Runner’s Knee

It’s not just for runners. Anyone who spends time doing things that make you bend your knees a lot, like walking, biking, and jumping, can get runner’s knee, an aching pain around the kneecap. It’s also called patellofemoral pain syndrome.

Runner's knee isn't a specific injury. It's a broad term that describes the pain you feel if you have one of several knee problems. For example, chondromalacia patella, a condition in which the cartilage under the kneecap breaks down, can lead to runner’s knee symptoms.  

Runner’s knee can happen for several reasons:

  • Overuse. If you do a lot of repeated bending or high-stress exercises, such as lunges or plyometrics, they can irritate your knee joint.
  • A direct hit to the knee, like from a fall or blow.
  • Your bones aren’t lined up(called malalignment). If any of the bones from your hips to your ankles are out of their correct position, including the kneecap itself, that can put too much pressure on certain spots in the joint. Then your kneecap won’t move smoothly, which can cause pain.
  • Problems with your feet, such as hypermobile feet (when the joints in and around the feet move more than they should), fallen arches (flat feet), or overpronation. They may change the way you walk, which can cause knee pain.
  • Weak or unbalanced thigh muscles.The quadriceps muscles in the front of your thigh keep your kneecap in place when you bend or stretch the joint. If they’re weak or tight, your kneecap may not stay in the right spot.

What Are the Symptoms of Runner's Knee?

The main symptom you’ll notice is pain. It can happen:

  • In front, behind, or around your kneecap
  • When you bend your knee, such as when you walk, squat, kneel, run, or even get up from a chair
  • When you walk downstairs or downhill

You might also notice swelling around your knee or a popping or grinding feeling inside the joint.

To diagnose runner's knee, your doctor will give you a thorough physical exam. You may also need tests that can let him look inside your joint, such as X-rays, MRIs, or CT scans.

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What's the Treatment for Runner's Knee?

For most people, runner's knee gets better on its own with time and treatments that address the knee problem that’s causing your pain. To speed your recovery, you can:

  • Rest your knee. As much as possible, try to avoid activities that make the pain worse, such as running, squatting, lunging, or sitting and standing for long periods of time.
  • Ice your knee to ease pain and swelling. Do it for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain is gone.
  • Wrap your knee. Use an elastic bandage, patellar straps, or sleeves to give it extra support.
  • Elevate your leg on a pillow when you're sitting or lying down.
  • Take NSAIDs, like ibuprofen or naproxen. These drugs fight inflammation and help with pain and swelling. But they can have side effects, like a higher risk of bleeding and ulcers. Use them only occasionally unless your doctor says otherwise.
  • Do stretching and strengthening exercises,especially for your quadriceps muscles. Your doctor can recommend a physical therapist to teach you what to do.
  • Try arch supports or orthotics for your shoes. They may help with the position of your feet. You can buy them at the store or get them custom-made.

If you try these techniques and your knee still hurts, ask your doctor if you need to see a specialist, like an orthopedic surgeon.

Your doctor also may recommend that you get injections of a corticosteroid to help with inflammation. They won’t replace rest, strengthening exercises, or the other ways you should take care of your knee, but they may help you get more out of your treatment plan.

It’s rare, but severe cases of runner's knee may need surgery. An orthopedic surgeon can remove or replace damaged cartilage and, in extreme cases, correct the position of the kneecap to send stress through the joint more evenly.

When Will My Knee Feel Better?

People heal at different rates, so your recovery time depends on your body and your injury.

While you get better, you need to take it easy on your knee, but you don’t have to give up exercise. Just try out a new activity that won't aggravate your joint. For instance, if you're a jogger, try swimming laps in the pool instead.

Whatever you do, don't rush things. If you try to get back to your workouts before you’re healed, you could damage the joint for good. Don't return to your old level of physical activity until:

  • You can fully bend and straighten your knee without pain.
  • You feel no pain in your knee when you walk, jog, sprint, or jump.
  • Your knee is as strong as your uninjured knee.

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How Can I Prevent Runner's Knee?

  • Keep your thigh muscles strong and limber with regular exercise.
  • Use shoe inserts if you have problems that may lead to runner's knee.
  • Make sure your shoes have enough support.
  • Avoid running on hard surfaces like concrete.
  • Stay in shape and keep a healthy weight.
  • Never suddenly make your workouts more intense, especially with squats and lunges. Make changes slowly.
  • Try a knee brace while you exercise if you’ve had runner's knee before.
  • Wear quality running shoes and swap them for new ones once they lose their shape or the sole gets worn or irregular.
WebMD Medical Reference Reviewed by James Kercher, MD on August 20, 2016

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: "Runner's Knee." 

Arroll, B. British Journal of General Practice, February 1999. 

Fulkerson, J. American Journal of Sports Medicine, May-June 2002. 

Rouzier, P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.

Cleveland Clinic: “Knee Pain (Chondromalacia Patella).”

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