Understanding knee pain in runners
Why does my kneecap hurt?
Pain around or behind the kneecap is often linked to patellofemoral pain syndrome (PFPS), commonly called runner’s knee. This condition is typically aggravated by activities that load the knee in a bent position — such as running, going up or down stairs, squatting, or sitting for long periods.
Other possible causes of similar pain include:
- Patellar tendinitis – pain just below the kneecap.
- Iliotibial (IT) band syndrome – pain on the outer side of the knee.
These conditions can stem from a quick jump in training mileage, structural or biomechanical issues, or muscle weakness in the hips, knees, or ankles.
Common factors that contribute to knee pain in runners
Several issues can increase stress on the knee and lead to pain, including:
- Weak hip and knee muscles.
- Tightness in the quads, hamstrings, or calves.
- Excessive inward knee or foot movement during running or squatting.
Addressing these factors through strengthening, flexibility work, and running form adjustments can reduce pain and improve performance.
Staying active while managing pain
Activity modification is often part of treatment. A pain scale can help guide your training:
- 0–2/10: Green light — safe to continue.
- 3–5/10: Yellow light — monitor for 24 hours; if pain returns to baseline by the next day, continue with caution.
- Above 5/10: Red light — stop and reassess.
Also, avoid increasing weekly running mileage by more than 10%. This gradual progression helps prevent overuse injuries.
Some runners benefit from additional supports, such as Kinesio taping or foot orthotics, which can reduce strain on the knee.
When to see a physical therapist for runner’s knee
A physical therapist can perform a comprehensive evaluation, including a running gait analysis, to determine the root cause of your pain. They can then design a personalized plan that may include:
- Targeted strengthening and stretching.
- Running form coaching.
- Training load adjustments.
- Taping or orthotic recommendations.
If knee pain is interfering with your training, don’t push through it without a plan. Find a Therapeutic Associates Physical Therapy clinic near you to get assessed and return to running with confidence.
Start your physical therapy journey today.
As physical therapists, we know the importance of movement for overall health and well-being. From injury recovery to achieving optimal performance, our passion is to help every patient reach their goals and live an active, pain-free life. Get started with PT today!
