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Runner’s Knee

‘Patellofemoral pain syndrome’ (PFPS) is the medical term for ‘runner’s knee’. Obviously, as the name suggests, this is common with runners as the stress of movement between the patella and thighbone during gait can cause irritation and pain. This pain can be sharp and sudden or dull and chronic depending on how long you had the problem and how it started. The pain may also come one day and go away the next causing any patient to be confused with their own knee condition.


Runners knee (patellofemoral pain syndrome) is multi-factorial in nature and is caused by multiple influences. Podiatrists are concerned with runner’s knee when a patient’s lower limb biomechanics are out of sync. For example, we all know poorly conditioned quadriceps and tight hamstrings cause the patella to mal-track but if the foot is pronating the tibia (shin bone) will rotate inwardly causing a shearing force on the knee, this will also lead to chronic knee pain.



  • Pain can be in both knees or just one knee
  • More common in women due to wider hips that give a greater thighbone angle and increased kneecap stress
  • Tenderness around or behind the patella
  • Pain at the back of the knee
  • Feeling of knee giving out
  • Pain worsens with uneven ground i.e. steps, hills, sand



  • Biomechanical variances
  • Bone differences i.e. patella larger on outside than inside, patella too high in the femoral groove, cartilage wear and tear reducing joint shock absorbency
  • High arch feet have less shock absorbency in the knee joint
  • Flat foot can pull the patella sideways as the tibia rolls inwards
  • Weakness in the quadriceps muscle
  • Tight calves and hamstrings put pressure on the knees



Treatment options vary based on symptoms experienced and length of time the problem was present. You may need to do the following if the pain is not relenting:


  • Ice, rest, reduce running mileage, change or update your footwear
  • Avoid walking on uneven surfaces until the pain subsides
  • See podiatry for orthotic controls designed to specifically address your biomechanics
  • Soft tissue treatments including ultrasound, shockwave (ESWT), etc
  • X-ray or diagnostic imaging may be required


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