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Runners knee

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 4 minutes read

Runner’s knee is a condition characterised by a dull, aching pain felt around or under the knee cap at the front of the knee. The pain is typically worse during or after physical activity such as running or jumping, when walking up or downstairs and when sitting for long periods. Runner’s knee is very common and, as the name suggests, most often affects runners or those who perform regular exercises involving running or jumping.

What is actually causing the pain?

The kneecap, or patella, sits at the front of the knee and is responsible for transmitting the force from the quadriceps muscle to the shin bone to enable the knee to straighten. Significant forces are placed through the patella when walking up or downstairs, running or jumping.

The causes of runner’s knee pain are poorly understood. However, factors that are thought to cause runner’s knee include a sudden change or increase in training programmes, muscle tightness around the knee or hip, muscle strength imbalance around the knee or hip, anatomical abnormalities around the knee and poor running biomechanics.

The majority of people with runner’s knee see improvement in their symptoms without needing any treatment. Simple self-help measures can be very effective at relieving symptoms caused by runner’s knee, these include;

  • Stretching exercises of your hamstrings and quadriceps
  • Weight loss if you are overweight
  • Application of an ice pack after periods of exercise
  • Strengthening exercises of your hamstrings and quadriceps

When to see your doctor?

If your symptoms have failed to improve despite these simple measures after six weeks you should contact your doctor. Your doctor may refer you to a physiotherapist for further management. You may be offered a structured stretching and exercise programme which is very effective at relieving your symptoms. People often see significant improvement in their symptoms with these exercises, though this can take up to 12 weeks for improvements to be felt.

What will the doctor do?

The doctor will ask you about your symptoms and examine you. If they are satisfied that you have runner’s knee they may refer you to see a physiotherapist, depending upon local services available.

Very rarely, if your symptoms fail to improve despite physiotherapist input, you may be referred for further investigation such as an MRI or to an orthopaedic surgeon. Only very occasionally does runner’s knee require consideration of surgery.

Runners Knee vs Other Conditions

Osteoarthritis of the knee

Osteoarthritis (OA) is a degenerative joint disease characterised by the breakdown of cartilage in the knee joint. It is commonly associated with ageing, joint injury, obesity, or genetic factors. Pain, stiffness, swelling, and reduced range of motion in the knee joint. Symptoms may worsen with weight-bearing activities and improve with rest. Crepitus (grinding or cracking sensation) may also be present. Management focuses on pain relief, preserving joint function, and improving quality of life. This may include weight management, physical therapy, NSAIDs, corticosteroid injections, viscosupplementation, or, in severe cases, surgical interventions such as arthroscopy or knee replacement.

Ligament injuries

Ligament injuries, such as ACL tears, often result from sudden twisting or hyperextension of the knee joint during sports or physical activities. At the time of injury, immediate pain, swelling, instability, and sometimes a popping sensation may occur. Difficulty bearing weight on the affected leg and limited range of motion may also occur. Treatment depends on the severity of the injury and may include rest, ice, compression, and elevation (RICE), followed by physical therapy to restore strength and stability. Severe tears may require surgical reconstruction of the ligament.

Meniscal tears

Meniscal tears can occur due to sudden twisting or pivoting motions of the knee, particularly in athletes or individuals with degenerative changes in the knee joint. Pain, swelling, stiffness, and locking or catching sensation in the knee joint. Symptoms may worsen with activities that involve bending, twisting, or bearing weight on the affected leg. Treatment options include rest, ice, compression, and elevation (RICE), along with physical therapy to improve strength and flexibility. Severe tears or those causing significant symptoms may require arthroscopic surgery to repair or remove the damaged meniscus.

Patellar tendonitis (jumper's knee)

Patellar tendonitis is an overuse injury characterised by inflammation or degeneration of the patellar tendon, which connects the kneecap to the shinbone (tibia). It commonly occurs in athletes involved in jumping or repetitive activities.

Pain and tenderness around the lower part of the kneecap, especially with jumping, running, or kneeling. Stiffness and swelling may also be present, particularly after activity.

Treatment focuses on rest, activity modification, ice, and anti-inflammatory medications to reduce pain and inflammation. Physical therapy to strengthen the quadriceps and improve biomechanics may also be beneficial. In severe cases, corticosteroid injections or surgery may be considered.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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