Runner's Knee: What It Is and How to Treat It
Patellofemoral pain syndrome, more commonly known as runner’s knee, is a condition that primarily affects the articulation of the kneecap and the thigh bone.
It’s a very common injury for runners as well as other athletes and is a reason many patients find their way to Oregon Running Clinic.
What is Runner’s Knee?
As stated above, runner’s knee describes pain specifically at the patellofemoral joint, which sits between the kneecap (patella) and the thigh bone (femur). The underside of the patella has a convex notch (the trochlea notch) which, when the knee bends, glides in a concave groove on the femur (the trochlea groove). The patella itself is a sesamoid bone, which is a bone embedded within a tendon.
There is not one reason that someone will start to develop pain in their patellofemoral joint. However, often it can be caused by poor running form, which can result in unequal pull on different parts of the knee joint. One study in 2019 found the biggest risk factor might be quadricep weakness.
The following complaints are all symptoms of runner's knee:
Pain while performing single leg squats, or when stepping down a step (eccentric quad contraction).
Occasional ‘puffiness’ to the front of the knee joint, especially over the patellar.
Pain that is often felt somewhere under the kneecap or 'deep' – it can be hard to put your finger on it.
How to Treat Runner’s Knee
There are two rehab exercises you can try to reduce the pain in your knee joint. These will help relieve stiffness and tightness in the knee so that the joint can move more smoothly.
Patellar mobilisation
Sit on a chair with both feet flat on the ground, with the affected knee bent to roughly 90 degrees.
If you're mobilising your right patellar, place the heel of your right hand on the outer edge of your knee cap and gently grip the inside edge with the tips of your fingers.
Place the opposite hand on the inside of your lower thigh to prevent the thigh from moving.
Using the heel of your hand, apply a gentle inward pressure to gently mobilise the knee cap.
While this may feel stiff initially, do not continue the exercise if it feels sore.
Perform this for one to two minutes, twice a day.
Lateral patellar retinaculum release
Sit on a chair with both feet flat on the ground, with the affected knee bent to roughly 90 degrees.
Using either your thumbs or a smooth rounded object – a wooden spoon is great for this – apply a pressure into the soft tissue at the top of your knee cap. Then, maintaining this pressure, massage in the area.
You're only working within an area about an inch big, so the movements should not be too big.
Perform this for a couple of minutes every other day.
How to Avoid Runner’s Knee
One way to keep yourself healthy is to improve your overall running form. A running gait analysis can help you pinpoint any issues in your form and give you targeted exercises to improve it.
You can also work on strengthening your knees and hips with a variety of exercises, including:
Banded glute bridges
Step ups
Banded split squat
If you’re concerned about any new pain, working with a specialist is a great way to stop the issue at the source.