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Runner’s Knee (Patellofemoral Pain Syndrome)

Posted on 19th August 2016 by

Knee pain is one of the most common running injuries we see here at goPhysio. A regular injury is ‘runner’s knee’ or more technically Patellofemoral Pain Syndrome (PFPS).

What is ‘Runner’s Knee’?

As you bend and straighten your knee, the knee cap (or patella) naturally moves up and down in a Runners knee groove in your thigh bone (or femur) . The knee cap is held in place by various muscles and tendons, helping it to move well. If any part of this isn’t quite working right it can affect the knee cap, particularly if you’re doing a repetitive movement such as running. Such problems around the knee cap can cause damage to cartilage, ligaments or fatty tissues near the knee cap and as a result cause pain and inflammation.

Pain often originates from the contact between the back of the knee cap and the thigh bone.

What does it feel like?

Pain is often felt during a run behind the knee cap or infant of the knee. It can be a dull achey pain or may be quite sharp and severe. Other symptoms include:

  • Pain during other activities, sports or even walking
  • Pain when squatting or going up or down stairs, down especially
  • Stiffness and swelling around the knee cap (‘puffy’ knees)
  • Loss of muscle bulk in your quadriceps (front thigh muscles)

What causes it?

A number of issues can cause runner’s knee. It’s often something that comes on gradually and people endure for some time before seeking help, so often, by the time a runner comes to see us there are a few things going on and compensations have developed. Problems that can contribute to runners knee include:

  • Overworking the patellofemoral joint (joint between knee cap and thigh bone)
  • Stiff hip joints
  • Over pronation at the foot (flattened arches
  • Tight hamstrings, calf and quadriceps muscles
  • Lack of strength in quadriceps  muscles
  • Issues around the glutes and pelvis

What can Physio do to help? 

To settle the pain and discomfort of your knee pain, you can rest and use ice and painkillers. Rest is crucial, as the problems is often a result of  overuse, so reducing activity will help this. However, if you’re like most runners, you aren’t going to be keen on resting for long.

As with any overuse injury (read a previous blog about overuse injuries here), it is crucial to identify the cause of the problem. This is where physio comes in, as we’ll be able to identify exactly where the cause of the problem lies and address it. This may be through a tailored exercise programme to strengthen, stabilise and stretch particular areas around your knee, hips or pelvis. It could be that you’d benefit from orthotics and if so we can assess your need and advise accordingly. Or it may be an issue with your running technique, training programme, running shoes or other activity you’re doing.

In combination with addressing the underlying issue, we provide relief of your symptoms to make you feel more comfortable. This could be through hands on physio techniques to release soft tissues, acupuncture, electrotherapy or taping. We have a huge range of techniques and tools that can help you.

Most importantly, we’ll guide you back to doing what you love to do and that’s run! We make sure you know when to start running again without re-injuring yourself, it’s a difficult balance. We advise on distance, timing, rest, speed and making sure you are progressing your specific exercises to support your recovery.


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