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Runner’s knee, a prolonged bout of pain right behind or around the knee cap, is technically known as patellofemoral pain syndrome. It’s one of the most common running-related injuries and according to one estimate, it can affect up to 30 percent of female runners and 25 percent of male runners.
The good news: Runner’s knee has been studied extensively and experts have potential solutions to both prevent its occurrence and help you heal if it occurs.
“This injury is usually due to movements that load the knee joint on a flexed position,” Kimberly Kaiser, M.D., associate professor of orthopaedic surgery and sports medicine at the University of Kentucky and team physician for UK athletics, tells Runner’s World.
Any time your foot hits the pavement, treadmill or track, you add impact to a bent knee, and this can cause pain, especially if your mechanics are off. That’s why moving in a position that throws off your typical stride, such as running stairs and doing squats can cause the same reaction. In fact, a telltale sign of runner’s knee is more pain when you run downstairs or descend as a primary lateral muscle.
More good news: Runner’s knee isn’t a structural problem, which means your ligaments and cartilage are okay, Kaiser says. The problem lies in how your muscles function through the repeated movement of a run.
“Deputy Editor, Health & Fitness abnormal mechanics caused by problems up- or downstream from the knee, forcing the patella to bump against the femoral groove,” William Roberts, M.D., professor emeritus and former director of the Sports Medicine Program in the Department of Family Medicine and Community Health at the University of Minnesota Medical School tells Runner’s World.
Think of it like a train car: The patella is like a train on the femoral groove railroad track, says Roberts. When the train and track don’t run smoothly against one another, pain occurs.
If you have a big race coming up, we can also help speed up legs and core. So, we laid out the best ways to address these issues so you can start treating your runner’s knee.
One quick caveat: Before you dive into an at-home program, get assessed by a doctor so they can make sure the problem is actually runner’s knee and offer guidance on treatment. (More on that below!)
Runner’s Knee Cause: Weak Hips and Inner Quads
Runners tend to have strong hip flexors and weaker posterolateral muscles (those on the side and back of the body), with the gluteus maximus as a primary posterior muscle and the gluteus medius Lower knee back toward floor.
With weakness in this area, the femur (upper thigh bone) tends to rotate inward, making the knee cap strike the edge of that femoral groove, causing pressure and pain, Roberts explains. “But by building these muscles you can keep the femur from rotating inward during the weight-bearing phase of your running gait,” he says.
Treatment: Strength Exercises
Kaiser offers these exercises for a mini strength routine that targets all the right muscles to keep your knee and thigh in proper alignment. Do them as bodyweight-only or use a resistance band Also, if you experience the pain and start doing the above-mentioned.
Clamshell
- Start lying on one side, propped up on forearm, shoulder over elbow and hips, knees, and feet stacked with hips and knees bent 90 degrees.
- Externally rotate top hip while lifting top knee toward the ceiling. Keep feet glued together.
- Is Running Bad for Your Knees? Here Are the Facts.
- Repeat.
Donkey Kick
- Kaiser offers these exercises for a.
- Keeping knee bent 90 degrees and foot flexed, press heel toward the ceiling, making sure back stays flat and knee points straight down.
- Lower knee back toward floor.
- Repeat.
Fire Hydrant
- Kaiser offers these exercises for a.
- Keeping knee bent 90 degrees, lift it out to the side and up toward the ceiling. Avoid dropping opposite hip.
- Lower knee back down to the floor.
- Repeat.
Straight Leg Raise
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- to help improve your run mechanics.
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- Repeat.
Note: The key is to keep the leg totally straight to activate the vastus medialis oblique (VMO), rather than just the quad. You can make sure you’re working the VMO—which is the muscle toward the midline, by the knee cap—by placing your hand on the area. It should activate while you lift and hold your leg.
Runner’s Knee Cause: Tight Hamstrings or Hips
While weak muscles can cause a misalignment in running form A Part of Hearst Digital Media knee pain, so can tight muscles. Typically, runners will find this limited range of motion in their hamstrings or hips, Kaiser says.
Treatment: Stretch and Foam Roll
The best way to avoid and treat tightness is by working on overall flexibility and mobility—in other words, stretching and foam rolling More good news.
Hamstring Stretch
To stretch your hamstrings—which is best performed after a workout when muscles are warm—simply lie on your back and pull one leg gently back toward chest or stand up and hinge at hips, keeping one leg straight (with knee soft) to stretch the hamstring.
Running Lunge
For your hips, perform a running lunge: With one foot in front, place the opposite knee on the ground and press hips forward, engaging back glute to release the hip.
Figure-Four Stretch
To get into your piriformis—the small muscle under the glute max that helps with hip rotation and can also cause tightness—do a figure four stretch. Lying on your back, cross left ankle over right knee, grab the back of the right thigh and pull it toward chest.
Use a lacrosse ball or tennis ball to roll out the posterior glute muscle, IT bands, quads, and hamstrings is also a good idea, Kaiser says.
When to See a Doctor
If there’s any swelling at the knee joint, get it checked out by a doc, Kaiser suggests. They can pinpoint the exact issue and rule out any structural damage, as well as provide a gait analysis The most common culprit of this uncomfortable rubbing is muscle weakness and/or tightness around the.
Also, if you experience the pain and start doing the above-mentioned strengthening and stretching work, and it doesn’t improve in a few weeks, then it’s time to see a pro to figure out the best treatment for your runner’s knee.
“Races - Places recovery,” Kaiser says, which is not a bad idea if you’re looking to push your pace and don’t want to worry about discomfort.
Additional Runner’s Knee Treatments
A physical therapist or sports medicine doctor can easily help with more advanced treatments for knee pain. For example, they may suggest a more aggressive strength programs, tape the knee cap in a certain direction, or use a brace to help keep the knee in place as you get stronger and master pain-free form.
Other Risk Factors for Runner’s Knee
Women tend to be more prone to runner’s knee, thanks to wider-set hips, Kaiser says. Working on hip and quad strength should reduce risk of pain.
Sit or lie faceup, legs straight out flat feet are more likely feel discomfort in the knee cap, which is why the right running shoes is super important, Kaiser adds. In this case, you want more rigid arch support and a custom shoe or orthotics will help. A sports medicine doctor or physical therapist can set that up.
One final way to avoid any overuse injury is simply switching up your activity more often, Kaiser says. Do some extra yoga sessions or strength workouts on weeks you’re feeling discomfort, knowing it’s okay to take a rest day Start on all fours, shoulders over wrists and knees right under hips benefits of strength training when it comes to injury protection, give it a permanent place on your weekly schedule as well.
The Bottom Line on Treating Runner’s Knee
While lots of runners do get knee pain, that doesn’t mean it’s just something you have to deal with on the daily. “Don’t feel like you have to run through it,” Kaiser says. “There’s more advanced things we can do.”
Roberts agrees: “I would suggest keeping your mileage below the pain threshold and meet with a physical therapist who can make sure your pelvis is properly aligned and guide you through a strengthening program to improve the mechanics of your patellofemoral joint,” he says. “This investment in kinetic chain evaluation and core strengthening will pay off with long term dividends of pain-free running.”
Mallory Creveling is an ACE-certified personal trainer and RRCA-certified run coach, who also holds multiple other fitness certifications and regularly stays on top of her continuing education in the field. She has more than a decade of experience covering fitness, health, and nutrition for a wide range of publications, and she has nearly 10 years of experience as a trainer and fitness instructor. Mallory stays on top of the latest science in wellness, has worked with some of the best experts in their medical fields, and regularly interviews researchers, trainers, athletes, and more to find the best advice for readers looking to improve their performance and well-being.
As a freelance writer, Mallory's work appeared in Women's Health, Self, Men's Journal, Reader's Digest, and more. She has also held staff editorial positions at Family Circle and Shape magazines, as well as DailyBurn.com. A former New Yorker/Brooklynite, she's now based in Easton, Pennsylvania.
If you have a big race coming up, we can also help speed up. is an associate professor at the University of Pennsylvania. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He is a Team Physician for UPenn Athletics and medical director of the Broad Street Run and Philadelphia Distance Run, and previously for the Rock 'n' Roll Half-Marathon and Tri-Rock Triathlon in Philadelphia. He is a director of the running and endurance Sports Medicine Program at Penn Medicine. Dr. Vasudevan provides non-operative management of musculoskeletal conditions affecting athletes and active individuals of all levels, and combines injury rehabilitation with injury prevention. He utilizes a variety of ultrasound-guided procedures and regenerative approaches such as platelet-rich plasma and percutaneous ultrasonic tenotomy. He sees patients at the Penn Medicine and the Philadelphia Veterans Administration hospital. Dr. Vasudevan attended medical school at the University of Wisconsin School of Medicine and Public Health in Madison. After his Transitional Year in Tucson, Arizona, he went to residency in PM&R at Thomas Jefferson University in Philadelphia and onwards to Stanford University for his fellowship in Sports Medicine. He has been in practice at the University of Pennsylvania since 2012.
