Specializing in Spine, Sports & Physical Medicine

Runner’s Knee

Runner’s Knee/Patellofemoral Pain Syndrome (PFPS)

Runner’s knee is a term used to refer to a number of medical conditions that cause pain around the front of the knee (patellofemoral pain). These conditions include anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella. Forty-two percent of all overuse injuries affect the knee. It is the most common overuse injury amongst runners.  It occurs when a mistracking kneecap (patella) irritates the femoral groove in which it rests on the thighbone (femur). PFPS can affect one or both knees. It affects mostly younger, recreational runners and twice as many women as men. Women tend to have wider hips, resulting in a greater angling of the thighbone to the knee, which puts the kneecap under more stress.

Symptoms can include a dull, aching pain under or around the front of the kneecap. Some may feel pain toward the back of the knee, a sense of cracking or a feeling that the knee is going to give out. Pain occurs when walking up or down stairs, kneeling, squatting, and sitting with a bent knee for a long period of time.

The knee is a complex structure and is very sensitive. A number of factors can contribute to runner’s knee, including:

  • Malalignment of the kneecap
  • Complete or partial dislocation of the patella
  • Injury
  • Excessive training or overuse
  • Tightness, imbalance, or weakness of thigh muscles/
  • Flat feet

Patellofemoral pain may be the result of irritation of the soft tissues around the front of the knee. Other contributing factors to patellofemoral pain include overuse, muscle imbalance and inadequate stretching.

In some people with runner’s knee, the kneecap is out of alignment. If so, vigorous activities can cause excessive stress and wear on the cartilage of the kneecap. This can lead to softening and breakdown of the cartilage on the patella (chondromalacia patella) and cause pain in the underlying bone and irritation of the joint lining.

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