who can diagnose my Runner’s knee?

Physio’s are fantastic at diagnosing Runner’s knee by performing a thorough physical examination and a comprehensive subjective examination to determine the root cause for the pain. No scans are necessary to diagnose Runner’s knee. 

How long will it take for me to get back to running after suffering from Runner’s knee?

In most cases, patients will return to their normal physical activities after 6-12 weeks of treatment, permitting you have a good rehab program, and follow the advice of your health professional. 

5 tips to relieve pain caused by Runner’s knee.

If you think you may have runner’s knee, you should seek the assistance of your Physiotherapist. In the meantime, try the strategies below –
  1. Modify your training and other activities that aggravate your knee pain – 

This does not mean stopping all exercise altogether. It means modifying activities that can cause repetitive stress on your knee until you see your physiotherapist. For example, reducing your overall mileage or changing the terrain on which you train i.e. training on flat ground instead of hills. 


2. Use Rest, Ice. Compression and Elevation (RICE) to relieve pain and swelling

ICE – may help to reduce pain and swelling in the acute phase of injury. Place a towel on the skin, then apply an ice pack to the area, keep this on for 20 minutes and then rest for 2 hours.

COMPRESSION – To help with swelling and stability, use a compressive garment. 

ELEVATION – when applying ice, sitting, or lying down, elevate your knee using pillow. Try to keep the area above the level of your heart, this will help to reduce swelling.


3. Physiotherapy 

One of the most effective treatment options for runner’s knee is exercise rehabilitation. It’s a proven method for significantly reducing pain and improving overall function. The specific rehabilitation program for your knee will focus on strengthening the hip, thigh and knee muscles. 

In the early and inflamed phase, try these exercises below. Make sure not to push past pain when attempting these exercises at home and book in to see your physiotherapist as soon as possible to have your knee properly assessed. 
Quad stretch – 3 lots of 30 second holds

Isometric knee extension – 10 lots of 5 second holds, by 3 sets

Clams – 3 lots of 10 repetitions each side

4. Orthotics
Trial orthotics from your local chemist. It’s not necessarily a “one-size-fits-all” so if you’re not seeing any changes, book in a visit to your local podiatrist or physiotherapist. They will assess your lower leg and prescribe specific orthotics to fit your individual need if needed.
5. Taping or Bracing
Knee taping or braces can also have a significant impact on reducing knee pain. This treatment method works by offloading stress from the knee by improving support. However, it acts as a short term pain reliever and should not be a long-term solution. Physiotherapists can provide knee taping and advise appropriate knee braces. 


How can I prevent Runner’s knee in the future?

You can minimise this risk by:
  • Keeping muscles of your legs strong
  • Increasing your physical activity gradually
  • Making sure you spend some time warming up your legs before running
  • Wearing supportive running shoes and replacing them when they are worn out
  • Keeping a healthy body weight
  • Making sure you have a good training program with good structure
In summary – 
Runner’s knee is a common problem that can happen to just about anyone. Even if you’re not a runner,  you can still fall victim to patellofemoral pain syndrome if you regularly perform activities, exercise, or even work in a way that places excessive, repetitive stress on your knee. 
Thankfully, it can be easily addressed and managed in most cases. Keep in mind that some symptoms of runner’s knee might look like other health problems and conditions. That’s why it’s a good idea to talk to your physiotherapist for a professional diagnosis, particularly once you start to feel pain in or around your knee. Here at Pathways, we love treating knees because we get such good results!
Julia is a Physiotherapist working at Pathways Physiotherapy. To make a booking to see Julia, or any of our other Physiotherapists CLICK HERE.