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Unlock the Secrets to Avoiding Runner's Knee

Updated: Apr 21, 2023

Runners knee, or patellofemoral pain syndrome (PFPS), is one of the most common injuries among athletes and runners. PFPS can be an extremely troublesome issue if not taken care of, potentially causing enduring harm to the knees. In this blog post we will discuss an overview of PFPS, how to prevent it with prehab exercises, treatment options for those who are already suffering from runners knee, as well as conclude by stressing the importance of strength training in order to avoid future injuries. So whether you're a runner looking for prevention tips or someone dealing with PFPS already – read on.

What is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome (PFPS) is a common condition that affects runners, athletes, and active individuals. The misalignment of the quadriceps muscle group, iliotibial band (ITB), tibia tubercle, and patellar tendon can lead to irritation and inflammation of the kneecap that causes PFPS. The anatomy of PFPS involves the quadriceps, ITB, tibia tubercle and patellar tendon - any misalignment or overuse of which can lead to irritation and inflammation in the kneecap. It is important for the soft tissue surrounding the joint has the necessary flexibility and for the muscles in charge of moving the knee cap to have adequate strength. When these structures are out of balance due to overuse or misalignment of any one component, it can lead to PFPS.

Risk Factors and Symptoms of PFPS

Risk Factors

There are many risk factors that could lead to PFPS both anatomical and training errors could lead to this injury.

  • Excessive foot pronation/inadequate footwear

  • Tightness of Tensor Fascia Lata (TFL), Iliotibial Band, calves and hamstrings

  • Leg Length Discrepancy

  • Weak hip abductors, quads, glutes, core and external rotators

  • High weekly mileage

  • Increase in hill training (specifically downhill)

The likely cause of runner's knee is a combination of factors; simply citing pronation or tight/weak muscles, while possible culprits, does not provide the full picture. Understanding risk and training errors enables us to address this issue more effectively - giving runners the ability to take care of their health safely and successfully.

Symptoms of PFPS

Athletes suffering from PFPS may feel:

  • Pain/ache in front of their knee

  • Pain during or after engaging in physical activity

  • Pain after sitting for prolonged periods with the knees bent. This is because this particular position increases pressure between the femur and kneecap which can bring on discomfort - especially while running downhill.

  • Pain with kneeling, squatting or direct contact to the front of their knee area

  • Possible grinding/clicking and swelling around the knee

Prevention of Patellofemoral Pain Syndrome

Prehab exercises are a key component of injury prevention for runners. These exercises can bolster the muscles around the knee and hip, thus diminishing strain on those joints while running. Prehab regimens, such as glute bridges, diagonal walk outs, clamshells, front squats, and step-up/downs can be used to reinforce muscles that are vital for appropriate running posture. Furthermore, prehab exercises can be beneficial for improving hip and knee mobility to enhance a runner's stride.

Front Squats

Step Downs


Diagonal Walk Outs

Strengthening your core muscles is essential in avoiding the discomfort associated with patellofemoral pain syndrome among runners. Adding exercises such as planks and bird dogs to a strength training regimen can help you maintain good posture while running, resulting in less strain on your lower body joints including knees. To further capitalize upon this benefit of improved posture from strengthening the abdominals and back, engage these key muscle groups at the beginning of each exercise - whether it's an upper or lower body movement. Doing so will activate these important stabilizers throughout all workouts!

Maintaining proper musculature is key for a successful running experience. Neglecting to stretch can lead to imbalances that cause painful conditions like Runner's Knee and other injuries, so don't forget about stretching those quads, hamstrings, and calves regularly as part of your overall routine!.

By engaging in proper prehab exercises strength training and stretching, runners can reduce their risk of developing patellofemoral pain syndrome. For those already suffering from patellofemoral pain syndrome, let's investigate the available therapies.

Key Takeaway: Prehab exercises such as front squats, clamshells, step downs and diagonal walk outs can help strengthen the muscles around the knee and hip to reduce strain while running. Additionally, core strength training like planks or bird dogs will improve posture during runs to prevent patellofemoral pain syndrome.

Treatment of Patellofemoral Pain Syndrome

Dealing with PFPS is essential for runners who are experiencing this issue. The good news is that there are both at home treatments and professional treatments available to help alleviate the pain associated with patellofemoral pain syndrome (PFPS).

There are several self-care strategies that can be implemented to reduce the symptoms of PFPS. These include rest, ice, compression, elevation (RICE), stretching exercises, and strengthening exercises targeting muscles in the lower leg such as calf raises and quadriceps stretches. If you begin to experience knee pain the first thing I recommend is always REST. It's not always easy but running through knee pain will often prolong your healing if not cause further injury. Another recommendation is to check your footwear and to get appropriately fitted for a good running shoe. Foam rolling and massage can be advantageous for providing relief from tightness or strain in the affected region. It's essential to recall that these techniques should not be a replacement for expert medical counsel, but rather an addition when necessary. If you notice your pain is not improving or you are experiencing increases in pain seeking out your healthcare provider is always enoucarged and recommended. Tackling patellofemoral pain syndrome necessitates an involved, drawn-out effort that requires commitment and determination.


Prehab and strength training is essential for runners looking to stay injury-free and reach peak performance. Kim Miller Fitness' workouts are tailored specifically with this in mind, helping you reduce the risk of developing many common injuries among runners and athletes. With our programming strategies on your side, there's no limit to what you can achieve! Don't let PFPS be the reason you are sidelined during your training. Educating yourself on injury prevention and implementing a plan will help you unlock your fitness potential.

Train smart, be consistent and unlock your fitness potential,

Dr. Jennifer McMahon PT, DPT

**The content in this physical therapy blog post is provided for informational purposes only and is not intended to serve as medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. The author and publisher of this blog post are not liable for any errors or omissions in the content, nor for any losses, injuries, or damages arising from its use. Reliance on any information provided by this blog post is solely at your own risk.**
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