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Runner’s knee and everything you need to know about knee pain when running

For runners, knee pain is a common problem.

According to a study conducted by the American Academy of Orthopedic Surgeons, approximately 25% of all running injuries are due to knee pain.

‘Runner’s knee’ is one of the most common knee injuries.

Runner’s knee describes the pain resulting from injury to the knee cap. In medical terms, Runner’s knee (knee pain when running) is known as patellofemoral pain syndrome (PFPS)

What happens during Patellofemoral Pain Syndrome?

Patella or knee cap is the most prominent sesamoid bone (a small bone found near the joints’ surfaces, commonly embedded within a muscle, soft tissues, or tendons). The knee cap is located at the front of the knee joint to provide an attachment point to the quadriceps muscles or patella tendon and patellar ligament to connect the knees with the lower leg of the thigh bone.

In patelliform syndrome, the knee cap (patellar tendon) gets injured, damaged, or out of place, or the patella veers off the patellar grove. It results in patellofemoral aches due to damaged or torn cartilage, which ranges from mild to severe depending upon the severity of the syndrome.

Read more about knee injections to replace cartilage

Some other most common knee injuries and knee problems include IT band syndrome, knee pain bursitis, chondromalacia patella(CMP), meniscus tear(or torn meniscus), kneecap subluxation and Posterior Cruciate Ligament (PSL). These are common running injuries of soft connective tissue among athletes.

Is the jumper’s knee or the runner’s knee the same?

Jumper’s knee or patellar tendonitis (also spelt as Patellar tendinitis) is another running syndrome. Patellar tendinitis occurs when inflammation of the tendon connects the knee bone with the shin bone of your leg. At the same time, patelliform syndrome happens when the knee cap veers off the patellar groove. So, it is different from Patellar tendinitis.

You might find this helpful: Knee pain location chart

Causes of knee pain when running

There are several reasons why knee pain can occur while running, including:

Overuse injury

An overuse injury is common in athletes, runners, and those who are more into body shaping and strengthening exercises. Repetitive bending of the knees and performing activities that put massive stress on the knees can lead to pain and swelling and ultimately become the cause of PPS.

Chondromalacia patella

It is an underlying condition for the Runner’s knee. In this conditioning, cartilage under the patella breaks down, leading to a chronic knee injury like Runner’s knee. However, it could also be due to other underlying conditions such as arthritis, tendinitis, or knee bursitis.

Iliotibial band syndrome

Iliotibial band syndrome (IT band syndrome) is also one of the common knee injuries which result from running. In iliotibial it band syndrome, it band or iliotibial band(tendon ) gets swollen, inflamed, or irritated. This painful knee can also lead to the development of PPS.

Weakness or tightness of muscles

Weak or tightened quadricep muscles can also cause patelliform pain and injury. Strengthening quadricep muscles is necessary because the patella or knee cap is in shape or place while bending or stretching across the joints.

Malalignment or Improper form

It is the imperfect alignment of your bones. In this case, the bones of your lower abdomen become out of place and put heavy pressure on your knee joint or patella.

A sudden blow to your knees

A sudden blow or hit can also displace your patella and cause chronic joint pain.

Other causes of such running injuries include:

  • Running on hard surfaces or downhill can also cause this common running injury.
  • Excessive training
  • Tight hamstrings
  • Tight Achilles tendons
  • Poor Foot Support
  • Knee bursitis
  • Meniscus tear (or torn meniscus)
  • IT band syndrome

Symptoms of knee pain when running

The most common symptom of Patellofemoral Pain Syndrome is pain around the kneecap. The pain is usually worse when you bend your knee, run, or jump. The ache can feel sharp and sudden or a dull ache that persists. It may feel like your knee is giving out on you, or it will buckle. You may also feel pain in the front, back, or side of your knee.

Knee-causing pain can make running, walking, or even standing challenging. In addition, it can impact your ability to participate in activities you enjoy.

You might also have:

  • Swelling around the knee or soft surfaces of joints
  • Stiffness in the joint
  • Popping, grinding, or cracking sounds when you move your knee
  • Aching after sitting in knees bent position
  • Tiny tears of tendons and a small fluid-filled sac located on the inner side and between the joints.

If you have any of these symptoms( for long periods), seek medical attention. They can help you determine if you have a problem and how to treat it.

Diagnosis of knee pain when running

Diagnosis is made based on a person’s health history and current symptoms of the disease. In severe cases, physiotherapists may also recommend an X-ray or MRI scan based on your physical examination to confirm the diagnostic results.

How to treat PPS?

Some of the accessible treatments for Patellofemoral Pain Syndrome(PPS) are:

  • Stretching or strengthening Exercises
  • Medications (sports medicine for athletes)
  • Physiotherapy
  • Orthotics
  • Applying ice to reduce pain
  • Patellofemoral taping
  • Elevation


Over-the-counter anti-inflammatory medications like ibuprofen can also be effective in treating pain and inflammation. However, if the pain is severe, you may need to see a doctor for more specific treatment options.


Many of the structures have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is required to heal and repair.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.

How to prevent knee pain when running?

There are several things you can do to prevent PPS:

  • Strengthen your quadriceps and hamstrings.
  • Increase the flexibility in your hips and thighs.
  • Improve your running mechanics.
  • Use proper footwear or running shoes
  • You Must Warm up before any physical activity
  • Make a regular running routine with appropriate care
  • Make sure to keep joints lubricated
  • Maintain a healthy weight to reduce pressure on the patella
  • Stretching before and after physical activity
  • Take recommended sports medicine regularly.
  • If you are a sportsperson or amongst experienced runners, you must always stay in touch with a doctor or expert who can guide you to prevent knees or other joint injuries from maintaining your athletic health and spirit up to the mark.

What to do while experiencing knee pain when running?

If you are experiencing a knee pain while running, there are a few things you can do to ease the pain and get back on the road or trail.

Rest: Stop running, take a break from running, and give your knees a chance to recover.

Ice: Apply ice to the affected area for 15-20 minutes to reduce swelling and inflammation.

Compression: Use an elastic bandage or compression sleeve to help support your knee joints.

Elevate: Raise your legs above your heart to reduce swelling.

If the knee pain persists despite these self-care measures, see a doctor or other healthcare provider. They can determine the cause of your pain and recommend appropriate treatment options besides physical therapy.

Why is Exercise essential for PPS?

Ironically, exercise is a critical part of treating and preventing a runner’s knee. It helps strengthen the muscles and stabilise structures around the knee joint, which can help take some stress off the knee cap. Exercise can also help to improve the range of motion and flexibility in the knee joint, which helps prevent pain and stiffness.

In addition to these physical benefits, exercise reduces stress and improves your overall mood, contributing to better pain management.

Best Exercises to treat runner’s knee

You can do a few different things to help ease the patelliform pain. One is to focus on strengthening your quadriceps, the muscles in the front of your thigh. Strengthening these muscles can help take some pressure off your kneecap(or patellar tendon).

You can also try doing exercises that stretch your hamstrings and hip flexors. These are the muscles in the back of your thigh and the front of your hip, respectively. Tightness in these thigh muscles can contribute to PPS, so keeping them loose is essential.

Some of the best exercises for PPS are the following :

1. Hamstring curls

This Exercise strengthens the hamstring muscles, which helps to take pressure off the knees.

2. Leg lifts

This Exercise helps strengthen the quadriceps, the muscles that support the knee.

3. Heel raises

This Exercise helps stretch and strengthen the calf muscles, supporting the knee joint.

4. Hip abductions

This Exercise strengthens the muscles around the hip, which can help to stabilize the knee joint.

5. Clamshells: 

This Exercise targets the gluteus medius muscle, stabilizing the hip and pelvis.

6. Hamstring stretches

Start standing and place your heel on a stool or raised surface in front of you. Keep your back straight, and lean forward until you feel a stretch in the back of your thigh. Hold for 30 seconds and repeat 3-5 times on each leg.

7. Quadriceps stretches

Start standing, bring your heel up toward your buttock, and fully extend your body. Use your hand to help guide your leg back until you feel a stretch in the front of your thigh. Hold for 30 seconds and repeat 3-5 times on each leg.

You can try doing balance or other pain-free exercises. It is essential to have flat feet or pronate when you run (meaning your feet roll inward when they hit the ground). Exercising that challenges your balance can help strengthen the muscles around your knee and prevent the Runner’s knee pain.

Runner’s knee is a common injury, but several exercises can help prevent it or lessen its severity. Be sure to consult with a doctor or physical therapist before starting any new exercise program and physical therapy.


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