Runner’s Knee

The Rundown on Runner’s Knee

The name is obviously the giveaway here – runner’s knee is a condition often suffered by dedicated runners and a common complaint seen by the Sydney Podiatrist team. But while runner’s knee can often ground exercise junkies who love the thrill of hitting the pavement, that’s not to say that it can’t strike anyone.

The 1, 2, 3 of Runner’s Knee

Essentially, runner’s knee is the overarching category to define any problems of the bone which protects the knee joint – and it generally comes on gradually. These are the different types and causes of kneecap (patella) pain which can stop runners in their tracks.

  1. Patellofemoral Pain Syndrome (PFPS)

This type of runner’s knee usually causes pain on the front of the knee, which generally feels like a dull ache. While it affects runners, cyclists and hikers, PFPS runner’s knee can ironically present in sedentary people. Anyone who sits a lot on the job has a constantly flexed knee which contributes to the fatigue of the kneecap.

  1. Chondromalacia

Chondromalacia patellae explains the process of deterioration that can happen to runners over many years. With Chondromalacia patellae, the cartilage found in the underside of the patella breaks down. When that part of the kneecap softens or wears away, runner’s knee kicks in. Most often this type of runner’s knee is defined by an aching knee cap, a grinding sensation or stress when bending.

    1. Iliotibial Band Syndrome

ITBS tends to involve pain in the side of the knee. The IT band are the tendon-type structures that cover the side part of the knee and the thigh – connective tissues which act as a stabilizer when the knee flexes and extends. ITBS occurs most prominently as a result of overuse, and is known to affect cyclists if they have the wrong bike posture.

Root Causes of Runner’s Knee

Just because you’re a keen jogger or marathon runner, doesn’t necessarily mean your daily run is the only thing to blame for runner’s knee. Yes, overuse is one of the main reasons for the development of runner’s knee, but it’s worth considering there may be other factors contributing to problems of the patella.

  1. Over pronation in the feet
  2. Patella trauma
  3. Dislocation of the kneecap
  4. Tight thigh muscles
  5. Weak hips
  6. Lack of stretching
  7. Arthritis
  8. Extended sitting

What are the Signs of Runner’s Knee?

What you’ll probably notice first is that your knee begins to hurt in and around the kneecap.

Podiatrists and physiotherapists say many patients describe the feeling as like a rubbing or grinding, or a popping or clicking sensation that can also be heard.

Because the kneecap is free floating, moving back and forth and not in a straight line, that unsteady movement puts the kneecap at risk of coming off track.

One patient at the Sydney Podiatrist Clinic who is a long-distance runner says she knew she might be dealing with runner’s knee when she started getting burning pain in the kneecap after her regular 10km runs. Sometimes that runner’s knee pain would last for hours after her workout.


No athlete wants to be side lined forever, so it’s of comfort to know there are plenty of options available when it comes to runner’s knee treatment.

The first course of action for runner’s knee treatment is rest, pain relief and physiotherapy.

But if you continue to have pain behind and around the knee cap, then it’s worth having a podiatrist delve a little deeper to analyse your foot structure and your gait.

Poor foot alignment and lower limb mechanics can affect the position of the knee – and if you have flat feet for example, that can adversely affect the rotation of the whole leg.

Physical assessments, resistance testing of the knee, stretching exercises and 3D foot scans for the fitting of sports orthotics are all part of the professional arsenal available when it comes to runner’s knee treatments – professional direction to rectify the encroachment of runner’s knee pain to ensure you hit your stride again in no time.