Runner's Knee: Why It Happens and Exercises That May Help
Runner's knee usually reflects more load through the kneecap joint than it is currently prepared for. Reduce running volume temporarily rather than stopping, strengthen the quadriceps, glutes and calves, and rebuild mileage by roughly ten percent per week.
Pain at the front of the knee that appears a few kilometres into a run, worsens on downhills and aches after sitting is one of the most familiar patterns in running injuries.
What is going on
Patellofemoral pain, commonly called runner's knee, involves irritation of the joint between the kneecap and thigh bone. It typically follows a change in training: more distance, more hills, faster sessions or new shoes. Strength deficits in the quadriceps, glutes and calves increase the load the joint has to absorb with each stride.
Adjusting your running
Complete rest is rarely necessary. Reduce weekly distance to a level that keeps pain at or below three out of ten during and after running, avoid steep downhills initially, and consider slightly increasing your step rate, which may reduce load at the knee. Rebuild volume gradually once symptoms settle.
Running physiotherapy in Centurion
If you are training for a race and knee pain keeps interrupting your build up, a running assessment can look at your strength, training load and mechanics together rather than in isolation.
Exercise programme
Work within a comfortable range. Mild discomfort is common, sharp or increasing pain is not.
1. Spanish Squat
IntermediateStarting position: Standing with a resistance band looped behind your knees and anchored in front.
- 1Lean back into the band and bend your knees.
- 2Keep your shins fairly vertical and your trunk upright.
- 3Hold the position, then return to standing.
Suitable for: Reducing kneecap pain while loading the quadriceps.
Adjust depth so pain stays at or below three out of ten.
2. Single Leg Calf Raise
IntermediateStarting position: Standing on one foot with light hand support.
- 1Rise onto the ball of the foot.
- 2Pause at the top.
- 3Lower slowly over three seconds.
Suitable for: Runners, since calf strength absorbs a large share of running load.
Start with both legs if single leg is too demanding.
3. Hip Abduction Side Lying
BeginnerStarting position: Lying on your side with legs straight and stacked.
- 1Lift the top leg towards the ceiling.
- 2Keep the leg slightly behind your body and toes facing forwards.
- 3Lower slowly.
Suitable for: Strengthening the gluteal muscles that control the knee.
Avoid rolling backwards to make the lift easier.
When to stop and get assessed
- Knee pain above three out of ten during a run.
- Pain that is worse the morning after running.
- Swelling at the front of the knee.
When to see a physiotherapist
If pain persists beyond three to four weeks of load reduction and strengthening, or keeps returning each time you increase mileage, get assessed.
Related physiotherapy services
Frequently asked questions
Can I keep running with runner's knee?+
Often yes, at reduced volume and intensity, provided pain stays low during and after the run.
Do I need new running shoes?+
Shoes are one small factor. Comfort matters most, and shoe changes rarely fix a load related problem on their own.
How long does runner's knee take to settle?+
Many runners improve within six to twelve weeks with consistent strengthening and sensible load management.
Is a knee strap useful?+
Some runners find a patellar strap reduces symptoms during running. It is a comfort aid rather than a treatment.
Medical disclaimer: this article is general education and does not replace a personal assessment. If your pain is severe, worsening, or accompanied by numbness, weakness or loss of bladder or bowel control, seek care promptly.
Book with N S Physiotherapy
In clinic in Eco Park, Centurion, or home visits across Centurion and Midrand.
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