The Center for Podiatric Care and Sports Medicine

What’s Runner’s Knee?

Posted by on Tuesday, April 23rd, 2013


Do you have pain behind the kneecap? Does it hurt to squat, kneel, run, sit, or bend your knee? Is it difficult for you to walk downhill or downstairs? Is there a popping or grinding in your knee? How about noticeable swelling? These are the symptoms of a medical condition known as patellofemoral pain syndrome — or, more colloquially, as “runner’s knee.”

What Is Runner’s Knee?

A closer inspection through a CT scan, x-ray, or MRI will help the doctor rule out other conditions and reveal internal damage to the knee. Sometimes doctors will find a tear in the meniscus, bursitis, bone or cartilage contusion, tendinopathy (a disease of the tendons), or a stress fracture instead.

If you have runner’s knee, then the pain you are feeling is the base of the femur gliding across the patella (knee cap). Usually, a smooth layer of cartilage protects you from feeling this routine movement, but some individuals soften and wear down the cartilage through injury or intense physical activity, causing the joint lining to become painfully irritated.

What Causes Runner’s Knee?

“Pinpointing a single cause of runner’s knee is difficult,” explains Runner’s World. “It could be a biomechanical problem—the patella may be larger on the outside than it is on the inside, it may sit too high in the femoral groove, or it may dislocate easily. Also, worn cartilage in the knee joint reduces shock absorption, high-arched feet provide less cushioning, and flat feet or knees that turn in or out excessively can pull the patella sideways.” Furthermore, tightened calves and hamstrings, weakened quadriceps, or even just the repetitive force of movement can trigger symptoms.

How Is Runner’s Knee Treated?

The American Academy of Orthopedic Surgeons recommends the RICE treatment for runner’s knee:

  • Rest: Take a load off! If you must do something, switch to swimming, which is easy on the joints.
  • Ice: Apply cold packs for a short duration, several times a day.
  • Compression: Use an elastic band that fits snugly over the knee.
  • Elevation: Keep the knee resting above the heart as often as you can.

Pain relief through ibuprofen or aspirin is also recommended to manage the symptoms. Stretching is also important therapy. If these home care treatments do not ease your suffering, you will need to see a doctor.

How Can A Podiatrist Help?

A podiatrist can fit you with custom orthotics to correct your gait. A 2003 study found that more than 76 percent of patients with runner’s knee saw “a significant decrease in the level of pain” and the disappearance of symptoms after receiving custom orthotics. It should also be noted that these particular patients did not respond to other treatments.

Dr. Stephen M. Pribut DPM, a past President of the American Academy of Podiatric Sports Medicine, explains how the orthotics work to alleviate pain in greater detail: “Orthotics limit the maximum amount of excessive pronation. They also have been demonstrated to reduce the speed (acceleration) of internal tibial rotation. Reducing the speed of internal tibial rotation will reduce the amount of sudden stresses applied to the undersurface of the patella and the need for the VMO ( vastus medialis ) to work so hard in maintaining proper tracking and positioning of the patella. As per Newton’s Laws slower motions will require less force to counterbalance them.”

A podiatrist can also conduct a gait analysis to find out if your running or walking is contributing to the condition. If you need help learning how to wrap the knee properly, stretch, or perform regular exercises that strengthen weak muscles, our NYC Center for Podiatric Care and Sports Medicine can help!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.