Runner’s Knee – Physiotherapy Advice for a Common Cause of Knee Pain.

Knee pain while running? You are not alone. As physiotherapists, the knee is one of the most common areas we treat runners for.

Read on for more about one common cause of pain in the front of the knee.

Patellofemoral pain: “Runner’s Knee”

Patellofemoral pain syndrome is also described as anterior knee pain because the symptoms are mostly located around or under the patella, also known as the knee cap. The pain is intermittent and usually presents with squatting, going down stairs, hiking downhill, or running. It can last after the activity, but usually subsides after the activity.
The symptoms are usually trigged by a sudden significant increase in activity level and might be precipitated by muscle imbalance, increasing pressure under the knee cap and producing pain.

What Can You Do to Make it Better?

Load Management: Monitoring symptoms during exercise is key in the management of this condition. This is true for strengthening exercises as well as for other sports. I recommend keeping the pain level at maximum 4/10 during the activity. It is also important to monitor symptoms after the activity, as the pain response could be delayed.

Strengthening Exercises:

The following strengthening exercises may be of benefit to strengthen the hips and address weakness in the supporting muscles of the knee.

*Please note these are not intended to replace a thorough assessment of your knee. If you experience any pain while doing these exercises, I recommend you seek assessment by an orthopaedic physiotherapist. 

1.Single leg deadlift

Stand on one leg and then lean forward while keeping your pelvis level and your back straight. Hinge at the hip joint. You should feel the posterior muscles of the hip you are standing on working.
This exercise will help strengthen your gluteus medius and maximus muscles which are really important in the alignment of the leg. It will also work on your balance.

Single Leg Deadlift 1 Single Leg Deadlift 2

2. External Rotation of hips with band

Lie down on your back, with an elastic band around your knees. Put your feet on a bench or a wall. Slowly open your knees against the elastic tension.

This exercise will help activate your gluteus medius muscle (posterior and lateral of your hip). When done lying down, it can be particularly useful to start exercising your gluteus without putting too much pressure on your painful knee.

External Hip Rotation 1External Hip Rotation 2

3. Hip thrust

Put your upper back on the bench and keep your feet and hips on the floor. Raise your hips up squeezing your gluteal muscles. Make sure to keep your back straight and knees aligned with your feet. You can also add an elastic around your knees as a progression.

This exercise will also help strengthening your gluteal muscles and your core.

Hip Thrust 1Hip Thrust 2

When Should You Consult a Physiotherapist?

If you tried these exercises and they increase your knee pain or the condition doesn’t improve, a physiotherapist can help design a more personalized exercise prescription for you.

It is also important to note that there are many different conditions that can produce anterior knee pain. Therefore, one must be careful to self-diagnose with patellofemoral pain syndrome and seek professional help to get the correct evaluation and appropriate treatment.

As a general rule, I recommend seeking treatment for any injuries that have not resolved within two weeks.

Florence Charbonneau-Dufresne, M.Sc.
Registered Physiotherapist