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Knee Pain

Runners Knee Physio Dublin

Understanding Runners Knee and Treatment

If like many other runners you have suffered from knee pain as a direct result of running the following article will provide much needed information and prevention.

Patellofemoral Pain Syndrome

Better known as Runners Knee, is one of the most common and frustrating running injuries. PFPS is a term used to describe pain experienced in or around the front part of the knee where the patella (kneecap) glides over the lower end of the femur bone (Patellofemoral Joint – PFJ).

PFPS is a very frustrating to all runners and should be assessed professionally if it persists.

PFPS has a lot of similarities to other running injuries in the lower leg such as IT Band Syndrome. As is the case with ITBS there is an overload of the structures in and around the knee leading to pain and abnormal functioning or movement. In most cases what is occurring further up the leg at the hip or below at the foot is of greater importance.

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How do I know if I have Runners Knee?

Common symptoms are:
  • Pain during activities that place excess load and pressure on knee like lunging, squatting, kneeling, going down or upstairs and of course running (especially downhill).
  • Pain that has gradually increased over time.
  • Possibly aggravated by long periods of seating, as the knee remains in a flexed position.
A non-specific or vague pain that can be hard to pinpoint.

What is causing this pain?

The factors contributing to PFPS can come from multiple sources and this is where working with your therapist is crucial. The likely causes are:


Any changes in movement at the knee, hip or foot will contribute. Issues like over pronation, increased angle from hip to knee and patella positioning need to be considered

An increased PFJ load.

This can be  an introduction of a new training stimulus i.e. hill running, speed work or increased distance.

Previous injuries

Poor understanding of pain and pain management along with poor advice can lead to further altered mechanics and load distribution. The intervention of your therapist is crucial in this area.


Increased tightness and tone in muscles that cross the knee joint can pull the patella out of its groove.

Muscular weakness

An inability to control movement at the knee. The main muscle groups here to consider are the Glutes (Maximus & Medius), Quads (Vastus Medialis) and those involved in Pelvic Control.

Running Form

Foot strike, stride length (are you over striding?), cadence (amount of times your foot strikes the ground per minute), over pronation and hip adduction all have the potential to affect PFJ load. It is important to note that pronation in itself is not a cause as the foot naturally pronates during gait.

Can I recover and get back running?

The short answer here is ‘yes of course’, but treatment and intervention is often necessary.

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 Treatment options include:

  • Offloading the PFJ, controlling symptoms and gradually reloading the leg through a tailored rehab plan.
  • Identifying underlying causes such as technique, over striding, low cadence and focusing rehab and treatment on these issues.
  • Breathing techniques – identifying if your breathing patterns are contributing to the condition.
  • Taping to offload PFJ load has been proven to be beneficial in some cases.
  • Soft tissue techniques aimed at improving muscular flexibility and motor output.
  • Structured training plan with incremental loading to strengthen the important muscles that deal with load and force production.


Questions, bookings or feedback? Contact me by any of the channels below. I’ll respond ASAP!

P: 087 652 9287


A: Pain & Performance Clinic, 12 Trinity Court, Fonthill Business Park, Dublin 22

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