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What is Runner’s Knee and How to Treat It?

image of runners knee What is Runner’s Knee and How to Treat It? www.walkjogrun.net

If you have pain around or under your kneecap, you may be experiencing Runner’s Knee. This injury often referred to as a patellofemoral syndrome, is an overuse injury, where there is the excessive load being placed on the knee.  This could be due to running, jumping, even squatting and climbing stairs may cause this syndrome. Often highlighted by a dull ache in or around the knee, this condition can get worse when engaging in downhill activities.

But there is good news.  If you’re suffering from Runner’s knee, you may think that there might be some type of injury. However, in most cases of this condition, the tendons, ligaments, and cartilage are fine. It just involves an imbalance in your muscle tissue, which may be easily fixed.

What is Runners Knee?

Runner’s knee is, as we mentioned before, an overuse injury common with runners, athletes, and even nonathletic people.  It’s a pain that is often felt around the knee, or right behind the knee.  You may find it difficult to run and enjoy regular everyday activities.


Some activities that may be harder to do with it include: Climbing stairs, kneeling down, and doing squats or other exercises that load the knee joint. This is one of the most common injuries that can happen to athletes, runners, and walkers.

So what causes Runner’s Knee? There are plenty of things that could contribute to your knee pain. For example, making sudden changes to your activity level, increasing your intensity too soon, and extending the duration of the workouts may all contribute to Runner’s knee.

But the most common reason involves an imbalance in muscle strength, especially weakened quadriceps.

The Structure of the Knee

You may, or may not know this, but your knees are the largest and most complex joint in your entire body.


Combining bones from the tibia and femur, strong tendons form a tight grip on these bones to keep them in place.

One of the hallmarks of the knee is the patellar tendon.   Found in the front of the knee, your patella tendon moves back forth along a groove in the bone, called the trochlea.

Normally, when you bend or straighten your knee, your kneecap moves pretty smoothly in this groove.

However, due to imbalances in muscles, or weakness in tendons, the patellar tendon may tract to the outside, inside, or even higher in the knee.

Besides the muscles and tendons, there are also articular cartilage, synovial membranes, and a fat pad underneath the kneecap.

The fat pad acts as a cushion, while the cartilage and synovial membranes act to lubricate the joint.

Now, in the runner’s knee, there could be many different reasons why there is a pain.

There could be damage to the cartilage, or the kneecap could be tracking differently, which could lead to inflammation.

Since there is really no nerve activity in the cartilage, inflammation in the soft tissue (cartilage, muscles, tendons, etc.) is usually what causes the pain in the knee.

What Causes Runner’s Knee?

First and foremost, the runner’s knee is an overuse injury. Although it’s mainly seen in athletes, especially young and women athletes, it can also be seen in nonathletes alike.

The most common reason why someone experiences a runner’s knee is overuse.

It could be too much running, too much jumping, or repeated stress on the knee.

Along with overuse, it could be caused by changes in your activity level. If you’re adding longer runs, or more days to your routine, this could lead to more stress placed on the joint.

Also, if you’re just starting a workout program, the sudden increase in activity (even just increased walking speed or distance) could add enough stress to the joint to cause pain.


It could also be due to an imbalance in muscle strength—usually in the quadriceps muscles.

These muscles, which are responsible for extending the knee, may become weaker (due to under training, injury, or something else), which could lead to the kneecap shifting too far to the left or right, or higher in the joint.

This means that the kneecap is not comfortable in the groove, often leading to increased pressure, causing inflammation and the potential for injury.

How do you know if you’re suffering from runner’s knee compared to something like arthritis?


What are the Symptoms?

The first sign of the runner’s knee is a dull ache behind or surrounding the kneecap.

It often starts off slowly, and gradually gets worse as time goes on.   It may ache when you’re at rest, but most of the time, the pain starts when you’re doing an activity.

For example, climbing stairs may add stress to your knee, which could lead to pain.

Although most people complain of pain in one knee, runner’s knee can be present in both knees at the same time.

You may confuse this pain with arthritis pain. However, there are some differences.

Runner’s knee often leads to pain when you’re running, climbing, hiking, walking, or kneeling. You may also experience pain when getting up from sitting for long periods of time.

Prolonged sitting keeps your knee in a bent position, which could lead to stiffness in the joint. And when you go from sitting to standing, your kneecap may not be in alignment, causing pain.

There may even be loud cracking or popping sounds in your knee when climbing stairs, walking, or squatting.

The Treatment Options

Luckily, the runner’s knee may be alleviated by making some small changes to your lifestyle. Some of those changes include:

  • Orthoticssmall, plastic or foam inserts that stabilize your ankle joint. This could help in stabilizing the knee as well
  • Changing your activity—ceasing the activities and switching to low impact exercises (like swimming and biking) may strengthen the muscles and allows the knee cap to rest and recover.
  • Medication—over-the-counter medications, such as Advil, Aleve, and Tylenol, may lower inflammation, which could gradually decrease the pain in the joint.
  • RICE—this treatment is geared to healing the injured area. It includes:
    • Rest—allow the injured area to rest to start the healing process.
    • Ice—ice the injured area for 15 minutes each time, several times each day. This will help reduce inflammation and swelling, allowing the body time to heal.
    • Compression—to lower swelling and stabilize your joints, you should lightly wrap an ace bandage around the knee joint, leaving the kneecap open. This could help keep the kneecap in alignment, therefore keeping it in the groove.
    • Elevation—frequently elevating your knee throughout the day, keeping it above your chest, reduces swelling.
  • Exercises—although the runner’s knee is an overuse injury, there are times when the muscles are weaker, causing the kneecap to slide out of alignment.   Performing certain exercises to strengthen the hips, quadriceps, and hamstrings are needed to maintain proper stabilization of the kneecap.

Sometimes, however, your injury may be more severe. If the pain does not subside, it’s important to speak with your doctor.

Your doctor can set up x-rays and referrals to a specialist who may decide that further treatment may be needed.

Some surgical options may clean up damaged cartilage to allow the kneecap to move smoothly in the joint. They may also decide to cut tight tendons to alleviate tight muscles that could be pulling the kneecap to the outside, or the inside, of the joint.

Prevention Steps

Although the runner’s knee may be alleviated with home remedies, it’s important that you incorporate exercises in your routine to prevent it from occurring again.

You may also want to have the appropriate footwear for the activity. Replace worn running shoes with a newer one that supports the ankle joint to cut down on your risk for the runner’s knee.

Also, be sure that you warm up thoroughly before you exercise. The warm-up is the best way to bring blood flow to the working muscles, which allows them to be more pliable during your workout.

Stretching could also go a long way to maintaining balance in your muscles, and keeping them limber.

Whatever program you’re starting, be sure that you change the workload and intensity gradually. Don’t rush into your workout or add too much at one time.

These tips could go a long way to preventing the runner’s knee.

The Final Word On Runner’s Knee

One of the most common overuse injuries happens to be runner’s knee, often referred to as patellofemoral syndrome.

Often seen in athletics, particularly young and female athletes, it can also be seen in nonathletes as well.

Runner’s knee is highlighted by a dull ache behind or around the kneecap that interferes with normal, daily activities.

Although there could be damage to the cartilage, the runner’s knee is often associated with an imbalance in your muscles, usually the quadriceps.

Runner’s knee could be prevented by warming up, maintaining strength in the muscle groups, having the right running shoes for knee pain, and increasing your workload gradually.

These tips could help you avoid developing runner’s knee, and keep you improving your health every day of the week.


  1. Lilley K, Dixon S, Stiles V. A biomechanical comparison of the running gait of mature and young females. Gait Posture. 2011 Mar;33(3):496-500.
  2. https://www.health.harvard.edu/blog/taking-the-pain-out-of-runners-knee-201106072801
  3. https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-pain-syndrome/