Runner’s Knee: Causes, Treatment, and Prevention

Running is a great way to stay active, but repetitive training can sometimes lead to pain around the knee. One of the most common running-related conditions is runner’s knee, which typically causes pain around or behind the kneecap.

The good news is that runner’s knee can often be successfully managed with physiotherapy, targeted exercises, and adjustments to your training routine.

At Physical Edge Physiotherapy in Oakville, Ontario, our physiotherapists can help identify what may be contributing to your knee pain and develop a treatment plan to get you back to running comfortably.

What Is Runner’s Knee?

Runner’s knee is commonly used to describe patellofemoral pain, which is pain around the kneecap that develops during activities such as running, squatting, climbing stairs, or prolonged sitting.

You may notice:

• Pain around or behind the kneecap

• Pain while running

• Pain going up or down stairs

• Discomfort during squats or lunges

• Pain after sitting for a long period

• Clicking or grinding around the knee

• Symptoms that become worse as your running volume increases

Runner’s knee doesn't necessarily mean there is significant damage inside your knee. Often, pain develops when the tissues around the knee become sensitive to the amount of load being placed on them.

What Causes Runner’s Knee?

There isn't always one single cause of runner's knee. Instead, it can develop when the demands being placed on the body increase faster than the body can adapt.

Some common contributing factors include:

Increasing Your Running Too Quickly

Suddenly increasing your mileage, adding more hills, or increasing the number of running days can place additional stress on your knees.

This is particularly common when runners are preparing for a race or returning to running after a break.

Muscle Weakness

Weakness in the hips, thighs, or core can affect how your leg moves when you run.

Your physiotherapist may assess the strength and control of your:

• Gluteal muscles

• Quadriceps

• Hamstrings

• Calves

• Core

• 
  

Limited Mobility

Restrictions in areas such as the ankle, hip, or knee can affect your running mechanics and change how forces are distributed through your leg.

Training Errors

It's not always the running itself that causes the problem. Changes such as adding hills, speed work, longer runs, or additional training sessions can increase the overall workload on your body.

How Can Physiotherapy Help Runner’s Knee?

Physiotherapy focuses on more than simply treating the pain.

Your physiotherapist can assess your strength, mobility, running mechanics, training routine, and movement patterns to identify factors that may be contributing to your symptoms.

Treatment may include:

• Strengthening exercises

• Hip and knee exercises

• Mobility exercises

• Running technique assessment

• Training modifications

• Manual therapy when appropriate

• Gradual return-to-running programs

• Education about managing training load

The goal is to help your knee tolerate the demands of running again rather than simply avoiding running indefinitely.

Exercises for Runner’s Knee

The right exercises will depend on your individual assessment, but strengthening the muscles around the hip and knee is often an important part of rehabilitation.

1. Squats

Squats strengthen several of the muscles involved in running, including the quadriceps and glutes.

Start with a comfortable range of motion and gradually increase the difficulty as your strength improves.

2. Step-Ups

Step-ups are a useful exercise for developing single-leg strength and control.

Stand in front of a step, place one foot on the step, and slowly push through that leg to step up. Focus on keeping your knee controlled throughout the movement.

3. Glute Bridges

Glute bridges strengthen the muscles at the back of your hips.

Lie on your back with your knees bent and feet on the floor. Push through your feet and lift your hips while squeezing your glutes.

As this becomes easier, your physiotherapist may progress you to more challenging variations.

4. Calf Raises

Your calves play an important role in absorbing and producing force while running.

Stand with your feet about hip-width apart and slowly raise your heels off the ground. Lower yourself back down in a controlled manner.

5. Single-Leg Exercises

Running is essentially a series of single-leg movements. Exercises such as single-leg squats, step-downs, and single-leg bridges can help develop the strength and control needed for running.

Your physiotherapist can determine which exercises are appropriate for your current level and gradually progress them.

Do You Need to Stop Running?

Not necessarily.

Whether you should continue running depends on your symptoms and the severity of your pain.

For some runners, reducing mileage, slowing down, temporarily avoiding hills, or taking additional recovery days may allow them to continue running while their knee gradually adapts.

Your physiotherapist can help determine an appropriate return-to-running or training modification plan. The goal is to find the right balance between allowing your symptoms to settle and maintaining your fitness.

How Can You Prevent Runner’s Knee?

You can't prevent every running injury, but there are several ways to reduce your risk.

Increase Training Gradually

Avoid making large increases in mileage or intensity from one week to the next. Give your body time to adapt to changes in training.

Strength Train Regularly

Strength training can help your muscles tolerate the demands of running. Include exercises for your hips, thighs, calves, and core.

Don't Ignore Persistent Pain

Mild muscle soreness after a new workout is normal. Persistent or worsening knee pain, however, is worth paying attention to.

Addressing symptoms early may prevent them from becoming a bigger problem.

Give Your Body Time to Recover

Rest and recovery are an important part of training. Your body needs time to adapt to the workload you're giving it.

When Should You See a Physiotherapist?

Consider seeing a physiotherapist if:

• Your knee pain keeps returning

• Pain is affecting your running

• You have stopped running because of knee pain

• Your symptoms are getting progressively worse

• You have difficulty with stairs or squatting

• You are preparing for a race and want to safely increase your training

A physiotherapist can help determine what is contributing to your symptoms and create a plan based on your running goals.

Get Back to Running

Runner's knee can be frustrating, especially when you're training for a race or simply enjoy running as part of your regular routine. However, you don't necessarily have to give up running because of knee pain.

With the right combination of strength training, mobility work, training modifications, and gradual progression, physiotherapy can help you build your capacity and return to running with confidence.

At Physical Edge Physiotherapy in Oakville, Ontario, our physiotherapists work with runners of all levels to assess injuries, improve strength and movement, and develop individualized return-to-running programs.

If knee pain is keeping you from running, book a physiotherapy assessment and let us help you get back on track.