Runner’s knee is pain behind the kneecap. It may also be called patellofemoral disorder, patellar malalignment, patellofemoral pain syndrome, and chondromalacia.
Runner’s knee can occur from overuse of the knee in sports and activities such as running, walking, jumping, or bicycling.
The kneecap (patella) is attached to the large group of muscles in the thigh called the quadriceps. It is also attached to the shin bone by the patellar tendon. The kneecap fits into grooves in the end of the thigh bone (femur) called the femoral condyle. With repeated bending and straightening of the knee, you can irritate the inside surface of the kneecap and cause pain.
Runner’s knee also may result from the way your hips, legs, knees, or feet are aligned. For example, if you have wide hips or underdeveloped thigh muscles, or if you are knock-kneed You may also have this problem if your foot flattens too much when you walk or run (a condition called over-pronation).
The main symptom is pain behind the kneecap. You may have pain when you walk, run, or sit for a long time. The pain is usually worse when you walk downhill or down stairs. Your knee may swell at times. You may feel or hear snapping, popping, or grinding in the knee.
Your healthcare provider will review your symptoms and examine your knee. You will have knee X-rays. You may have an MRI to check for damage to the surface of the patella or femur or another injury.
Treatment includes the following:
While you recover from your injury, you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to bicycle or swim instead of run.
In cases of severe patellofemoral pain syndrome, surgery may be recommended.
Pain behind the kneecap often lasts a long time and can come back after symptoms were better for a while. Treatment requires proper rehabilitation exercises that are done regularly.
Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.
You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:
Runner’s knee can best be prevented by strengthening your thigh muscles, particularly the inside part of this muscle group. It is also important to wear shoes that fit well and that have good arch supports.