How to Deal With Pain From Runner's Knee

Your Personal PT, Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS), so she knows how to get your body back on track when it’s out of line. In this weekly series, she gives you tips on how to feel better, get stronger, and train smarter.

For many runners, aches and pains are par for the course. But when nagging knee pain gets in the way of logging miles, you’re going to want to do something about it.

Runner’s knee, also known as patellofemoral pain syndrome (PFPS), is one of the most common overuse injuries among runners (hence its name). This particular type of pain is an umbrella term, but typically presents as a dull and irritating unspecific ache in or around the kneecap (the patella). It is often worse with activity but it can also arise after sitting still for hours.

The knee joint is formed by the femur, tibia, and patella. The patella is a floating bone that sits on top of the joint, gliding within a groove in the femur called the femoral groove. When the patella doesn’t glide smoothly in this groove, it can lead to increased friction in the joint. This friction often causes pain in the joint, especially with repeated unilateral loading or bending at the knee since knee flexion creates an increased compressive force at the patellofemoral joint.

Instead of tracking smoothly along its groove, the patella is often pulled laterally, leading to discomfort. If the hips or quads are weak, the hamstrings are tight, the tibia doesn’t properly rotate, or soft tissue restrictions limit mobility or muscle activation, this can all lead to poor biomechanics and an increased pattern of maltracking.

Runner’s knee often develops over time. Get ahead of the pain by addressing these areas early on.

Your Move:

Try straight leg raises in flexion and with toes pointed up and slightly turned out to the side (slight external rotation) to target the quads (and specifically, the VMO portion of the muscle). To do this: Lie on your back the painful knee straight and the other bent. Draw in abdominals to stabilize core, tighten the front of the affected side’s thigh by pressing the knee down towards the floor and straightening the leg as much as possible, then lift your leg straight up and down. Do 2 sets of 10 with the toes towards the ceiling and 2 sets of 10 with the toes slightly turned outwards. Maintain a totally straight knee throughout the movement.

You’ve heard this before, but here we go: Glutes glutes glutes! If you’re a runner or any type of running/jumping/cutting athlete, you will need a strong set of glutes. Thankfully, there are a million ways to strengthen the muscles. Try straight leg raises in abduction lying on your side with a band around your ankles or in standing with band around both ankles. Also, try lateral walking with a band around the ankles and resisted clamshells to strengthen external rotators to prevent the knees from going inwards. Repeat for 2 to 3 sets of 10.

You can do this lying down with a strap around the foot or in a long sitting position on the floor with legs (both or one at a time) straight out in front of you.

Yes, the research is mixed on the true effectiveness of foam rolling the ITB (which doesn’t actually “stretch”). But there does seem to be a neuromuscular component of foam rolling that helps relieve symptoms, and it feels pretty darn good (and by good I mean terrible, but runners like that sort of thing). Give it a try and see if it helps provide relief. Kinesio taping may also help.

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