Runner’s Knee (Pain Around the Kneecap): Causes, Exercises and When to See Someone

Runner’s knee (patellofemoral pain) is a dull ache around or behind the kneecap. It is one of the most common causes of knee pain in active people, but you don’t have to be a runner to get it. Climbing stairs, squatting and long hours on your feet can all trigger it.

Imagine your knees aching every time you take the stairs between wards, and stiffening after a long sit at handover. Strengthening the right muscles is often what turns it around.

Symptoms

• A dull ache around or behind the kneecap
• Pain going up or down stairs, squatting, kneeling or running downhill
• Pain after sitting for a long time with bent knees
• Sometimes a grinding or clicking feeling

Common causes

• A sudden increase in activity, running or stair climbing
• Weak thigh (quadriceps) and hip muscles
• Unsupportive footwear and long periods on your feet

What helps

• Strengthening exercises for the thigh and hip muscles have the best evidence
• Cut back on the activities that hurt for a while, then build up gradually
• Ice and painkillers for flare-ups
• Supportive shoes; taping or insoles may help some people in the short term

See a doctor or physiotherapist promptly if

• Your knee is swollen, locks, or gives way
• The pain started with an injury or you can’t put weight on it
• The knee is hot, red and swollen, or you have a fever

But won’t exercise wear my knees out?

The opposite is usually true for this condition. Stronger muscles take load off the kneecap. Start gently and increase slowly; some discomfort during exercise is acceptable, as long as it settles within a day.

Sources: NHS, “Knee pain”; American Academy of Orthopaedic Surgeons (OrthoInfo), “Patellofemoral pain syndrome”. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.