Runners Knee – Expert Advice Sheet


What is Runners Knee?


Runners Knee or Patellofemoral Pain Syndrome is a condition where there is a suspected misalignment of the patella (kneecap) at the knee joint. Where the patella most commonly sits centrally to the knee joint, Runners knee is caused when the patella rests or sits on the femur (thighbone).


What is the onset of Runners Knee?

Where you can say most people are under the impression that Runners Knee is caused by a huge amount of continuous or repetitive running, this isn’t in fact the case. As we now know that runner’s knee is a case of misalignment of the kneecap, there are few ways in which this can be caused.

1: Impact or trauma to the kneecap itself. For example, a direct blow to the knee, or a bad fall.

2: Instability of the Knee, Pelvis or Foot and Ankle. Instability can be caused by lack of tendon or ligament function, and the possibility of weak or poor muscle group function related to the joints named above. For instance, weakness of the Quadricep group can be common factor or onset to runner’s knee, as this muscle group attaches to the patella itself. Alternatively there could be the odd chance of bone abnormality in the knee joint which could also lead to knee symptoms

3: Muscle and Joint Overuse/Fatigue. This can relate to high intense, repetitive or prolonged joint/muscle activity around the knee. Good examples of this are repetitive knee flexion with weight bearing, plyometric type activity, long durations of running but repetitively and consistent over stretching of the muscle which are associated with the knee.

4: Skeletal Imbalance, which involves general misalignments of the joint structure of the knee.

5: Inflammation/Swelling under the kneecap. This can be caused by trauma to the knee cap or other structural compartments of the knee.

6: History of knee problem. In this case, past knee problems can be problematic and cause further onsets of knee or patellofemoral pain syndrome.


How can Runners Knee be treated and prevented?

If you feel like you could be the unlucky victim of Runners knee, and you are experiencing symptoms listed above, the do not panic. Address the knee with some self treatment, by applying ice and resting the joint. It is important to try and reduce the symptoms initially and seeking further advice from a specialist.

If you are an active individual, then it is important to cut back on the level of intensity of your training, or stop completely to seek advice from a specialist. Further assessments can be made by a specialist to determine the grading of the condition, which will lead to either advanced treatment protocols for the symptoms, or a good level of advice. Once the symptoms have been addressed through treatment, aftercare would be essential in order to prevent the condition from returning.

A common example of aftercare for Runner’s knee would be stabilising the knee and pelvis through strengthening the quadricep muscle group. This will enable improved stabilisation of the kneecap (patella tracking) and contribute towards better performances in your daily routine. Other ways to prevent runner’s knee symptoms is to become self aware of equipment and surface areas.

Try to wear appropriate footwear and clothing which will put you knee and ankle joints under less stress. If in doubt, see a clothing or foot specialist who can assess and lead you in the right direction. Avoid prolonged amounts of time on inclined surfaces which can put the knee, hip and ankle joints under stress. Be sure to also seek help for an appropriate training programme if you are a keen sporting individual.

If you require further advice from one of our specialists at Perfect Balance Clinic, then please feel free to call us 0800 0724 012 or email us on Our team are here to help!

This article was written by our sports therapist Aaron Trim.

Head Crop 1000px-38 (1)


Need more information? Why not contact us using the form below and we will get back to you as soon as possible.

Your Name (required)

Your Email (required)

Best Number to Contact You (required)


Your Message


American Academy of Orthopaedic Surgeons: “Runner’s Knee.”
Arroll, B. British Journal of General Practice, February 1999.
Fulkerson, J. American Journal of Sports Medicine, May-June 2002.
Rouzier, P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.

Leave a Reply