What You Need to Know about Patellofemoral Pain Syndrome (Runner’s Knee)

In the running community, patellofemoral pain syndrome (“PFPS”), or Runner’s Knee, has a reputation for being painful and frustrating. Despite its nickname, Runner’s Knee can affect people who have never run a single step.

Signs & Symptoms of Runner’s Knee

Typically patients affected by PFPS will feel vague, diffuse unilateral or bilateral pain throughout the front of the knee that can feel like aching pain or sharp pain.  

It can be easier to understand if you know that the patella, or knee cap and femur, or upper leg bone, are connected -- so PFPS is essentially pain caused by the joint where the knee cap and upper leg bone meet. 

PFPS pain can become worse during running, jumping and ascending and descending stairs.  It can also increase with prolonged sitting and inactivity.  One of the common symptoms is referred to as “Movie Theater Sign”, which is pain in the front of the knee when standing after a prolonged period of sitting with your knees bent.

Runner’s Knee symptoms are usually vague because there is not a specific mechanism of injury, and pain can develop for many different reasons.  The athlete will typically not remember when the injury occurred, and the symptoms will gradually worsen with time if nothing is done about it.  

Runners might initially notice the pain after a run, and as time passes they will start to have pain during running, and ultimately will reach a point where they can no longer run due to pain. 

For people who aren’t runners, going up and down the stairs, sitting, walking and other activities that involve flexing the knee may feel painful.

Causes of Patellofemoral Pain Syndrome

The cause of PFPS pain can be multifactorial, coming from a number of places.  It can occur for these reasons, among others:

• Natural posture: patellar position, knee position (being knock-kneed)
• Weakness in your core, gluteus or thigh muscles
• Tightness in the hip, thigh or calf
• Improper training
• Starting a physical activity without proper warm-up
• Increasing distance or frequency too quickly when training for a race
• Lack of cross training
• Improper footwear, including wearing the wrong style running shoe for your body or not changing out your shoe wear often enough. The average running shoe will safely last 300-500 miles

Treatment Options for Runner’s Knee

The best option for PFPS treatment is to seek evaluation from a Sports Medicine provider or physical therapist as soon as you experience symptoms.  

Resting or avoiding the activity causing your symptoms is one way to get rid of Patellofemoral Pain Syndrome, but others that your medical provider can help with may include: 

• Adding correct strengthening exercises tailored to you, for glutes, quads and core muscles
• Changing your training techniques.  Runners typically shouldn’t increase distance more than 10-15% per week, or less for new runners
• Shoe wear.  Your physical therapist can offer shoe advice as well as direct you to knowledgeable running-specific shoe stores in your area
• Bracing or taping techniques that may be helpful
• Incorporating correct stretching for the hip flexors, hamstrings, IT Band and calf muscles
• Adding cross-training to your routine. If you are only running, sometimes it can be helpful to add another activity to the mix, like cycling, swimming, Zumba, yoga and Pilates

Taking Control of Runner’s Knee: Next Steps for Recovery and Prevention

Patellofemoral pain syndrome, or Runner’s Knee, doesn’t just affect runners—it can impact anyone who’s active or on their feet frequently. Recognizing early symptoms, understanding the underlying causes, and taking proactive steps are essential to prevent pain from worsening and to stay active. From targeted strengthening exercises and proper footwear to cross-training and expert guidance, there are proven strategies to manage PFPS and return safely to your favorite activities.

If you’re experiencing persistent knee pain, don’t wait! Schedule an evaluation with the specialists at OrthoCarolina. OrthoCarolina’s sports medicine experts can create a personalized plan to reduce pain, improve function, and help you get back to moving comfortably.

Frequently Asked Questions

Can non-runners get Runner’s Knee?

Yes. PFPS can affect anyone whose knee flexes frequently during daily activities such as walking, climbing stairs, or sitting for long periods. It is not limited to running.

How long does it take to recover from PFPS?

Recovery varies depending on the severity of symptoms and adherence to treatment. Mild cases may improve in a few weeks with rest and strengthening exercises, while more persistent cases may take several months with physical therapy and proper training adjustments.

Are knee braces or taping techniques effective for PFPS?

Bracing or taping can help reduce pain and improve patella tracking during activity, but they are most effective when combined with exercises to strengthen the quads, glutes, and core.