What runner's knee feels like
Runner's knee, or patellofemoral pain if you want the clinical name, is a dull ache around or behind the kneecap. It usually builds during a run rather than arriving all at once. Most runners notice it more going downhill or down stairs, when they squat or kneel, or after sitting for a while with their knees bent.
Why it happens
Most of the time it comes down to load. The knee is being asked to do more than it's ready for. A jump in mileage, more hills, faster sessions or a change of shoes can all be enough to tip it over.
The muscles around the knee decide how that load is shared, and the quads do a lot of that work. They attach to the top of the kneecap. When they're tight and tired, they can press the kneecap harder into its groove on the thigh bone, which is one reason the front of the knee starts to ache. Studies that followed athletes over time have linked tight quads with a higher chance of developing this kind of knee pain.
Weak hips and glutes, the way your foot lands and your running form can all play a part too. Everyone's mix is different, which is why we look at the whole leg rather than just the sore spot.
How we treat it
We start with an assessment: where the pain is, what sets it off, what your training looks like, and how your hips, knees and feet are moving.
For a lot of runners, tight quads are a big part of the picture. Sports massage and dry needling can ease that tension and settle the pain, which gives you room to keep moving. They work best as part of a plan rather than on their own.
The longer-term fix is strength and sensible load. That means exercises for your quads, hips and glutes, and a running plan that builds back up gradually. It's what stops the pain coming back.
What you can do now
- Ease back rather than stopping. Cut the runs that hurt, usually the hills and the long run, and keep the ones that don't.
- Keep an eye on the pain. Mild discomfort that has settled by the next morning is usually fine. Pain that builds as you run, or is still there the next day, means back off a bit more.
- Start strengthening. Wall sits, slow step-downs from a low step and side-lying leg raises for your hips are a good place to begin.
- Stretch or foam roll your quads if it feels good. It won't fix the problem on its own, but it can ease the tightness between sessions.
When to get it checked
Book in if the pain hasn't settled after a couple of weeks of easier running, if the knee swells, locks or gives way, or if the pain started with a fall or a twist. Those can be signs of something other than runner's knee.
If you'd like us to take a look, you can book an assessment online at our Sandymount clinic.
This article is general information, not a diagnosis.