Runners Knee

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Attractive woman with knee pain - probably from runners knee - sitting on bed in apartment

Runners knee, also commonly referred to as patellofemoral pain syndrome, is an injury that causes pain around the kneecap or patella. It belongs to a group of closely related kneecap problems that includes chondromalacia patella and anterior knee pain syndrome.

Although runners knee is sometimes also compared to iliotibial band (ITB) syndrome, the symptoms of the two are quite different. ITB syndrome causes pain just above the kneecap and on the outer side of the knee. By contrast, the pain of runners knee usually appears at the front of the knee and just below the patella.

The condition can be brought on by any activity that stresses the knee joint. However, activities such as running, walking, skiing, bicycling, jumping and even playing soccer can also make its appearance more likely. In general, any activity that involves repeated knee bends can potentially provoke the appearance of runners knee.


Studies conducted by Harvard Medical School indicate that runners knee tends to affect women more than men.

The same studies also indicate that it tends to appear most often among middle aged adults and in overweight individuals. The latter is perhaps not surprising. A higher body weight places more stress on all the weight bearing joints, including the knee.

What Causes Runners Knee?

Runners knee pain is a result of irritation of the soft tissue, tendons or cartilage of the knee. The pain can also be exacerbated by:

  • Trauma to the kneecap, such as may be caused by a blow to it. This can result in damage such as a fractured patella;
  • A poorly aligned kneecap within the trochlear groove at the bottom of the femur;
  • Dislocation (including partial) of the kneecap;
  • Pes planus or adult acquired flat feet, a condition that caused flattened foot arches;
  • Underdeveloped or tight thigh muscles;
  • A failure to properly stretch before physically strenuous activity;
  • Knee arthritis;
  • Synovial plica syndrome, in which the knee joint lining becomes thickened and inflamed.

Symptoms Of Runners Knee

The signature symptom of this condition is a dull pain around and behind the kneecap. Most of the pain is usually concentrated just below the kneecap and on the lower part of the femur (thigh bone).

The pain usually intensifies when you are walking or running. Activities that involve bending the knee (going up or down stairs, squatting or kneeling) also aggravate the pain. Sitting for a long time with knees bent can also increase the risk of developing runners knee.

If you have runners knee, you may also experience:

  • Swelling around the kneecap;
  • A popping, clicking or grinding sensation when you bend your knee.


To diagnose the cause of your runners knee pain, your doctor will usually review your medical history. He or she will conduct a physical examination of your knee.

In addition, he or she may request a blood test. Imaging scans of the knee, such as an X Ray, CT scan or MRI, may also be requested.

Treatment Of Runners Knee

The good news is that runners knee usually responds positively to a conservative R.I.C.E. based treatment plan. As a result, your doctor will most likely suggest this treatment as a first step:

  • Rest – by refraining from strenuous activity, especially activity requiring repetitive and/or deep knee bends;
  • Icing the knee every 2-3 ours for periods of about 20 minutes. A cold compress can be used instead of ice. This will help to control pain and swelling (if any);
  • Apply Compression just below the knee cap with an elastic bandage. A knee strap can also be worn just below the patella for the same purpose. This will help to control swelling and improve blood flow through the knee;
  • Keep your kneecap Elevated above heart level as much as possible. When lying down, for example, you can rest your knee on a pillow or 2 to achieve this.

As your runners knee pain starts to improve, you should consider physical therapy exercises. They will help you prepare to return to your normal activities. These exercises will strengthen the muscles around your knee and will also help to restore the range of motion.

Your doctor may conclude that your runners knee is a cause of flattened arches. If so, he or she may suggest wearing shoe inserts. They will provide additional arch support and mitigate the pain.

Many individuals with flattened arches find that the condition can be mitigated by avoiding going barefoot, even while indoors. Try to wear at least a pair of socks at all times.


In the eventuality that your runners knee condition does not respond to conservative treatment, you may be asked to consider surgery. This is relatively rare but, if it occurs, your doctor can discuss the various options with you.

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