Runner's Knee: 9 Things Doctors Want You to Know

  • Close-up of young Caucasian female runner holding need in pain
    Runner’s Knee: A Common but Treatable Problem
    Runner’s knee, or patellofemoral pain syndrome, is one of the most frequent diagnoses among people who see their doctors with complaints of knee pain. Treatment for runner’s knee is fairly straightforward, often managed by a family doctor, but it may be treated by orthopedic specialists. Here are nine things orthopedic specialists who treat runner’s knee want their patients to know about the condition and tips on how to manage the condition and prevent it from recurring.

  • Cropped image of Caucasian female runner bent down on road holding knee and shin
    1. “Runner’s knee is very common.”
    Anyone can develop runner’s knee and it is the most common injury that affects runners, says Dr. Matthew Matava, an orthopedic surgeon at Washington University in St. Louis. It can be caused if you don’t train properly or run too fast, too far, too soon, he explains. The condition can also be caused if you wear worn-out shoes, the wrong shoe for your feet, or by consistently running on hard surfaces, such as asphalt and concrete. Any activity that causes you to consistently land on your feet can also cause runner’s knee.

  • Cropped image of Caucasian male patient having knee examined by male doctor
    2. “Don’t assume your knee pain runner’s knee.”
    “Runner’s knee is a grab-bag catch-all term for lots of pain around the knee,” says Dr. Matava. But pain from runner’s knee is diffuse, covering the kneecap area. When describing it, “Patients will take their whole hand and cover right in front of their knee, as opposed to when it’s a structural issue, like a tear or fracture. That has them pointing with one finger where the pain is,” he explains. If you suspect you have runner’s knee, check with your doctor to be sure it’s not something more serious which may require a different treatment approach.

  • Diverse group of women running charity race
    3. “Women tend to develop runner’s knee more than men.”
    Although runner’s knee is a common injury in both men and women, it does affect women more often. “Women tend to be a bit wider at the hips and narrower at the knees,” explains Dr. Nancy Yen Shipley, an orthopedic surgeon at the Multnomah Orthopaedic Clinic in Portland, Ore. This makes the muscles want to pull the kneecap out to the sides. If the other muscles aren’t strong enough to counteract that pull, the kneecap becomes misaligned and doesn’t fit perfectly into the groove, causing pain.

  • Young African American female runner at top of hill smiling and drinking water
    4. “Runner’s knee can be painful, but it’s not dangerous.”
    “I call runner’s knee a painful but not dangerous condition,” says Dr. Harrison Youmans, a sports medicine specialist at Orlando Health in Orlando, Fla. Unless the problem is caused by a defect in the knee that causes malalignment, the condition doesn’t cause any structural damage to the knee or future problems like degeneration or arthritis. With treatment and by paying attention to the initial cause to avoid future bouts of runner’s knee, the prognosis is good, he says.

  • Close-up from behind of woman's feet wearing running shoes
    5. “Your shoes may be causing the problem.”
    Running without proper conditioning is a common cause of runner’s knee. However, even if you train carefully and take care not to overtax your body, you could still develop runner’s knee if your shoes aren’t right for the job or your feet. “For runners, shoes are very important,” explains Dr. Youmans. He advises his patients to buy their shoes at a specialty running-shoe store. “These people are going to look at the mechanics [of how you walk or run] and help choose the right shoe.” If your feet tend to roll outward, this affects your legs and knees differently than someone whose feet may turn inward. Proper footwear can help reduce the risk of injury.

  • Close-up of Caucasian male on couch holding ice pack on knee
    6. “Try easing off your exercise regimen as first-line treatment.”
    In the early stages of runner’s knee, all the treatment you may need may be to ease off the activity causing the pain, says Dr. Shipley. She also suggests over-the-counter anti-inflammatories if your doctor agrees. Otherwise, she may recommend the RICE treatment: “I’ll have my patients do rest, ice, compression and elevation.” When resuming your activity, it’s important to get back to it gradually though, as a sudden and aggressive resumption may cause the runner’s knee to return.

  • African American male patient in physical therapy using stretch band on leg
    7. “Your doctor may refer you to a physical therapist.”
    A physical therapist can help assess how you move and determine what muscles need strengthening. “Many times, I will send patients to physical therapy with the goal of building strength in the leg,” says Dr. Youmans. They may want to work on the inner part of the quadriceps, but it’s important not to forget other related muscles, he adds. “Another thing people ignore a lot is strengthening the glute muscles and the side hip muscles. If those are weak, they put the knee in a bad position and [that] increases pressure on the kneecap.”

  • Diverse group of young people doing kettle bell squats in gym
    8. “Pay attention to more than just your legs to prevent or treat runner’s knee.”
    Hip stability, core stability, and core strength also play a role in how your legs and knees are affected during exercise. “It’s important for individuals to have good muscle balance and not neglect any muscle group,” says Dr. Shipley. “And I think that in addition to having good-balanced quads, we also don’t want to neglect the muscles in the back of the legs, the hamstrings.” She recommends working with a trainer or physical therapist to ensure you are using proper form and not neglecting one part of the body over another.

  • Young Caucasian woman running next to river during sunrise or sunset
    9. “Prognosis is good, but pay attention to what caused it in the first place.”
    Runner’s knee generally responds well to treatment, including exercises if necessary. But it can reoccur if the initial causes aren’t addressed. “People are at risk of having runner’s knee again,” explains Dr. Matava. So, it’s important to pay attention to the signs. If your knee pain returns, check to see if your shoes are wearing out and how you are exercising. Are you pushing yourself too hard? Have you changed where you train or how you train? Being aware can keep your knee pain from becoming a more frequent problem.

Runner's Knee: 9 Things Doctors Want You to Know

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
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Last Review Date: 2020 Dec 24
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