That Pain in Your Knee Could Be PFPS (aka Runner’s Knee)

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Could that pain in your knee be patellofemoral pain syndrome--aka runner's knee? That Pain in Your Knee Could Be PFPS (aka Runner’s Knee)

Although it is categorized as an overuse injury, PFPS—patellofemoral pain syndrome or runner’s knee—isn’t really a specific injury at all. PFPS is a blanket term for a number of different knee conditions.

And, runner’s knee isn’t limited to runners. Any athlete is susceptible to having PFPS, although sports that involve running and jumping have a higher incidence of the condition.

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How can you get runner’s knee?

Runner’s knee can be caused by a number of different things, most of the chronic conditions, although a fall or blow to the knee can result in PFPS. Knee surgery, especially ACL repair surgery that uses a patient’s own patellar tendon for the repair can also cause PFPS.

Chronic conditions that can cause runner’s knee include:

  • overuse, which is extremely common
  • flat feet
  • pronation
  • bones (from hip to knee) that are misaligned which prevent the knee from moving properly
  • chondromalacia patella, in which the cartilage under the knee cap erodes
  • thigh muscles that are imbalanced or weak
  • joints around the foot that are too loose allowing more movement than normal.

Runner’s knee is most often diagnosed in adolescents and young adults and more often in females than males.

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Symptoms of runner’s knee

The predominant symptom of runner’s knee is dull, aching knee pain although it can be accompanied by a popping noise, grinding feeling or swelling.

The pain can be felt most often in the front of the knee although it can be located around the knee or even behind it. The pain can be felt when you run, squat, kneel, get up from sitting or even just walking.

You may notice that the pain feel worse when you are walking down the stairs or walking down a hill.

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How is runner’s knee diagnosed?

So, if you suspect you have runner’s knee based on the symptoms listed above, there are things you can do on your own to lessen the pain and alleviate some of the symptoms. (We’ll get to those later.)

If you would rather have a definitive diagnosis, especially if you are in a great deal of pain and/or find the condition debilitating, a visit to an orthopedist is in order.

In addition to some physical tests, the doctor might suggest additional imaging tests in order to accurately diagnose the condition.

These tests may include an X-ray, CT scan or an MRI.

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How does a doctor treat runner’s knee?

Ideally, the hope is that a patient with runner’s knee would respond to the least-invasive treatment available.

The orthopedist will probably suggest taking over-the-counter pain relievers such as acetaminophen, ibuprofen or naproxen sodium. These might help with pain, swelling, and inflammation when taken at regular intervals.

He or she may also prescribe a course of physical therapy during which a patient would undergo strengthening exercises for the muscles that support the knee and help control the alignment of the leg. The physical therapist also might encourage the use of ice following therapy or physical activity, using a brace or taping for support and a switch to low-impact physical activities like cycling, swimming or aqua jogging.

Usually, a combination of any of those treatment options will result in improvement in the condition. In extreme cases that don’t respond to non-invasive treatment, the orthopedist may recommend arthroscopic surgery to remove damaged cartilage or realignment surgery to correct the angle of the kneecap or to lessen pressure on the knee cartilage.

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A DIY approach to rehabbing runner’s knee

You know what they say…“An ounce of prevention is worth a pound of cure.” Well, there are things you can do to help prevent the occurrence of runner’s knee.

These include:

  • Watch your weight—Maintain a healthy weight for your frame. Excess weight puts undue stress on the knees.
  • Ensure you are well-shod—Shoes that fit well and are supportive can absorb shock better than a pair that are poorly constructed with flimsy soles. If you have flat feet, which puts you at greater risk for knee issues, you might try wearing inserts in your shoes to offer extra arch support.
  • Pump up—Strengthen your quadriceps and hip abductor muscles. Stronger muscles will do a better job of keeping the knee in balance during physical activity.
  • Don’t go from 0 to 60 in seconds—Increase the intensity and frequency of your workouts (whatever they are!) gradually. Sudden changes in either can put you at greater risk for runner’s knee.
  • Get ready to sweat—Make sure you warm up slowly prior to any type of exercise. Light jogging or controlled dynamic drills are good warm-up options.
  • Stretch it out—Stretching after exercise or after long periods of sitting or standing can increase flexibility.

There are also stretches and strengthening exercises you can do on your own both to prevent runner’s knee but also to recover from it if you don’t have a severe case.

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Some of those stretches/strengthening exercises include the following.

  • Single leg balance—Stand upright with your arms at your sides. Raise your arms and one foot off the floor by bending your knee. Hold this position for 5 seconds. Complete 10 repetitions on both legs.
  • Mini squat—Stand upright with your feet hip-width apart. Drop into a shallow squat position by bending your knees and hips, hold for 5 seconds then straighten your legs back to standing. Remember to keep your back flat, not rounded, and don’t let your knees bend past your toes. Complete 10 repetitions.
  • Mini lunge—Stand upright. Step forward with one foot, lowering down into a shallow lunge position, holding for 5 seconds. Return to the standing position and repeat with the opposite leg. Do 10 repetitions on each leg. As with the mini squats, ensure that your knee doesn’t bend past your toes.
  • Alternating leg extensions in the quadruped position—Begin in the quadruped position: hands and knees on the ground, lower legs behind you. Extend one leg behind you so that it is parallel to the floor, with your toes pointing toward the floor. Hold for 5 seconds and return your leg back to the quadruped position. Complete 10 reps on each leg.
  • Iliotibial band stretch—Stand upright next to a wall. Cross your outside leg over the inside leg and place your lower arm against the wall. Press your hip gently toward the wall until you feel the stretch on the side of your leg. Hold for 5 seconds. Do 10 repetitions on each side.

These are only a few of the stretches and strengthening exercises indicated for runner’s knee. Many more can be found online or from your orthopedist or physical therapist.