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Runner’s Knee: What is it, and How is it Treated?

Remember that old saying: You can have too much of a good thing? This may be all too true when it comes to exercising to the point of injury. Specifically, an injury called patellofemoral pain syndrome (PFPS) better known as Runner’s Knee.

With any activity, you may experience soreness after a workout, so how do you know that knee pain after running is PFPS? Could you just be over-training?

Symptoms of Runner’s Knee

Typically, Runner’s Knee feels like a dull pain on the sides or front of the kneecap. You may experience some knee swelling after running; due to inflamed tissue. The kneecap will be tender to the touch. There may also be a sensation of grinding in the knee, called crepitus, or stiffness after periods of rest when you try to bend it. You may hear a crackling or popping sound when you stand up or climb stairs. The pain will only intensify without proper healing.

Diagnosis of Runner’s Knee

If you are experiencing these symptoms, it’s best to see a pain management specialist who will diagnose by considering these factors:

  • Overall health
  • Health history
  • Age
  • Pain level
  • Results of a physical exam and x-ray

A pain management specialist will want to make sure you are not dealing with a more serious knee issue like an ACL tear or chronic underlying joint issues.

Causes of Runner’s Knee

PFPS is the most common over-use injury, affecting about 25 percent of male runners and 30 percent of female runners.

The exact cause is not known, but there are factors that contribute to the development of PFPS. According to research by the Cleveland Clinic, causes may include:

  • Overuse of the knee joint
  • Problems with kneecap alignment
  • Certain anatomy or body types
  • Weak muscles surrounding the knee
  • Improper equipment use or sports training techniques
  • Changes to footwear
  • Hard playing surfaces

Although PFPS has been dubbed Runner’s Knee because it is so prevalent in runners, anyone can develop PFPS when overusing the knee. Typically, injury is more likely to occur when doing activities that cause strain on the knee, like jumping, running, and squatting.

Women are more prone to Runner’s Knee because of anatomy. For example, because women have wider hips than men, the hip muscles tend to be weaker, putting more pressure on the knees. Ligaments are looser in women, which can cause the kneecap to slide. The way a woman’s leg is aligned affects the way she lands during a running stride, which in turn can damage the knee. Plus, changing hormone levels in a female affect the structure and function of muscles, tendons, and ligaments — thus creating a higher possibility of injury and pain.

Runner’s Knee Pain Relief

To alleviate the pain, it’s important to take time to rest that injury to prevent it from getting worse. Runner’s Knee could sideline your activity for up to six weeks.

A pain management specialist will encourage you to rest, ice the injury, elevate, and perhaps use a compression wrap.

If necessary, you may face specific Runner’s Knee treatment ranging from exercise modification to an MRI, possible cortisone injections, or simply evaluating the type of shoe you are wearing.


Once you get back on your feet and you are ready to ease back into your exercise routine, Johns Hopkins Medicinesays there are some preventative measures you can take to try and prevent Runner’s Knee from recurring.

  • Lose weight
  • Stretch before running
  • Increase activities gradually
  • Wear better running shoes
  • Run while leaning forward with knees bent

Runners should also always try to cross-train. Experts say having weak thigh muscles, tight hamstrings or a tight Achilles tendon can place unnecessary strain on the knee structure, which puts too much work on that joint. A proper warmup, stretching, and strengthening can help prevent Runner’s Knee from becoming a recurring injury.

Your pain management specialist may also recommend the use of orthotics in your running shoe for better arch support, as well as wearing a knee brace for running.

Whether you are a long-time runner or new to the sport, taking steps to prevent injury is key to your success. Should you find yourself experiencing Runner’s Knee or any pain associated with exercise, it is best to book an appointment with a pain management specialist at National Spine & Pain Centers.

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