Runner's Knee Explained
In brief: Runner's knee, known clinically as patellofemoral pain syndrome, is pain felt around or behind the kneecap. It is one of the most common overuse complaints in running, typically a dull ache that gets worse going down stairs, running hills or sitting with bent knees for a long time. It is usually caused by the kneecap not tracking smoothly, often linked to weak hip and thigh muscles or a sudden jump in training. Most cases settle with load management and targeted strengthening.
What is runner's knee?
Runner's knee is the everyday name for patellofemoral pain syndrome, a broad term for pain at the front of the knee around or behind the kneecap, or patella. It is not a single injury but a pattern of irritation where the kneecap glides over the groove in the thigh bone. When that movement is not quite smooth, the surfaces are loaded unevenly and the area becomes sore. It is extremely common in runners because each stride sends repeated load through the joint.
What causes it in runners?
The usual driver is simply doing too much too soon, a sudden rise in mileage, pace or hill work that the knee is not yet conditioned for. Weakness in the hip and thigh muscles, especially the glutes and quadriceps, lets the kneecap drift slightly off track. Other contributors include very worn shoes, running camber, tight muscles and individual differences in leg alignment. It is typically a combination rather than one single cause.
Symptoms to recognise
The hallmark is a dull, aching pain around the front of the knee rather than a sharp, pinpoint pain. It is often worse going downstairs or downhill, when squatting, and after sitting for a long stretch with the knee bent, sometimes called the theatre sign. Some runners notice a grinding or clicking sensation. The pain often eases with rest and returns when running resumes too quickly.
Treatment and recovery
Most cases respond to reducing the aggravating load rather than stopping completely, alongside a structured strengthening programme for the hips and quadriceps. Ice can ease a flare-up, and a gradual, paced return to running helps avoid a relapse. Because the underlying issue is often muscle control and training load, building strength is usually more effective than rest alone. A physiotherapist can tailor the exercises and rule out other causes.
Runner's Knee and your running kit at OD's
The right footwear will not cure runner's knee on its own, but well-cushioned, properly fitted running shoes that are replaced before they are worn out give the joint a more consistent, supportive platform. At OD's Designer Clothing we stock premium running footwear from On, Saucony and Salomon, and our team in St Helens can help you find a fit that suits your foot and your mileage. We offer next-day delivery and free click and collect.
Please note: This guide is general information for runners, not medical advice. If you have pain that is severe, persistent or getting worse, see a GP, physiotherapist or qualified sports clinician for diagnosis and treatment.