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What is Runner's Knee? What are 2 exercises to help with your Runner's Knee pain?

Writer's picture: Physiotherapy Recovery ClinicPhysiotherapy Recovery Clinic

Updated: Aug 5, 2021


What is runner's knee?... What causes it?... What are the signs and symptoms?... What are 2 exercises you can do to help with your knee pain?... Read on to find out!

What is Runner's Knee?, Runner's knee pain, knee pain, physiotherapy

What is runners' knee?

Well, runner's knee is the common term used to describe pain that you feel on the front of your knee around your patella (fancy term for your kneecap). It's technical term is patellofemoral pain syndrome or otherwise referred to as PFPS.


To properly understand what it is and what causes it, we first need a slightly better understanding of our knee anatomy and how our knee joint works.

Firstly, our kneecap is a loose roundish bone that sits above and in front of our main knee joint. Our main knee joint operates much like the hinge of a door to open and close our knee joint (bend and straighten). The kneecap itself, has many muscles and ligaments that attach onto it and hold it in its groove on top of our knee joint. These strong tendons and muscles use their attachments on the kneecap to control the bending and straightening of our knee. To do so, the kneecap itself must glide smoothly in its groove during bending and straightening. This is the vital part that unfortunately is not working properly in someone with runner's knee pain.

Patella, kneecap, bending and straightening, runner's knee pain
Kneecap Gliding

Ok... so now we understand how the knee actually operates... so what actually CAUSES runner's knee pain?

Continuing on from the above, runner's knee pain is caused by the muscles, tendons or ligaments that are suppose to help glide your kneecap efficiently in its groove, not doing their job properly. This means that imbalances or damage in these muscles, tendons or ligaments are causing abnormal tracking of your kneecap. This leads to unwanted friction, and wear and tear under the knee cap and thus inflammation and pain.


What causes this abnormal tracking of the kneecap?

Some of the common causes that lead to the development of PFPS include:

* Overuse: Suddenly increasing your training amount or intensity and doing lots of high stress knee exercises can irritate tissues in and around your kneecap (Eg: running, jumping, lunging, stepping, etc).

* Impact: a fall or a direct blow to the knee can irritate or damage soft tissue around the kneecap.

* Weakness/imbalance in your knee stabiliser muscles: The main culprit is usually your quadriceps (the big muscles in the front of your thigh) which keep your kneecap in place when you bend or straighten the joint. If they’re weak, damaged or tight, then your kneecap may not stay in its place. * Chondromalacia: which is when the cartilage underneath your knee cap begins to wear away and break down.

* Genetic predisposition: There are some other structural factors that can contribute to increasing your likely hood of developing pain from PFPS. Some of them include increased kneecap-to-tibia angle, hypermobile joints, abnormal running gait pattern, and abnormal foot or knee posture.

Knee anatomy, Runner's Knee Pain
Knee Anatomy

So what are the main signs and SYMPTOMS that can help me identify if I have runner's knee?

* Pain that is felt under and around the kneecap and usually towards the front of the knee.

* Pain that usually begins or worsens when you're active (especially running, jumping, lunging, and stepping).

* Pain that is felt after prolonged sitting with your knees bent. * Feelings of weakness and/or instability of the knee.

* Regular grinding or clicking sounds coming from the knee during bending or straightening.

* Noticeable swelling and puffiness around the kneecap.

* Tenderness and pain when touching the kneecap or around it.

* Dislocations of the kneecap.


What are 2 exercises that you can do at home to help with your knee pain?

Due to the fact that runner's knee pain is caused by damage, weakness or imbalances in the soft tissue of the knee and kneecap. We want to be doing exercises that help with gentle strengthening and stretching of your knee stabiliser muscles, especially your quadriceps muscles. It is important to note that depending on how bad your runner's knee pain is, the below exercises may need to be modified.


1. Heel Slides

1. Lie down on your back on a flat comfortable surface with your legs straight. 2. Begin by bending your right knee and sliding your heel as you do so. 3. Bend your knee so that your heel comes as close to your buttocks as is comfortable for you. 4. Then, slowly straighten your knee and slide your heel back out to its starting position. 5. Repeat 10-15 times on each knee, 2 times each day.

(This exercise helps to stretch and strengthen your knee stabilisers as well as practicing good and stable tracking of the kneecap during bending and straightening of the knee.)

Heel slides for Runner's Knee Pain
Heel Slides

2. Seated Knee Extensions

1. Sit up tall in a comfortable position in a comfortable chair with your legs bent downwards in front of you. 2. Begin by slowly straightening your right knee until it is completely straight in front of you. 3. Ensure that you hold this position at the top briefly and give your quadriceps a comfortable tense to fully activate it. 4. Then, allow your knee to bend back down in a slow and controlled movement to its starting position. 5. Repeat this 10-15 times on each knee, 2 times each day.

(This exercise also helps to practice good and stable tracking of your kneecap as well as providing good strengthening for your quadriceps which is vital in stabilising your knee joint and kneecap.)

Seated knee extensions for Runner's Knee Pain
Seated Knee Extensions

By: Adam Fracassi

(Physiotherapy Recovery Clinic Concord)


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