Patellofemoral Pain Syndrome (Runner's Knee)

Runner's knee—the medical term is patellofemoral pain syndrome—is a condition that causes pain on the front of the knee, around and/or beneath the kneecap (patella). This is where the knee connects with the lower end of the thighbone (femur). It can occur in one or both knees.

While it’s called runner’s knee, this condition also affects hikers, skiers, cyclists and soccer players, and athletes who perform activities that require a lot of knee bending, such as weightlifters. It also affects people who sit for a living because the kneecap can be fatigued when a knee is constantly flexed or if a person sits cross-legged.

Women are twice as likely to get runner’s knee as men.

Runner’s knee most often develops when the knee is overused or injured. The most common symptom is knee pain that gets worse when you walk up or down stairs. Squatting, kneeling or sitting cross-legged may also hurt.

Fortunately, runner’s knee usually can be treated without surgery. The best course of treatment is often to stop running (or whatever activity caused the condition) until you can resume the activity without pain. Icing the knee, compression, elevation and over-the-counter pain medication can be beneficial.  Physical therapy and correcting any body mechanics can also help

Because the symptoms of runner's knee may look like other conditions, it’s important to see a specialist for an accurate diagnosis and appropriate treatment.

With appropriate treatment—which seldom requires surgery—the prognosis of runner's knee is usually excellent.

Why Choose Cooper to Diagnose and Treat Runner’s Knee

Cooper University Health Care has a team of seven fellowship-trained and board-certified sports medicine specialists with extensive experience in diagnosing and treating runner’s knee. You can count on us for:

  • Fast access: Our policy is to see patients within 24 to 48 hours of a sports injury, whenever possible
  • Comprehensive diagnostic resources: Your doctor will take a thorough health history, perform a physical exam, and order state-of-the-art diagnostic imaging, when necessary
  • Personalized treatment: Treatment is personalized based on your age, general health and severity of symptoms, and may include:
    • Rest/restricting activity until the pain subsides
    • Cold packs to reduce pain and swelling
    • Elevating the leg
    • Compression knee wrap
    • Medicines such as ibuprofen
    • Stretching and strengthening exercises
    • Arch support in shoes

Runner’s Knee Causes and Risk Factors

While runner’s knee usually results from excessive training or overuse, or an injury, it may be caused by a variety of factors, including a structural or anatomical defect, or a certain way of walking or running. These factors can include:

  • A kneecap that is too high in the knee joint (what’s called high patella)
  • Weak or tight thigh muscles
  • Tight hamstrings
  • Tight Achilles tendons
  • Flat feet
  • Walking or running with the feet rolling in while the thigh muscles pull the kneecap outward

There are certain risk factors associated with runner’s knee, including:

  • Participation in sports such as skiing, cycling, soccer or weightlifting
  • Continuous knee-bending or sitting cross-legged
  • Gender—women tend to get runner’s knee twice as often as men due to anatomical differences, including proportionately wider hips (so their thigh bones angle in more sharply from hip to knee, causing greater stress and instability in the knee)
  • Congenital defects involving the knee joint such as trochlear dysplasia, abnormal location of the kneecap, knock knees
  • Loose placement of the kneecap on the knee joint (when the patella is loosely attached, it creates instability, increasing the risk of runner’s knee)
  • Lack of conditioning can increase the risk of muscle and ligament strains in the knee joint

Symptoms of Runner’s Knee

The most common symptoms of runner's knee are:

  • Pain in and around the kneecap that occurs when you’re active
  • Pain after sitting for a long time with the knees bent; this sometimes causes weakness or a feeling of instability
  • A rubbing, grinding or clicking sound of the kneecap that occurs when you bend and straighten your knee
  • Swelling of the kneecap
  • A kneecap that is tender to the touch

Managing Runner’s Knee

The key to managing runner’s knee—and preventing it from happening again—is to avoid overstressing your knees. Some ways to help:

  • Lose weight, if needed
  • Ease into exercise—warm up before exercise and stretch your muscles after you work out
  • Perform exercises to strengthen the muscles that help support the knee, including the hips and quadriceps
  • Vary your exercise routine to avoid overuse of specific muscles and joints
  • Increase your physical activities gradually
  • Wear good running shoes with adequate support
  • Lean forward with your knees bent when you run

Make an Appointment with a Cooper Sports Medicine Specialist

To learn more about the sports medicine services available for treating runner’s knee at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).