How to Prevent and Treat Runner's Knee

Runner’s knee is one of those common overuse injuries that’s at first just annoying, but can end up being very painful if you ignore it. Fortunately, there are some simple strategies to both prevent and treat it.

Marked by pain and swelling around and sometimes behind the kneecap, runner’s knee is often aggravated by running downhill, squatting, going up or down stairs, or jumping. Your knee may feel stiff and sore after sitting down for long periods. You might even hear a clicking sound when you bend or extend your knee.

At first, you might only notice the pain and tenderness when running. As it gets worse, however, you’ll notice it during the day, even when you’re not exercising.

Causes of Runner’s Knee

Runner’s knee (also known as patellofemoral pain syndrome or anterior knee syndrome ) is usually caused by weakness in the middle quadriceps muscles and tight hamstrings or IT bands. Your quads should hold your kneecap in place, so it tracks up and down. But if they’re weak, your kneecap moves left and right and ends up scraping your cartilage, causing painful friction and irritation.

You may also be at risk if you overpronate (your feet roll inward) when you run. Running on uneven running surfaces or running in incorrect or worn-out running shoes may also a contributing factor.

How to Treat Runner’s Knee

First, you can reduce the pain and inflammation by icing your knees immediately after running. Experts also advise elevating your leg, compression knee wraps, or ibuprofen.

Stretching and foam rolling your hamstrings and IT bands can also help. Don’t run through pain. Take a couple days off from running or cross-train, as long as it’s pain-free. Activities such as swimming, cycling, and using an elliptical machine put less stress on your knees while still allowing you to maintain cardiovascular fitness. Be sure to start slowly and gradually increase the duration and intensity of these workouts.

You’ll know that it’s safe to start running again when you’re able to run with a normal gait and without pain. If you find that you’re limping or overcompensating because of pain, you’re not ready to run again.

When to See a Doctor

If you don’t get relief after trying the above recommended self-treatment for a few days, you may need to seek medical advice from a doctor or physical therapist. Runner’s knee sometimes has similar symptoms as other injuries, so it’s important to rule out other issues.

If you’re diagnosed with runner’s knee, your doctor or PT may recommend more rest, as well as stretching and strengthening exercises. If your runner’s knee is caused by overpronation (foot rolling inward when you run), he or she may also suggest over-the-counter arch supports or custom-fitted orthotics.

How to Prevent Runner’s Knee

To prevent future occurrences of runner’s knee, work on strengthening your quad muscles, which will help support and stabilize your kneecap. You can do simple exercises, such as forward lunges, squats, or straight leg raises.

Regularly stretching the muscles in your legs, including the quadriceps, hamstrings, and calves, can help maintain their flexibility and prevent tightness that may contribute to runner’s knee. Focus on both static stretches, where you hold a position for 15-30 seconds, and dynamic stretches, which involve controlled movements that mimic the motions of running. You can also massage your hamstrings, quads, and IT Bands with a foam roller.

Investing in a good pair of running shoes that provide adequate cushioning and support can help absorb the impact of each stride and reduce the strain on your knees. You can visit a running specialty store to make sure you have the right kind of running shoes for your foot type.

Also, don’t run in worn-out running shoes that have lost their cushioning. You should replace your shoes every 300-400 miles.

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Running coach, marathon runner, and fitness writer Christine Luff is an RRCA-certified running coach and ACE-certified personal trainer. Founder of the website Run for Good and author of the book Run for Good: How to Create a Lifelong Running Habit, she coaches runners, from beginners to advanced, who are training for races, from 5Ks to marathons.