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Runner’s Knee (Patellofemoral Pain Syndrome)

By July 13, 2025August 1st, 2025Sports Injury Rehab

Runner’s Knee (Patellofemoral Pain Syndrome)

Anterior knee pain is the single fastest way to turn a finish-line dream into an ice-pack reality. “Runner’s Knee,” or Patellofemoral Pain Syndrome (PFPS), describes diffuse pain around or behind the kneecap that flares during running, squatting, or even a casual flight of stairs.

Quick Take

What it is Overuse-driven irritation of the cartilage and soft tissues where the kneecap meets the thighbone.
Common in Runners, hikers, cyclists—especially females and high-milers.
Feels like Dull ache during stairs, hills, or after sitting with knees bent (“the movie-theater sign”).
Fixes Load management + targeted hip/quad exercises, taping, footwear tweaks.

Why Does Runner’s Knee Happen?

Multifactorial mechanics. A 2023 review notes that mal-tracking of the patella, hip weakness, over-striding, and shoe wear all shift abnormal force onto the joint (Walli et al., 2023) (SpringerLink). Think of the kneecap as a train that wants a straight track; anything that twists the rails—hip drop, foot collapse, sudden mileage spikes—invites friction.

Hall-Mark Symptoms

  • Achy, diffuse pain around or under the patella
  • Worse with downhill running, squats, lunges, or after prolonged sitting
  • Occasional crepitus (“grinding”) without significant swelling
  • Symptoms often ease during steady running but roar back afterward

Proven Rehab Strategies

1. Progressive Strengthening

Combining hip and knee exercises outperforms single-muscle programs for pain reduction and return to sport (Walli et al., 2023) (SpringerLink).

2. Foot & Stride Optimization

A 2024 RCT added short-foot exercises to standard rehab and saw greater pain relief and functional gains than hip-and-knee work alone (Kamel et al., 2024) (PubMed).

Coach’s tip: Aim for a cadence of ~170–180 steps per minute and land with the foot under the center of mass to drop patellofemoral load.

3. Patellar Taping & Bracing

Elastic tape applied by a clinician can provide short-term pain relief—ideal for getting through a race if you’re mid-training block.

4. Load Management

Cut weekly mileage by 20–30 %, swap in pool running or cycling, then ramp 10 % per week. Pain ≤ 2/10 during activity and back to baseline by the next morning is a green light.

5. Education & Self-Monitoring

Understanding flare triggers improves adherence and outcomes; patients who track pain and activity log faster recoveries (Walli et al., 2023) (SpringerLink).

When to See a Physical Therapist

  • Pain persists > 2 weeks despite rest
  • Swelling or locking accompanies the ache
  • Goals include a race on the calendar—early intervention shortens downtime

Our HolistiCare Approach

  1. Gait analysis to spot hip drop, over-stride, or excessive pronation.
  2. Targeted quad-hip activation sequence (banded clamshells, step-downs, isometric Spanish squats).
  3. Patellar taping & footwear consult—sometimes the answer is swapping a soft heel for a firmer mid-sole.
  4. Load-management plan that lets you keep moving while symptoms calm.

Expect smoother miles, stronger knees, and race-day confidence—call 808-348-6336 to book your FREE Runner’s Knee assessment today.

FAQ

Is PFPS the same as chondromalacia?
No. Chondromalacia implies cartilage damage; PFPS is broader and often reversible with rehab.

Will I need imaging?
Most cases are clinical diagnoses. We refer for MRI only if mechanical locking, major swelling, or instability suggest additional pathology.

Can I keep running?
Usually yes—at a reduced volume and intensity following the pain-monitoring model above.

References

Kamel, A. M., Ghuiba, K., Abd Allah, D. S., Fayaz, N. A., & Abdelkader, N. A. (2024). Effect of adding short foot exercise to hip and knee focused exercises in treatment of patients with patellofemoral pain syndrome: A randomized controlled trial. Journal of Orthopaedic Surgery and Research, 19(1), 207. https://doi.org/10.1186/s13018-024-04688-x (PubMed)

Walli, O., McCay, M., & Tiu, T. (2023). Patellofemoral Syndrome: A Review of Diagnosis and Treatment. Current Physical Medicine and Rehabilitation Reports, 11, 139–143. https://doi.org/10.1007/s40141-023-00385-8 (SpringerLink)