Runner’s Knee: Recovering From Acute or Severe Symptoms

Medically reviewed by Oluseun Olufade, MD

Runner’s knee, also known as patellofemoral pain syndrome (PFPS), is a condition that causes pain at the front of the knee behind or around the kneecap (patella). Like its name suggests, this condition is common in runners, but also occurs in other populations. Recovery typically lasts a few weeks once aggravating activities, like running, jumping, or squatting. Fortunately, conservative treatments like performing exercises and getting physical therapy can help reduce your symptoms.

This article will review symptoms, causes, and treatments for runner’s knee and tips to help with recovery.

A Glance at Runner’s Knee Recovery

While runner's knee is generally not considered a serious condition, the pain and other symptoms can cause discomfort and interfere with your everyday activities. Runner’s knee accounts for 25% to 40% of all knee conditions, and impacts your ability to move around or even sit at school or work. If left untreated, pain can worsen and lead to cartilage breakdown and arthritis of the kneecap.

Recovery requires an initial period of rest from aggravating activities, including running, jumping, or exercise requiring deep knee bending. Performing corrective exercises and using pain-relieving methods, if needed, will help you recover. Most cases tend to resolve after several weeks.

Runner’s Knee Pain Symptoms

The most common symptom of runner’s knee is dull, aching pain in the front of the knee behind or around the kneecap. This pain worsens with weight-bearing activities when the knee is bent, such as squatting, lunging, or going down stairs. Pain and stiffness are also common with prolonged sitting with you knee in a bent position.

Grinding under the kneecap or mild knee swelling may also be present. Kneeling can be very uncomfortable, and walking downhill and going up and down stairs typically increases pain.

Takeaway

Factors that increase your risk of developing runner’s knee include:

• Overuse, especially with activities like running and squatting that stress the knees

• Sudden increase in physical activity

• Kneecap misalignment or abnormal tracking of the kneecap

• Muscle imbalances or weakness of the quadriceps and hip muscles

• Uneven running surface

• Poor foot alignment or unsupportive footwear

Home Treatment for Runner’s Knee Symptoms

Once you take a break from movements and activities that aggravate your runner’s knee symptoms, you will likely find lasting relief with conservative treatment methods.

Conservative Management

Short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful to reduce pain and inflammation when your runner’s knee symptoms are at their worst. If poor-fitting footwear or over-pronated or flat feet are contributing to your symptoms, foot orthotics can help improve the alignment of the joints of your lower body to reduce strain at your knees.

Kinesiotaping to your knees, typically performed by a physical therapist, may also help in supporting and stabilizing your kneecap with movement.

Exercise

Exercise is most effective for short-term and long-term improvement in pain from runner’s knee. In many cases, weakness in the quadriceps and gluteal muscles causes or contributes to the development of runner’s knee.

Strengthening these muscle groups through physical therapy and corrective exercises can help restore proper alignment of your knee with movement and decrease stress at your knee.

Surgical Treatment for Severe Runner’s Knee

Most cases of runner’s knee resolve with conservative treatment. Surgery, which is rarely needed, is only recommended as a last resort to manage ongoing symptoms that do not get better.

While imaging tests are generally not needed to diagnose runner’s knee, you may have an X-ray or magnetic resonance imaging (MRI) scan performed if your symptoms do not improve after several months of treatment. These scans can help determine if surgical treatment may be needed.

Procedures that may be done to help alleviate pain from runner’s knee include:

• Arthroscopic debridement, which removes irritated cartilage or bone fragments from the underside of the kneecap

• Lateral release, which loosens the lateral patellar retinaculum, the tough connective tissue that can pull the kneecap out of alignment

• Tibial tubercle transfer, which realigns the kneecap by moving the patellar tendon and the tibial tubercle, the bony prominences on the shinbone (tibia) where the patellar tendons attaches

Walking on Runner’s Knee: What Helps?

Because walking is a lower-impact activity than running, it is typically not as bothersome, but faster walking speeds and walking downhill can be irritating to people with runner’s knee. Wearing a knee brace to support and stabilize your kneecap may help to alleviate some discomfort.

Takeaway

People who have already had knee surgery or have osteoarthritis of the knee may be at an increased risk of developing runner’s knee due to knee instability and muscle imbalances that may already be present. If you are experiencing any pain in your knees, do not start running or high-impact activities as they will likely make your symptoms worse.

Consult with your healthcare provider about available treatment options and consider trying physical therapy.

Resuming Normal Physical Activity

Whenever attempting physical activity with runner’s knee, start off slowly and keep your intensity or duration of exercise to a minimum to see how your knee feels. If small amounts of physical activity do not aggravate your symptoms, you can gradually start to increase more.

RICE Method

If you experience discomfort with physical activity, you can try the RICE method. RICE stands for rest, ice, compression, and elevation:

• Rest: Avoid further physical activity and weight bearing on your knee.

• Ice: Apply ice or a cold pack to your knee for 10 to 20 minutes to help with pain and swelling.

• Compression: Lightly wrap your knee with an elastic bandage such as an Ace wrap or a soft brace to apply gentle compression and support to your knee.

• Elevation: Keep your knee raised up above the level of your heart to assist with drainage of swelling.

Summary

Runner’s knee (patellofemoral pain syndrome) is a condition that causes pain in the front of the knee behind or around the kneecap. Because this condition is worsened by physical activity that involves running, jumping, or deep knee bending, rest from aggravating activities is essential for runner’s knee treatment.

Most cases can be treated with conservative treatments, including activity modification, the RICE method, wearing supportive footwear, and performing corrective exercises to reduce muscle imbalances contributing to the condition.

Read the original article on Verywell Health.