What Is Runner’s Knee?

woman with knee pain from running


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Runner's knee refers to a dull ache or pain that is often felt in the front of the knee and can occur as a result of overuse or injury. Understanding its symptoms and causes can help you identify the best prevention and treatment options for you.

What Is Runner's Knee?

Runner's knee is a term used to describe pain in and around the patella, which is better known as the kneecap. It is also sometimes called "jumper's knee," patellofemoral pain syndrome (PFPS), anterior knee pain, or chondromalacia patella.

Runner's knee is one of the most common complaints among runners, especially those who run longer distances. Don't get too caught up by the name, though, as those participating in different sports and even nonathletes sometimes experience runner's knee.

Research indicates that females tend to experience runner's knee at a higher rate than males.

Symptoms of Runner's Knee

How do you know if you might have runner's knee? Some of the most common symptoms include:

  • Pain during exercises that involve repeated knee movements, such as walking or running
  • Pain during activities that require the knee to repeatedly bend, including squatting, kneeling, or going up and down stairs
  • Popping or crackling sounds when the knee bends or when standing after sitting for an extended period of time

Causes

There are several potential causes and risk factors associated with runner's knee. Knowing the underlying cause of your runner's knee pain may be important for successful treatment.

  • Weak knee muscles: Your quadriceps and hip flexors should hold your kneecap in place, so it tracks up and down. If these muscles are weak, your kneecap can move left and right, scraping your cartilage and causing painful friction and irritation.
  • Stiff soft tissues: Stiffness in the hamstring or iliotibial (IT) band can also lead to kneecap pain. The hamstring runs along the back of the upper leg and assists with bending of the knee. The IT band connects the hip to the knee and lower leg, running along the outside of the thigh.
  • Increased training loads: If you have recently increased the amount of exercise you do that involves the repeated movement of your knee, this may be the cause of your pain.
  • Running shoes and cadence: If your running shoes or the cadence in which you run increase the stress on your patellofemoral joint, this can be a contributing factor to runner's knee.
  • Flat feet: You may be more likely to develop runner's knee if you have flat feet.

Diagnosis

If your doctor suspects that you may have runner's knee, they will likely do a physical exam. This may involve gently pressing or pulling on the knee area, but might also include having you perform actions that require use of the knee—such as jumping or walking—to assess knee strength and alignment.

Your doctor may also order x-rays to make sure there is no damage to any of your knee bones. If your doctor suspects that there is damage to the soft tissues surrounding the knee (the muscle, tendons, or ligaments), they may order a magnetic resonance imaging (MRI) scan as well.

Treatment

Depending on the cause and severity of your runner's knee, you may be able to treat it at home. If this isn't successful, your doctor can suggest medical treatment.

Home Treatment

The American Academy of Orthopaedic Surgeons suggests several strategies for relieving the pain of runner's knee.

  • Rest: Take a couple of days off from running, or cross-train, as long as you can do so without pain.
  • Ice: Reduce pain and inflammation by icing your knees for 20 minutes several times throughout the day.
  • Compression: Using some type of compression or wrap on your knee can keep swelling down.
  • Elevation: When possible, rest with your knee elevated, preferably above your heart.
  • Over-the-counter pain relief: Taking an over-the-counter nonsteroidal anti-inflammatory (NSAID) can also help reduce your runner's knee pain.
  • Exercise: Research indicates that exercise therapy helps reduce pain and improve knee function. You may need to see a physical therapist for recommendations for exercises you can do at home.

If you only have runner's knee on one side, don't neglect the other leg. Some runners rehab one leg, only to develop the same pain on the other side. Make sure you do the same exercises and stretches on both legs.

Medical Treatment

If your runner's knee is more severe, medical treatment may be required. Nonsurgical options include physical therapy or orthotics. Orthotics can be used to better stabilize your foot and ankle joints, thus taking stress off the knee.

In rare cases, surgery may be required. This could include removing damaged cartilage from the patella, or loosening tissue around the patella to correct a misalignment.

Prevention

Fortunately, there are quite a few things you can do to prevent runner's knee.

  • Build your leg muscles: Strengthening your quad and hamstring muscles can help support and stabilize your kneecap. Try Squats, lunges, and deadlifts build these muscles.
  • Stretch out: If stiffness is your issue, loosen up tight hamstrings and IT bands with stretching and flexibility exercises.
  • Wear the right shoes: Some running shoes work better for bad knees. If you're prone to knee pain while running, go to a specialty running store for a professional fitting and advice on the best shoes for you.
  • Use knee support: A knee brace can give the soft tissues around your knee added support while you run or engage in other exercises that require the use of the knees.

How to Safely Return to Running

You can start running again after runner's knee when you're able to run without changing your form due to pain. Stick to running on flat surfaces when you first return and only increase time and distance by 5% to 10% a week.

Shortening your stride and striking the ground directly underneath your center of gravity may also help alleviate the problem. Make sure you have the right kind of running shoes for your foot type.

Also be sure you're not running in worn-out shoes. You should replace your shoes every 300 to 400 miles. You may also want to consider buying over-the-counter arch supports.

Frequently Asked Questions

How long should you rest if you have runner's knee?

Ideally, you should not run or otherwise perform activities involving repeated knee movements until you can do so without pain. The amount of time this takes can be different for everyone and requires that you pay attention to your pain levels.

How long does runner's knee usually last?

The amount of time it takes to recover from runner's knee varies based on the severity of the condition as well as whether there is any damage to the surrounding bones or soft tissues. Receiving an accurate diagnosis is the first step to a successful treatment outcome.

How do you tape your knee to prevent or relieve runner's knee?

Research indicates that knee taping can help with runner's knee, but only when used in combination with physical therapy. So if you are pursuing physical therapy for runner's knee, ask your therapist for effective taping recommendations.

A Word From Verywell

Although some runners can treat and prevent future runner's knee by following the above steps, others may need further treatment. You may need to visit a physical therapist who can give you the proper stretches and exercises.

If your runner's knee is caused by foot-related issues, you may need to see a podiatrist about custom-fitted orthotics or further medical treatment.

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12 Sources
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