Runner's Knee

Symptoms can vary depending on the cause of runner’s knee and the structures involved. Pain may develop gradually over time or become more noticeable after increased activity.

Common symptoms include:

• pain at the front of the knee, around or behind the kneecap

• pain on the outside of the knee, particularly during running

• discomfort that worsens when walking up or down stairs

• pain during running, squatting, kneeling, or cycling

• pain after sitting for long periods with bent knees

• tenderness on the outer side of the knee

• a clicking, grinding, or popping sensation in the knee

• stiffness after rest or exercise

• mild swelling around the knee

• pain that becomes worse during downhill running or after repetitive movement

People with ITB syndrome often describe a sharp or burning pain on the outer side of the knee that begins after a certain distance or duration of exercise. The pain may ease with rest but return when activity resumes.

Runner’s knee is usually caused by irritation and strain affecting the tissues around the knee joint. This often develops because of overuse, muscle imbalance, poor movement patterns, or changes in training.

Patellofemoral pain syndrome happens when the kneecap does not track smoothly through its groove during movement. ITB syndrome develops when repeated bending and straightening of the knee causes friction between the iliotibial band and the bone on the outer side of the knee.

There’s rarely a single cause. Instead, runner’s knee is often linked to a combination of factors, including:

• overuse from repetitive exercise or training

• sudden increases in running distance, speed, or intensity

• weak hip, gluteal, or thigh muscles

• tight muscles around the hips, thighs, or calves

• poor running technique or movement patterns

• inadequate warm-up or recovery

• worn-out or unsupportive footwear

• flat feet or changes in foot alignment

• running on sloped or uneven surfaces

• previous knee injury

• reduced flexibility in the iliotibial band

Risk factors for runner’s knee

Some people are more likely to develop runner’s knee than others. Risk factors include:

• taking part in high-impact sports or repetitive exercise

• long-distance running or frequent hill running

• being female, due to differences in hip and knee alignment

• weak hip or thigh muscles

• poor core strength or balance

• spending long periods sitting with bent knees

• returning to sport too quickly after injury

• having previous knee problems

At Welbeck, your diagnosis will begin with a consultation with one of our orthopaedic knee specialists. They’ll take the time to understand your symptoms, activity levels, and medical history.

Your consultant will usually:

• ask about your pain, when it started, and what makes it worse

• assess how you move, including walking, squatting, or climbing stairs

• examine your knee to check for tenderness, alignment, and range of movement

In many cases, runner’s knee can be diagnosed based on this assessment alone.

However, your consultant may recommend tests to confirm the diagnosis or rule out other conditions. These can include:

• X-ray – to assess the bones and joint alignment

• MRI scan – to look at soft tissues, cartilage, and surrounding structures

• ultrasound scan – in some cases, to assess inflammation

These tests help ensure that your symptoms are not caused by other knee conditions, such as cartilage damage or ligament injury.

Runner’s knee is often preventable, especially if you take steps to protect your knees during activity.

Simple changes can make a big difference. Ways to reduce your risk include:

• increasing training intensity gradually

• strengthening your hips, gluteal muscles, and thighs

• improving flexibility with regular stretching

• warming up before exercise and cooling down afterwards

• wearing supportive, well-fitting footwear

• replacing worn-out running shoes regularly

• avoiding sudden increases in training volume

• including rest and recovery days in your routine

• improving running technique and posture

• avoiding excessive downhill running if symptoms develop

• maintaining a healthy weight to reduce pressure on the knees

For people with ITB syndrome, strengthening the hip muscles and improving running mechanics can be particularly important in preventing symptoms from returning.

Runner’s knee is not usually a serious condition, but it can become more problematic if left untreated.

Without proper management, it may lead to:

• ongoing pain that affects daily activities

• reduced ability to exercise or stay active

• worsening movement patterns, which can increase strain on other joints

• muscle weakness due to reduced activity

• long-term discomfort during routine movements

In rare cases, persistent issues with the kneecap can contribute to cartilage wear over time.

The good news is that with early treatment and the right support, most people recover well and return to their usual activities.

Treatment for runner’s knee focuses on reducing pain, improving movement, and preventing the condition from coming back.

Your treatment plan will depend on your symptoms, lifestyle, and overall health.

Common treatment options include:

• rest and activity modification – reducing or avoiding activities that trigger pain

• physiotherapy – exercises to strengthen muscles and improve movement patterns

• stretching programmes – particularly for the hips, thighs, calves, and iliotibial band

• pain relief – over-the-counter medications, such as paracetamol or ibuprofen

• ice therapy – applying ice to reduce pain and inflammation

• supportive footwear – improving foot support to reduce knee strain

• orthotics – custom insoles to correct foot alignment, if needed

• taping or bracing – to support the kneecap during activity

• weight management – where appropriate, to reduce pressure on the knee

For some patients, ultrasound-guided injections such as steroid, platelet-rich plasma (PRP), or hyaluronic acid injections may be recommended to help reduce pain and inflammation.

Surgery is rarely needed and is only considered in very specific situations where other treatments have not helped.

Your Welbeck consultant will guide you through the most appropriate options and create a tailored plan to support your recovery.

At Welbeck, our orthopaedic specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art centres, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.