Runner’s knee—often felt as a dull ache or sharp pain around or behind the kneecap—is one of the most common complaints among runners. It can creep in during longer runs, show up on hills or stairs, or flare after workouts that never used to be a problem. While it’s frustrating, runner’s knee isn’t just about the knee itself. It’s usually a signal that something in the system isn’t sharing load well.
Understanding the why behind runner’s knee is the first step toward lasting relief.
What Is Runner’s Knee?
Runner’s knee—commonly referred to as patellofemoral pain—describes pain related to how the kneecap moves and absorbs force during running. It’s typically aggravated by activities that increase knee load, such as running downhill, climbing stairs, squatting, or sitting with bent knees for long periods.
Rather than being a single injury, runner’s knee reflects how forces are moving through the leg with every stride.
Common Contributors to Runner’s Knee
Runner’s knee rarely comes from one cause. Contributing factors often include:
Weakness or poor control at the hips and pelvis
Reduced quad strength or endurance
Limited ankle or hip mobility
Poor single-leg control during stance phase
Sudden changes in mileage, speed, or terrain
Fatigue that alters running mechanics
When the hip, core, or ankle doesn’t do its share, the knee often takes the extra load.
Why Rest Alone Doesn’t Fix It
Taking time off may calm symptoms, but pain often returns once running resumes. Without addressing strength, mobility, and movement patterns, the same forces that irritated the knee remain in place.
Long-term improvement requires changing how the body handles impact—not just waiting for pain to fade.
How Physical Therapy Helps Runner’s Knee
1. Identify the Root Cause
Physical therapy looks beyond the knee to assess hip strength, ankle mobility, single-leg control, and running mechanics. The goal is to understand why the knee is overloaded.
2. Restore Strength Where It Matters
Targeted strengthening focuses on the hips, quads, and trunk to improve force distribution during running. Stronger support upstream reduces stress at the knee.
3. Improve Mobility
Restrictions at the ankle or hip can change stride mechanics and increase knee stress. Addressing mobility helps normalize movement and reduce compensation.
4. Retrain Movement Patterns
Single-leg control, alignment, and coordination matter with every step. Therapy retrains how you load the leg during running, squatting, and stairs.
5. Guide a Smart Return to Running
Rather than stopping indefinitely, physical therapy helps structure mileage, intensity, and terrain so the knee adapts without repeated flare-ups.
When to Seek Help
Runner’s knee is worth addressing if you notice:
Pain that lingers during or after runs
Discomfort going downhill or downstairs
Knee pain that returns every time you increase mileage
Reduced confidence or altered running form
Early intervention often shortens recovery and prevents the issue from becoming chronic.
The Goal: Durable, Confident Running
Runner’s knee doesn’t mean you’re “broken” or that running isn’t for you. With the right physical therapy approach, many runners return to pain-free training with better mechanics and resilience than before.
If knee pain is limiting your runs or keeping you from progressing, physical therapy can help identify what’s driving the problem and build a plan that supports long-term performance—not just temporary relief.
