Runners knee (patella femoral pain syndrome)

Despite what the name suggests, this is not an injury limited just to the running population. It is also not a specific injury, but rather a broad term used to describe the pain you feel in your knee in relation to your knee cap (patella).

Symptoms of runner’s knee

– The main symptom is pain at the front of your knee (over the kneecap/patella).

– The pain is usually worse with squatting and kneeling.
– Pain is typically worse with downhill runs or walking downstairs.

– The knee may be swollen.

– You may feel crunching/grinding inside your knee when you move it.

– In the initial stages of this injury, pain is only usually felt if you stress the area (eg running, hill work, squats).

– The pain is not usually felt at rest.

– Stiffness is often felt if in 1 position for a long time (eg if you are sitting for a while, when you stand up, the knee is stiff and sometimes painful)

– As the injury progresses or is not dealt with early on, the pain is present at rest.

What causes runner’s knee (or contributes to the condition?)

Runner’s knee can be caused by a structural defect or a certain running or walking style.

– A direct hit to the knee (or falling directly onto the knee cap/patella)

– Overuse (especially rapidly increasing exercises such as squats, lunges, excessive jumping). These can irritate the soft tissue around the knee cap.

– Biomechanical issues that have an impact on the optimal functioning of the knee (eg hip, ankle or foot issues). This can change the amount of load that goes through the knee joint.  A full assessment needs to be done in relation to the person as a whole to work out what the contributing and aggravating factors are. This is different for every person.

– Weak and/or tight quadriceps muscle. The quadriceps muscle keeps the knee cap in a good alignment. If this is slightly off, it can cause pain in and around the knee cap.

– Tight calf muscles can cause an increased pressure on the front of the knee.

– Wearing heels.

– Your physiotherapist can usually diagnose runner’s knee from a thorough assessment. On occasion, X-Rays may be required to fully assess the issue.

Can runner’s knee be prevented?

– While you cannot always prevent runner’s knee from happening, there are a few things you can do to reduce your risk. – Keep your quadriceps muscle strong. – Ensure that you are wearing the correct shoes. – Try not to always run on hard surfaces like concrete. – Keep your weight at optimal level. – Always warm up and cool down before and after exercise. – Keep your calf muscles stretched out. – Be careful not to suddenly increase or change your exercise regime too quickly or drastically. – Most injuries occur because of this. -Your physiotherapist will guide you regarding appropriate timeframes, return to sport, alternative exercise regime to enable you an optimal recovery time.

For more information or to book an appointment a physiotherapist in Durban, please call  031 563 1314 or email



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