Patellofemoral Pain: The Mystery Behind “Runner’s Knee”

A Common Cause of Knee Pain in Active People

Patellofemoral pain syndrome (PFPS), often called “runner’s knee,” is one of the most frequent knee complaints in runners, gym-goers, teenagers, and office workers alike. It makes up 25% of all knee injuries seen in sports clinics and is especially common in adolescent girls and active adults. Pain can last for months, affect both knees, and limit everything from exercise to stair climbing — making it a major quality-of-life issue. Despite its name, it’s not just runners who get it — anyone can develop this painful condition.

What’s Really Going On in the Knee?

PFPS occurs when the kneecap (patella) doesn’t move smoothly over the thigh bone (femur) during bending and straightening. This can cause irritation of the cartilage and surrounding tissues, leading to pain at the front of the knee. Poor muscle control, tightness, or weakness in the hips, glutes, or quads often play a big role. Common symptoms include:

• A dull ache around or behind the kneecap
• Pain with stairs, squatting, or sitting too long
• Clicking or a feeling of “grinding”

It’s usually not due to damage or injury, but rather imbalances in how the knee moves.

What Actually Helps?

Research shows that exercise-based rehab is the best treatment for PFPS. A physiotherapy program may include:

• Strengthening exercises for the quads, glutes, and hips
• Patellar taping or bracing to improve kneecap tracking
• Stretching tight muscles like calves, hamstrings, and ITB
• Manual therapy to improve joint mobility if needed
• Running technique or activity modifications

Most people improve in 6–12 weeks, especially with consistent rehab and education about load management.

What Doesn’t Work So Well

Scans like X-rays or MRIs often don’t show much and aren’t usually needed. The pain is real but rarely linked to visible damage. Rest alone may relieve symptoms temporarily, but without rehab, pain tends to return.

Other treatments such as ultrasound, dry needling, or laser therapy haven’t shown strong evidence unless they’re part of an active program. Surgery is not recommended for typical PFPS.

What’s Next in Knee Pain Treatment?

Future approaches include biomechanical assessments using video or wearable sensors to analyse how the body moves during running or jumping. Digital apps and telehealth rehab platforms are helping people track progress and stay consistent. There’s also growing interest in psychological factors, such as how fear of pain or poor confidence can delay recovery.

How to Prevent Runner’s Knee

• Strengthen your glutes, hips, and thighs
• Avoid sudden changes in running distance or intensity
• Use proper footwear for your activity
• Focus on balanced muscle control — not just quad dominance
• Keep your technique smooth during squats, stairs, and lunges