What Is Runners Knee (Patellofemoral Pain Syndrome), Symptoms, Causes & Treatment Options

by Besh T

As the name implies, runner’s knee, also known as Chondromalacia patella or Patellofemoral pain syndrome is a common problem among runners. However, it may take place in athletes that are involved in activities requiring frequent knee bending, such as jumping, biking and even walking. It often causes an aching pain around your kneecap and hence the name, runner’s knee.

Signs and symptomsrunners knee pain clenching


Some common signs and symptoms of runner’s knee include:

  • Pain around or behind your kneecap – this is most prominent where the kneecap and thighbone meet
  • Pain while bending the knee – this is common while walking, kneeling, running, sitting and squatting
  • Swelling around the affected region
  • Tenderness in and around the affected region
  • Pain that worsens when you walk downhill or downstairs
  • An audible pop or grinding sensation of the knee



It is difficult to point out a single cause of runner’s knee. Sometimes it may be associated with a biomechanical problem, such as the patella being larger on the outside as compared to the inside. It can also occur if the patella is situated higher than normal in the femoral groove or the patella just dislocates easily. Moreover, when the cartilage in the knee is worn out, there is less shock absorption and people with high-arched feet don’t have much cushioning.

However, having flat feet can excessively pull your patella sideways. Similarly, there are some causes associated with your muscles as well. For example, if you have tight calf muscles or quads, they may put pressure on the knees and having weak quads can affect the alignment of the patella. Any repetitive motion can easily trigger runner’s knee pain.

Some possible triggers include:

  • Overuse of the knee. Repeated bending of your knee may irritate the nerves of your kneecap. Moreover, overstretching of the tendons may also cause pain of the knee, which is characteristic of runner’s knee.
  • Direct trauma. This can be a fall or a blow to a knee.
  • Problems with your feet and faulty foot mechanics. People with flat feet or fallen arches are more at risk of runner’s knee due to overpronation. Overpronation is a condition, which occurs when an impact of a step leads to the collapse of the foot arches and stretching of the tendons and muscles.
  • Misalignment. When the bones are slightly out of place, any physical stress will not be evenly distributed throughout your body. There are certain parts of the body that carry too much weight and this can cause pain and damage to your joints. Tight quads and hamstrings may apply stress on the knee and weak quads may cause the patella to move from its original position. In some people, the kneecap itself tends to be slightly out of its natural position.


Risk factors


Factors that increase a person’s risk of runner’s knee include:

  • Age. The problem affects adolescents and young adults
  • Sex. Women are more likely to develop runner’s knee than men because of their wider pelvis. This increases the angle at which your bones meet in the knee joint
  • Sports. Sports involving excessive running and jumping can add too much stress in your knees

<runners knee patellofemoral pain syndrome

Tests and diagnosis

Runner’s knee is often diagnosed through a physical exam. This may be followed by X-rays, MRIs or CT scans. Other tests may be performed as well.



Despite the cause, minor to moderate runner’s knee can improve on its own within a given period. Fortunately, you can speed the healing process too with the RICE method:

  • Rest your knee. This is common sense. If you bend you knee, it will hurt so rest it as much as possible and avoid putting too much weight on it.
  • Apply ice on the knee. Apply an ice pack every 3-4 hours for 20-30 minutes to reduce pain and swelling.
  • Compress the knee. You can use an elastic bandage, knee sleeves, or straps to support your knee while moving. We recommend the McDavid Jumper’s Knee Strap for moderate support or the Body Assist Patella Stabilizer for more advanced support for this purpose.
  • Elevate the knee as much as possible. You can rest your knee on a pillow while lying down to reduce swelling.


Take OTC painkillers

Anti-inflammatory drugs or NSAIDs can help improve pain and swelling. Bear in mind that certain pain medications come with their own set of side effects so use them occasionally, unless instructed by your doctor otherwise.


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