Chronic Knee Pain in Runners/Sprinters: Runner’s Knee
by Melinda Burris

Did you know the knee is the biggest joint in the human body? Its composition is complex, and it is instrumental in allowing an individual to do the kind of movements many of us take for granted such as walking, running, and jumping. For us to accomplish these motions, we need healthy knees that can support and facilitate our freedom of movement. Because the knee is called upon to do so much, it relies heavily on support from the muscles and tendons to keep it stable so that it in turn can support the body’s movements.

A frequent cause of knee pain in runners, sprinters, athletes of all sorts, and people in general is commonly called runner’s knee. The medical term for this condition is patellofemoral syndrome.

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Typically, the cause of this condition and the pain it causes can be traced back to a history of overuse. Pain develops, generally around the kneecap. In most cases, the pain starts as mild and slowly becomes more pronounced over time. It is common for those with runner’s knee to describe the discomfort as a dull, aching pain that escalates whenever they engage the knee in movements that require bending such as climbing stairs or any activity that requires bending the knee repeatedly.

 Causes

• Overuse: As stated previously, overuse is one of the primary root causes of runner’s knee. Bending your knee repeatedly in the same motion or doing lots of high-intensity exercises, such as lunges and plyometrics can inflame the tissues surrounding the kneecap.
• Increasing intensity of training too quickly: Another common factor that can lead to the development of patellofemoral pain is accelerating your running training program intensity and distance too quickly. You should increase your speed and the length of your runs incrementally to give your body time to adjust. This gives the body adequate time to build a tolerance to the increased stress being put upon it.

Slowly building up to a higher level of endurance gives the bodily tissues the necessary time to avoid overloading them and thus leaving yourself susceptible to injury or even chronic conditions like runner’s knee.

• Damage to the knee from a direct blow: This sort of injury can be extremely painful and can have serious repercussions on an athlete’s future playing prospects.
• Misalignment of your bones: This is very important because if any of the bones that connect your hips to your ankles are not in their proper position (this includes the kneecap by the way), your body tries to compensate to allow you to continue to move by shifting movement to other areas. This can put too much pressure on these areas that were not designed to withstand such demands. The result? Your kneecap is unable to move naturally through its groove, which can lead to pain.
• Foot issues: A number of foot issues such as fallen arches (often referred to as flat feet) or overpronation, a condition in which your foot rolls in a down and inward motion when you take a step causing your feet to turn inward. This causes you to walk differently and changes the way you place weight on your knees, which can in many cases lead to knee pain.
• Weak or tight thigh muscles: The large muscles located in the front of your thigh are the quadriceps. This muscle group is responsible for keeping your kneecaps in place when stretching or bending the joint. Weak or tight quadriceps may be unable to properly stabilize the kneecap and keep it in its proper position when it is moving.

A good way to avoid runner’s knee is to make sure you keep your quadriceps strong and flexible. Doing stretching exercises including Dynamic Inner Thigh Stretches, Sumo Squats, and Lateral Lunges will help keep your quadriceps in fine working order so they can adequately support the knee cap.

• Chondromalacia patella: This condition breaks down the cartilage—a strong, yet flexible connective tissue that protects the joint and acts as a shock absorber. Without this protective barrier, the knee is left vulnerable to further wear and tear and additional breakdown.

Symptoms

The primary symptom of what is commonly known as runner’s knee (patellofemoral syndrome) is pain. The discomfort primarily presents right at the front of the kneecap, but the pain can radiate all around the knee or be felt mostly behind it.

Some movements that can cause the condition to flare up are simple everyday functions such as walking, which requires you to bend your knees with each step, standing up from a seated position, kneeling, or running.

A hallmark of this condition is that it commonly worsens when you descend stairs or walk on a downward trajectory.

When the condition is exacerbated, swelling around the knee is common as is hearing a popping noise or noticing a grinding sensation in the knee.

Prevalence

Research shows more than 40 million people run regularly in the United States alone. Of that number, almost 50% will suffer some type of injury or associated pain each year. Patellofemoral pain syndrome (PFPS), iliotibial band friction syndrome (ITBFS), and patellar tendinopathy are the three primary knee injury types with PFPS cited as the most prevalent overuse injury seen in active adults and the most common running-related injury. Scientific studies show that between 19-30% of female runners report suffering from this injury while 13-25% of their male counterparts experience the condition.

Treatment

Runner’s knee or (PFPS) can be treated at home with simple, common-sense measures.

• Stop running for a while to give your knee time to recuperate.
• Elevate the knee to avoid swelling.
• Apply ice packs as needed to alleviate pain.
• Stay active while on the mend by participating in low-impact activities such as water aerobics.

If your case is severe and does not respond to any of these home remedies, see your doctor who may recommend more aggressive therapies such as physical therapy or a series of strengthening exercises.

Conclusion

Although common, patellofemoral pain should be taken seriously. Scientific research has demonstrated a likely connection between instances of this condition in the early stages of life with an increased probability of developing osteoarthritis in the knee later on in life.

References:

1. WebMD. (15 December 2024). Runner’s Knee: What You Need to Know.
2. Martin, L. (12 April 2024). What Can Result in Knee Pain When a Person Bends Their Leg?
3. Mellinger, S. & Neurohr, G.A. (2019). Evidence Based Treatment Options for Common Knee Injuries in Runners.
4. Saxena, V. (14 February 2020). What Are Common Knee Injuries from Running?
5. Central Performance. (n.d.) How to Treat and Prevent Runner’s Knee Pain – Which Strength Exercises Should You Do?

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