Runner’s Knee: What You Need to Know

First, it isn’t just for runners. Also, it isn't really a specific injury. Runner’s knee is a broad term used to describe the pain you feel if you have one of several knee problems. You might hear a doctor call it patellofemoral pain syndrome.

Several things can bring it on:

  • Overuse. Bending your knee again and again or doing a lot of high-stress exercises, like lunges and plyometrics (training that uses the way your muscles lengthen and shorten to boost their power), can irritate tissues in and around your kneecap.
  • A direct hit to the knee, like from a fall or blow
  • Your bones aren’t lined up (your doctor will call this malalignment). If any of the bones from your hips to your ankles are out of their correct position, including the kneecap, that can put too much pressure on certain spots. Then your kneecap won’t move smoothly through its groove, which can cause pain.
  • Problems with your feet, like hypermobile feet (when the joints in and around them move more than they should), fallen arches (flat feet), or overpronation (which means your foot rolls down and inward when you step). These often change the way you walk, which can lead to knee pain.
  • Weak or unbalanced thigh muscles. The quadriceps, those big 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.
  • Chondromalacia patella, a condition in which the cartilage under your kneecap breaks down

What Are the Symptoms?

The main thing is pain. You might notice it:

  • Usually in front of your kneecap, though it could be around or behind it
  • When you bend your knee to walk, squat, kneel, run, or even get up from a chair
  • Getting worse when you walk downstairs or downhill

The area around your knee could swell, or you might hear popping or have a grinding feeling in the knee.

How Is It Diagnosed?

The doctor will give you a thorough physical exam. He might also do tests that can give him a closer look inside your joint, like X-rays.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on December 13, 2017

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: "Runner's Knee," “Patellofemoral Pain Syndrome.”

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).”

Pedorthic Association of Canada: “Overpronation and Under Pronation Correction.”

American College of Sports Medicine: “Plyometric Training for Children and Adolescents.”

© 2017 WebMD, LLC. All rights reserved.

How Is It Treated?

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

  • Rest your knee. As much as possible, try to avoid things that make it hurt worse, like 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 sit or lie down.
  • Take NSAIDs, if needed, like ibuprofen or naproxen. These drugs help with pain and swelling. But they can have side effects, like a higher risk of bleeding and ulcers. Use as directed on the label, 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. It’s rare, but you may need surgery for severe cases of runner's knee. An orthopedic surgeon can remove or replace damaged cartilage and, in extreme cases, correct the position of your kneecap to send stress through the joint more evenly.

When Will My Knee Feel Better?

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

While you get better, you need to take it easy on your knee. That doesn’t mean you have to give up exercise. Just try something new that won't hurt your joint. If you're a jogger, swim laps in a 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.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on December 13, 2017

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: "Runner's Knee," “Patellofemoral Pain Syndrome.”

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).”

Pedorthic Association of Canada: “Overpronation and Under Pronation Correction.”

American College of Sports Medicine: “Plyometric Training for Children and Adolescents.”

© 2017 WebMD, LLC. All rights reserved.

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.
  • Try not to run on hard surfaces, like concrete.
  • Stay in shape and keep a healthy weight.
  • Warm up before you work out.
  • Don’t make sudden workout changes like adding squats or lunges. Add intense moves slowly.
  • Ask your doctor if you should see a physical therapist.
  • If your doctor or physical therapist suggests it. Try a knee brace when you work out.
  • Wear quality running shoes.
  • Get a new pair of running shoes once yours lose their shape or the sole becomes worn or irregular.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on December 13, 2017

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: "Runner's Knee," “Patellofemoral Pain Syndrome.”

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).”

Pedorthic Association of Canada: “Overpronation and Under Pronation Correction.”

American College of Sports Medicine: “Plyometric Training for Children and Adolescents.”

© 2017 WebMD, LLC. All rights reserved.