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  • Writer's pictureMary Brooking

Injury spotlight: Runner's knee

Pain over the outside of the knee or behind the kneecap when running or going downstairs and which worsens with movement? Did it initially stop when you stopped running but has become a constant ache?


Runner's knee (PFPS or Patellofemoral pain syndrome) is perhaps the most common running knee injury which often starts in new runners when their distance reaches about 15-20 miles a week. In experienced runners increasing their mileage when training for a marathon it seems to arise often when their long run reaches 14-16 miles. It often co-exists with ITB (iliotibial band) syndrome and the causes are very similar.



The knee is a complex joint which can be injury prone if its foundation in the ankle and foot are wobbly and its controlling muscles in the hip are weak; preventing knee problems frequently involves building balance and strength through the hip, ankle and foot.


PFPS is pain between the inner surface of the kneecap (patella) and the base of the thigh bone (femur) as the patella is not tracking properly within its groove on the femur. The ITB is a band of connective tissue that travels down the side of the thigh from the outside of the hip to the knee. It's controlled by hip muscles, the TFL and glute max, and helps keep the knee aligned. If the ITB is overworked attempting to keep the knee aligned the TFL and Glute Max tighten and the ITB gets pulled tight against the lateral knee joint causing friction and pain, being ITB syndrome, and contributing to creating PFPS by pulling the patella laterally away from its tracking groove.


Don't ignore the niggle; stop it progressing:

  • Strength & conditioning work focussed on hip and core strength to enable better knee control

  • Improving functional balance and ankle & foot mobility

  • Sports massage & foam rolling to reduce tension in quads, TFL and glutes

  • Gait analysis to identify areas of weakness or a stride pattern which might be provocative e.g. too narrow a stride width

  • Running shoe & insert/orthotics assessment

  • Taping the knee can mean you can continue to run whilst building up muscle strength to provide long term knee support

  • Follow a training plan which increases running distance/volume slower

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