Runner’s Knee – Patellofemoral Pain

Runners put heavy stress on their knees, which can lead to patellofemoral pain, or pain around the front of the knee. A number of medical conditions may cause this pain, such as anterior knee pain syndrome, patellofemoral malalignment and chondromalacia patella.

Because the knee is structurally complex, sensitive, and used extensively in running, several factors can contribute to runner’s knee. These include:

  • Malalignment of the kneecap
  • Partial or total dislocation
  • Injury
  • Tightness or weakness of the thigh muscles
  • Flat feet

In addition to these potential causes, improper stretching, overuse, and referred pain from the back or hip can affect knee pain.

A runner may first notice a dull, aching pain under or around the front of the kneecap (patella) where it attaches with the lower part of the thighbone (femur). Pain usually first occurs only during runner, or during other activities such as walking up and down stairs, kneeling, squatting or sitting with a bent knee for a prolonged period. If training continues, however, patellofemoral pain may be felt while at rest.

As difficult as it may be for avid runners, the first step to treating patellofemoral pain is to avoid any activity, including running, that causes your knee to hurt. For first aid treatment, apply the RICE formula – Rest, Ice, Compression, and Elevation – and take nonsteroidal anti-inflammatory medications. Runner’s knee usually gets better by taking early action with treatment and reconditioning.

Depending on your particular situation, your physician may suggest nonsurgical treatments or surgical treatments. Nonsurgical treatments may include an exercise program to normalize flexibility and strength of the thigh muscles. Other nonsurgical options involve taping the kneecap or using a special brace for knee support during physical activity. If too much damage has occurred, surgical options by way of arthroscopy or realignment may be needed.

Consider whether poor running shoe selection, biomechanical factors and/or muscle weakness might have contributed or do contribute to your knee pain. Improper running form can greatly impact the health of your patella. Though runner’s knee is common, the good news is that, with proper prevention and treatment, the knee can return to full recovery.

Reference: American Academy of Orthopaedic Surgeons, “Runner’s Knee (Patellofemoral Pain,” August 2007,

Reference: Competitor, “How to Beat Runner’s Knee,” Fitzgerald, Matt, August 13, 2011,