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Understanding Knee Pain – Runner’s Knee

Knee pain is one of the more common symptoms experienced by the average person that can affect day to day activities, and reduce the enjoyment of sports and exercise. In this article, we will be discussing runner’s knee to help you better understand the condition, and what you can do about it.


Signs and symptoms

Runner’s knee is one of the more prevalent types of knee pain. You may be out running one day, or even just doing your daily chores when, you feel a sudden pain in your knee. It’s not uncommon to worry, or wonder why the knee is painful now. There are many different conditions of knee pain, with each requiring their own management and treatment. Here are some signs and symptoms that may indicate that you have runner’s knee:

  • It is painful to bend the knee: Runner’s knees tend to worsen with activities that involve bending the knee, or putting weight with the knee in a bent position. You may find it painful to kneel, squat and climb stairs. When the knee is very sore, you may even experience discomfort from prolonged sitting!

  • The pain is around the front of the knee: Pain from runner’s knees tend to be felt around the front of the knee. It can also sometimes be felt around the sides of the knee, or under the knee cap.

  • Clicking and grinding sounds when moving the knee: You may hear occasional clicks, or crunchy sounds when moving the knee. Although they may sound scary, it is important to remember that clicking and grinding sounds are also commonly heard from healthy, non-painful knees.

  • Swelling: You may notice some mild swelling around or under the knee cap. In rare instances, too much swelling may restrict the movement of the knee.


Why you may have runner’s knee

Runner’s knee occurs when there is irritation, or injury, of the tissues between the knee cap (patella) and the thigh bone (femur). There are some common risk factors for runner’s knee, but it is also important to understand that although these risk factors increase the chances of developing runner’s knee, these factors may not always result in the development of knee pain.

  • Running or exercise intensity: One common reason for developing knee pain is a sudden increase in the difficulty or amount of exercise that you do. A common situation where this may occur is if you exercise mainly only on the weekends, without regular exercise or movement during the rest of the week. This sudden spike in activity causes excessive strain around the muscles and ligaments of the knee, which are not conditioned for the increased load, leading to the onset of pain and soreness. Even the best athletes in the world will feel knee pain if they overuse their knees in a short period of time.


  • Knee alignment: How the femur aligns with the rest of the leg, such as the hip and ankle joints, may also affect the development of runner’s knee. Conditions such as knock-knees, bow-legs, or flat feet may increase the strain felt by the knee during exercise, making it easier to experience knee pain.

  • ·Muscle weakness: There are muscles of the hip and thigh that control how the knee cap moves during exercise. When we bend and straighten the knee, these muscles work to keep the knee cap in good alignment with the femur during movement. When these muscles are weak, or the exercise is too difficult, these muscles may tire quickly and not be able to control the alignment of the knee cap as well.

  • ·Muscle tightness: If the muscles of your ankles and hips are tight, they may also cause excessive strain on the knee joint. For example, the quadriceps, hamstrings and calf muscles join across the knee. When these muscles are particularly stiff and inflexible, they will not be able to absorb force or move as well, leading to increased force and strain on the knee.


What you can do to help manage runner’s knee

  • Managing exercise intensity: It is common to stop running or exercising when you have knee pain. While a short period of rest is helpful when the knee is particularly sore, or there is swelling, stopping exercise for too long can result in a loss of muscle strength and control. Doing another type of sport, such as swimming or light cycling, or working on upper body or trunk exercises will help keep the body strong and flexible, while allowing time for the knee to rest and recover. A physiotherapist will be able to help you plan an exercise program to maintain strength and flexibility without worsening your knee pain, so that you can quickly return to doing what you enjoy.


  • Strength training: Improving the strength and control of the muscles of the legs that control the femur and knee cap alignment will be important for effective management of runner’s knee. Key muscles to work on usually involve improving the function of the muscles of the thigh, the gluteal muscles around the hips, as well as the calf muscles. It is also beneficial to include some exercises that target the trunk muscles, as poor upper body posture can lead to increased knee strain during sports and exercise.



  • Flexibility: Improving the flexibility of the muscles around the knee can be helpful in reducing knee pain, by reducing the tension and strain from tight tissues on the knee. Although taking time to do stretching may feel it is reducing the time to do the actual sport or exercise, that time spent doing stretching can reduce chances of injury and development of knee pain, which may sometimes take a few weeks to recover.


Runner’s knee is a common type of knee pain experienced by many during running, or exercise. Some common reasons for developing runner’s knee include overuse injury, or muscle weakness and tightness that increase strain across the knee. A physiotherapist will be able to assess what is the cause of your knee pain, and provide a treatment plan for you to manage your knee pain effectively. . If you are looking for help to reduce knee pain or recover faster, feel free to contact our team of dedicated therapists at info@prophysio.com.sg or 6581 9688.

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