Understanding Runner’s Knee

If you’re an avid runner or engage in high-impact activities, you might be familiar with the term “runner’s knee.” This common condition, clinically known as patellofemoral pain syndrome (PFPS), can cause some serious discomfort around the kneecap and interfere with your fun activities in life. Whether you’re a seasoned marathoner or a recreational jogger, understanding the causes, symptoms, and management strategies for runner’s knee is essential for maintaining your knee health and enjoying pain-free movement.


Runner’s knee, or PFPS, refers to a broad spectrum of knee pain experienced around the patella (kneecap) and the surrounding structures. This condition typically arises from repetitive stress or overuse of the knee joint, resulting in irritation and inflammation. While running is a common trigger for runner’s knee, it can also affect individuals who participate in activities that involve frequent bending and straightening of the knee, such as cycling, hiking, or stair climbing.


The symptoms of runner’s knee may vary in severity but often include:

  • Dull, aching pain around or behind the kneecap, especially during physical activity or after prolonged periods of sitting with the knees bent
  • Swelling and tenderness around the kneecap
  • Crepitus or a grinding sensation when moving the knee
  • Instability or a feeling of the knee giving way

While runner’s knee is commonly associated with running, individuals of all ages and fitness levels can experience this condition, particularly if they engage in repetitive movements that place stress on the knee joint.


Diagnosing runner’s knee typically involves a thorough physical examination and assessment of the individual’s medical history and activity level. Specific orthopedic tests help to evaluate knee alignment, muscle strength, and flexibility. X-rays or MRI scans may be ordered to rule out other potential causes of knee pain, such as fractures or ligament injuries.

At Life Moves MT, our practitioners are trained in the orthopedic assessments used to identify runner’s knee. Please remember that while Licensed Massage Therapists (LMTs) may use these results to inform their treatment plan and recommendations, or to communicate findings to the Chiropractor, LMTs cannot legally provide a diagnosis to you, the client.


Managing runner’s knee often involves a combination of conservative treatments aimed at reducing pain and inflammation while addressing underlying biomechanical factors. Some common treatment strategies include:

  • Rest: Giving the knee adequate rest to allow the irritated tissues to heal and recover. Remember, once the joint and surrounding tissues are “angry” (inflamed), they will respond more sensitively to all activity. Think of this as a “cooling off” period.
  • Ice/Heat Therapy: Applying ice packs or a combination of ice and heat packs to the affected area can help to reduce swelling and/or increase circulation.
  • Massage Therapy: Clinical massage can help to ease discomfort and increase circulation (good for healing) as well as address other imbalances developing due to compensations from discomfort.
  • Chiropractic Adjustment: Healthy joint alignment is key in supporting proper body mechanics during and after healing. 
  • Frequency-Specific Microcurrent: Microcurrent can help alleviate inflammation in the affected tissues and promote increased ATP production to help speed up recovery. 
  • Strengthening Exercises: Incorporating exercises to strengthen the muscles around the knee can improve joint stability and reduce stress on the patellofemoral joint.
  • Stretching: Performing gentle stretching exercises to improve flexibility and reduce muscle tightness.
  • Orthotics: Using supportive shoe inserts or orthotic devices can help correct biomechanical imbalances and improve foot and knee alignment.
  • Patellar Taping: K-tape (kinesiology tape) applications can provide additional support and alignment.

In cases where conservative treatments fail to provide adequate relief, or if there are underlying structural issues contributing to the runner’s knee, more advanced interventions such as corticosteroid injections or surgical procedures may be considered.


Prevention is key to avoiding the recurrence of runner’s knee and maintaining knee health in the long term. As one of our favorite orthopedists likes to say, “overuse” injuries are really just “underprepared” injuries. So with that in mind, here are some preventive measures:

  • Gradually increase training intensity and mileage to allow the body to adapt to the demands of running or your activity of choice. We all want to think we’re super human, but shifting to a mindset of respect for our joints can help calm the ego and keep us from pushing too hard when we should be easing into training.
  • Using proper footwear suited to your foot type and proper body mechanics. When it comes to running, hiking, cycling, etc. it is very easy to get started without any coaching on form or feedback on your body mechanics. If you’re doing an activity regularly, get someone knowledgeable to watch you on occasion and provide feedback. Or at least take videos of yourself to review. Not sure what to look for? We provide body mechanic feedback at our clinic (in-person for local, and online for non-local).
  • Incorporating cross-training activities to reduce repetitive stress on the knees and promote overall fitness. For general fitness activities, cross training is key for proper joint stability. For athletes looking to train at the end of a spectrum (think elite or pro level training, extreme endurance, or extreme strength), there is more nuance in striking a balance that protects your joints but also supports your goals. Here again, professional input is essential to your longevity in your sport. 
  • Listening to your body and addressing any signs of pain or discomfort promptly to prevent exacerbation of symptoms. Pushing through does not make you tough. It just steals away future time in your favorite hobby. Leaving a joint dysfunctional for an extended period of time contributes to earlier signs of degeneration in the joint and arthritic conditions. 

Maintaining a balanced exercise routine that includes strength training, flexibility exercises, and rest days to prevent “overuse” injuries. Recovery is as important if not more important than your actual training. Schedule it and commit to it with the same diligence as you do your training routine.

By understanding the underlying causes of runner’s knee and implementing appropriate preventive measures and treatment strategies, individuals can effectively manage this condition and continue to enjoy their favorite activities without knee pain. If you’re experiencing persistent knee discomfort or are unsure about the best approach to managing runner’s knee, consult with a professional for personalized guidance and support. Prioritize your knee health, stay active, and keep running strong!