Runner’s Knee: Why It Happens and What Helps

That ache around the front of the kneecap can become particularly noticeable with running, stairs, hills or increases in activity. Often referred to as runner’s knee, there can be a number of factors contributing to why it develops.

If your knee starts complaining as your running or activity levels increase, you’re certainly not the only one. Runner’s knee is a common term used to describe pain around the front of the knee, although similar symptoms can have different causes.

In this guide, we look at what runner’s knee means, some of the factors that may contribute to it, and how assessment, activity management and rehabilitation can form part of care.

What runner’s knee actually is

Runner’s knee commonly refers to patellofemoral pain, which is pain felt around or behind the kneecap. Despite the name, you don’t have to be a runner to experience it. It can also occur in people who cycle, go to the gym, walk regularly or take part in other activities that load the knee.

Symptoms can sometimes develop following a change in activity, such as increasing running distance, adding more hills or returning to exercise after time away. Strength, movement, training load and other individual factors may also be relevant.

Because pain around the front of the knee can have different causes, an assessment can help determine what may be contributing to your symptoms and guide an appropriate management plan.

Common signs of runner’s knee

• An ache or discomfort around or behind the kneecap
• Symptoms that become more noticeable during running, particularly with hills or changes in training
• Discomfort with stairs, squatting or after sitting for longer periods
• Clicking or grinding around the knee, which may or may not be associated with pain

How runner’s knee is usually managed

Management of runner’s knee will depend on your symptoms, assessment findings and activity goals. For runners, this often involves finding a manageable level of activity while addressing factors that may be relevant to the knee and gradually building strength and capacity.

At Living Health Group, we look at the knee as well as relevant movement and strength through areas such as the hips, legs and feet. Your plan may include temporarily modifying aggravating activities, hands-on treatment where appropriate, and exercises tailored to your individual needs.

As symptoms and capacity change, running and other activities can be gradually progressed. The aim is not simply to settle the current symptoms, but to help you build towards the activities and level of running that matter to you.

When to get your knee pain assessed

If your knee pain is persistent, worsening or limiting your running or everyday activities, it may be worth having it assessed. Symptoms such as significant swelling, locking, giving way or difficulty putting weight through the leg also warrant further assessment.

Not all pain around the front of the knee is runner’s knee, and an assessment can help identify factors that may be relevant to your symptoms and whether further investigation or referral is appropriate.

At our Wheelers Hill clinic, we work with runners and active people from across Melbourne’s south east, including Glen Waverley, Rowville and Ferntree Gully. If knee pain is getting in the way of your running, we can assess what may be contributing and develop a plan around your needs and goals.

Reducing the risk of runner’s knee returning

Once your symptoms are improving, gradually building your strength and activity levels can be an important part of returning to running. Depending on the individual, this may include strengthening through the hips, knees and calves, alongside gradually progressing running distance, intensity or hills.

Changes in training load can be relevant to runner’s knee, particularly when returning after time away or increasing activity quickly. Rather than following a fixed rule for how much you should increase each week, your progression should take into account your current capacity, symptoms, training history and goals.

Continuing with appropriate strength work and paying attention to how your knee responds as training changes can help guide that progression. If knee pain repeatedly interrupts your running, an assessment may help identify factors worth addressing as part of your training and rehabilitation plan.

Common questions