What Is Runner's Knee?

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Cropped image of female Caucasian runner holding knee in pain on outdoor path
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The medical term for runner’s knee—pain around or in front of your knee cap (the patella)—is patellofemoral pain syndrome. It’s one of the most common causes of knee pain, particularly among people who run or participate in sports that involve a lot of running. The pain can occur at any age, but more women than men develop runner’s knee, and the chances of developing the pain increases with age.

However, despite its name, you don’t need to be a runner or an athlete for runner’s knee to develop. If you are living with chronic knee pain, speak with your doctor to get a diagnosis and start treatment before the pain worsens.

The Mechanics Behind Runner’s Knee

Runner’s knee can occur because of a defect to the structure of your knee or by overuse, which is why it is a common injury for athletes or people who put a lot of strain on their legs.

Your knee connects your upper and lower leg and acts like a hinge. The muscles move your lower leg back and forth, and the tendons and ligaments attach muscles and the bones together. Cartilage, the smooth tissue in the knee, also absorbs stress as you step forward or backward, or as you land a jump. It also allows your knee to move smoothly.

If your kneecap is not aligned properly, this can lead to runner’s knee. Other causes include:

  • Injury to the kneecap

  • Knee repair surgery

  • Weak upper leg muscles, particularly the quadriceps (thighs)

  • Tight hamstrings or Achilles tendon

  • Inadequate foot support, which forces your leg to compensate when you take a step

  • Excessive training, running, or jumping

  • Running and jumping on concrete or asphalt

Runner’s Knee Symptoms

The symptoms of runner’s knee include:

  • Dull, aching pain around your knee, particularly in front

  • Pain that worsens with exercises that bend the knee, such as running, jumping or squatting

  • Pain that increases when walking up or down stairs

  • Pain that increases when you sit for long periods

  • A clicking, popping or grinding sound when you move your knee

Risk Factors for Runner’s Knee

Anyone can develop runner’s knee, but some people are at higher risk, particularly those who run or jump a lot. The shock of running and jumping puts stress on the knee. Children and teens can develop runner’s knee through too much or improper activity, but it becomes more common as we age. Women are also more likely to develop the syndrome.

Here are some tips for reducing your risk of developing runner’s knee:

  • Wear proper shoes for the sport or physical activity.

  • Increase your activity level and intensity slowly.

  • Stretch and warm up before running or being physically active.

  • Maintain proper body mechanics for your activity.

  • Strengthen your leg muscles through training.

  • Limit running or other sports on concrete or asphalt surfaces. Synthetic surfaces, grass and dirt are gentler on your knees.

  • If you are overweight, lose weight to reduce stress on your knees.

  • Take a break if your knee starts to hurt.

Treating Runner’s Knee

Your doctor may diagnose runner’s knee with a physical examination and based on your history. However, you may have a few tests, such as an X-ray, CT scans, or magnetic resonance imaging (MRI), to rule out more serious knee injuries. Once the diagnosis is made, you can start your treatment plan to help reduce the knee pain and return to your activities.

  • Rest: You likely won’t have to stay off your knee completely, but you should cut back on activities that put stress on your knee. This includes squatting, kneeling, running, jumping and climbing stairs.

  • Ice: Place an ice pack on your knee for about 20 minutes a few times a day.

  • Over-the-counter (OTC) medications: Unless you have been told not to take these medications, OTC medications like acetaminophen, ibuprofen or naproxen can help relieve knee pain.

  • Invest in proper footwear: Activities like running require special shoes to help support and cushion your feet. A specialty footwear store can help you find the right shoe for your activity.

If you still experience pain after resting your knee, you may want to try:

  • Physical therapy: A physical therapist can give you exercises that will strengthen your leg to reduce the stress placed on your knees.

  • Braces: Bracing isn’t a common treatment for runner’s knee but may be helpful. Your physical therapist can determine if you might benefit from bracing.

Although not common, severe cases of runner’s knee may require surgery. Arthroscopic surgery is a minor surgery in which an orthopedic surgeon makes a few tiny incision in your knee. Using long, narrow instruments and a camera, the surgeon can remove any damaged tissue from inside. In more severe cases, the surgeon may have to make a larger incision to realign the kneecap, taking pressure off the rest of the knee.

The mechanics of the healthy knee joint are remarkable and it is normally extremely durable. Your knee is under a lot of stress, so knee pain could be caused by one of several problems. If you have pain that is not going away or worsens, speak to your doctor. Constant knee pain may cause you to restrict or stop your activities altogether. And if your knee pain is not caused by runner’s knee, continuing your usual activities with constant or worsening knee pain could cause serious injury.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 24
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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