Runner’s Knee Is Fairly Common, But These 5 Prevention Tips Can Help Fend It Off

You’re bending into a squat or climbing some stairs and notice that your knee feels tender and painful. Sound familiar? If so, you could be dealing with a condition called runner’s knee. 

As the name suggests, this is an injury frequently experienced by runners. “When you’re running, there’s a lot of force that goes into that area,” explains James Bicos, MD, a sports medicine orthopedic surgeon with Corewell Health in Bingham Farms, Michigan. Over time, this can irritate your knee.

But even though runner’s knee is painful—not to mention, can seriously limit your ability to move and train—it doesn’t have to mean the end of your running career. Read on for what to do if you think you may have runner’s knee, plus strategies to help prevent this injury from developing in the first place. 

What Is Runner’s Knee?

Officially called patellofemoral pain syndrome (or PFPS), runner’s knee refers to pain in the front of the knee or around the kneecap, says Todd M. Melegari, MD, a sports medicine orthopedic surgeon at GBMC Healthcare in Towson, Maryland. He explains that this area is prone to irritation because of the way the kneecap moves. “It glides back and forth, and has a tendency to sit at a bit of a tilt,” he says. “Extra friction there can lead to inflammation and ultimately pain.”

What Causes Runner’s Knee?

Runner’s knee can have a few possible causes, Dr. Melegari says, but the most common is simply overuse. Excessive movements over time can put strain on the area and lead to inflammation. This frequently happens to people who run a lot, since running places extra force on the knee. But other kinds of repetitive movements can cause it, too, like squatting, jumping, and cycling. 

“Runner’s knee got its name because we see it in a lot of runners, but you don’t have to be a runner to get it,” Dr. Bicos says.

Some people develop runner’s knee after an injury, while others might experience pain as a result of weakness in another part of the body—weak thigh muscles, tight Achilles tendons, poor foot support, cartilage abnormalities, or incorrect running form can all lead to runner’s knee. Younger people and those assigned female at birth have a higher risk of developing PFPS; in older adults, arthritis is more often to blame for knee-related pain.

Runner’s Knee Symptoms

You don’t have to be moving in order to experience symptoms of runner’s knee—in fact, some people experience discomfort even when they’re sitting completely still. You might have:

But the most common symptom you’re likely to notice is that bending your knee makes things worse, says Dr. Melegari. You’re likely to experience pain when you’re running, walking, riding a bike, or climbing stairs—a frequent complaint, he says, since when you’re bending the knee, you’re putting extra weight on the area. “Your knee is experiencing pressure up to five times your body weight [when you climb stairs], so if there’s any irritation, that’s when you’re going to notice it.”

You also might feel tightness or tenderness in surrounding muscles that support your knee, according to Frank B. Wyatt, an exercise physiologist. Cyclists may be more likely to feel this in their quadriceps and glutes, he says, while runners might feel tenderness along the outer portion of the upper leg.

How to Prevent Runner’s Knee

It’s not always possible to prevent runner’s knee, especially if an underlying health issue is playing a role. But many cases of PFPS can be prevented by taking steps to avoid overuse, experts say. Here’s what they recommend:

1. Do Exercises Correctly—and Safely

Whether you’re running, cycling, or doing HIIT or strength movements like squats, jumps, and lunges, proper form is key. If you’re not sure whether you’re doing a movement correctly, consider working with a physical therapist or personal trainer for guidance. Taking a class on the Peloton App can also provide a helpful visual for what the correct form looks across various moves and modalities. 

And always wear the right shoes for whatever activity you’re doing, making sure they fit you well.

2. Add Some Variety

Runner’s knee is caused by repetitive movements over time, so supplementing runs with other forms of exercise can help minimize that repetitive stress. “Try mixing up your routine,” says Travis Frantz, MD, an orthopedic surgeon at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford. If running is what you love most, he says, just make sure to also add in some strength training, swimming, yoga, or indoor cycling, for example.

3. Stretch

Before and after every workout, take time to stretch or massage your legs with a foam roller, focusing in particular on muscles that support your knee like the quads, hamstrings, and glutes. “This facilitates blood flow to that region and reduces the tightness that leads to excessive tendon strain,” Wyatt explains.

4. Maintain Your Strength

Runners are often laser-focused on miles logged. But to prevent runner’s knee, “maintaining strong, flexible, and balanced quadriceps and hamstrings muscles can also help,” Dr. Frantz says. Strength training exercises that target your lower body help keep these muscles strong so they can support your knee and lower your risk of injury.

5. Build In Time for Rest

“You cannot run 100 miles per week for 52 weeks of the year,” Wyatt says. Scheduling rest days into your fitness routine is critical: Rest gives all of your joints, including your knees, time to recover so they don’t eventually become strained and irritated.

Runner’s Knee Treatment

If runner’s knee comes on suddenly and isn’t interfering with your life, you can consider waiting a few weeks to see if the pain improves, Dr. Bicos says. During that time, it’s a good idea to stretch frequently and ice your knee to help reduce inflammation. But if the pain is excessive, limits your movement, makes it hard for you to sleep, or lingers after four to six weeks, your best bet is to make an appointment with your primary care doctor or an orthopedic surgeon. (And of course, always feel empowered to reach out to your healthcare provider sooner.)

Your doctor will examine your knee and look at any swelling you’re experiencing, as well as ask about your symptoms. They may also recommend additional tests like an x-ray, MRI, or ultrasound to determine exactly where your knee pain is coming from.

In most cases, runner’s knee treatment involves the following:

Most cases of runner’s knee can be managed without having to turn to surgery, Dr. Frantz says. But if your runner’s knee is caused by a more rare issue like an underlying bone or cartilage problem, “you may benefit from surgical intervention,” he says.

Is There a Typical Runner’s Knee Recovery Time?

Recovery time for runner’s knee can vary a lot from person to person. Yours will depend on how severe your pain was, as well as how long your symptoms lasted before you started resting. Everyone is different, but in general, your knee might start feeling better after a few weeks of treatment, experts say. But the longer you’ve been dealing with pain, the longer your runner’s knee recovery may take, Wyatt notes—which is why it’s important not to ignore or try to “push through” the pain.

As for running? Most experts recommend waiting until your pain improves before starting again. “Running is probably not causing harm,” Dr. Melegari says, “but irritating something that’s already irritated makes it hard to get over that hump.” 

If non-running exercises like strength training, swimming, and indoor cycling don’t trigger pain, you might be able to continue doing those while you recover. But check in with your doctor, go slow, and always stop if symptoms flare up again: “It seems simple, but if it hurts, then don’t do it,” Dr. Frantz says.

The Takeaway

Runner’s knee is often caused by overuse—over time, all of those steps hitting the pavement or treadmill without proper rest and support can put strain on your knees and lead to pain and inflammation. Having a well-balanced exercise routine can help prevent runner’s knee, as can making sure you’re regularly working to strengthen muscles like your quadriceps and hamstrings, which support your knee. Sometimes runner’s knee resolves on its own, but if symptoms linger, it’s important to see your doctor; pushing through the pain can make for a longer and more difficult recovery.