Runner’s Knee: A Painful Condition to Avoid, Especially If You’re Long-Distance Training

The medical term is patellofemoral pain syndrome (PFPS) — but you probably know the condition as “runner’s knee” — referring to pain in the front of the knee and around the patella, or kneecap. And, yes, as the term indicates, it is common in runners — professionals, amateurs and the steadfast joggers among us who seek to stay, or get, physically fit.

If you’re one of thousands training for the upcoming Life Time Miami Marathon & Half on Jan. 28, 2024, runner’s knee is a key physical hurdle to avoid. Baptist Health South Florida is a sponsor and the official medical provider for the Life Time Miami Marathon & Half, providing assistance at the various first-aid and medical stations along the full 26.2-mile route.

Pain and stiffness are associated with PFPS, and it can make it difficult to do everyday activities, such as climbing stairs or anything requiring the bending of the knees.

Michael Swartzon, M.D., a primary care sports medicine physician at Baptist Health Orthopedic Care.

“It is an overuse injury with pain typically around or behind the kneecap,” explains Michael Swartzon, M.D., a primary care sports medicine physician at Baptist Health Orthopedic Care. “It represents 20 to 40 percent of all knee problems and the most common running injury presenting to a sports medicine clinic. Usually, an increase in frequency type or intensity of activity can lead to this problem.  Prior history of knee issues, such as dislocation or prior trauma, can predispose someone to the injury. This is the No. 1 presenting complaint to a running clinic and also of the No. 1 cause of loss time and basic training for military recruits.”

Many factors may contribute to the development of PFPS. Problems with the alignment of the kneecap and overuse from vigorous athletics or training are often key reasons. Symptoms are commonly relieved with conservative treatment, such as changes in activity levels or a therapeutic exercise program.

Here’s more on “runner’s knee” from Dr. Swartzon:

Question: Precisely, where does it typically hurt?

Dr. Swartzon: “Pain is typically around or behind the kneecap with either prolonged sitting, squatting, stair climbing, running, kneeling or jumping.”

Question: How can you treat it?

Dr. Swartzon: “Physical therapy including close chain strength training can help correct any muscle deficits or kneecap alignment issues.  Reduction in activities with relative rest and alternating activities can be helpful.  It is also important to evaluate foot wear and make sure shoes fit well and are less than six months old. Bracing, orthotics and taping are additional treatment options available.”

Question: How can you prevent it?

Dr. Swartzon: “Since this is an overuse injury, the best prevention is a slow progression when starting a new activity.”

Question: Can pain from running result from a non-knee issue?

Dr. Swartzon: “A small percentage of running injuries are from the back hip or groin.  Almost 40 percent are from the lower leg, foot and ankle.  Knee is the most common injured site accounting for over 40 percent. Previous running injury, and an experienced runner with a sudden change in training, are all the biggest risk factors for any of these injuries.”

Question:  When does knee pain indicate that you should stop running?

Dr. Swartzon: “I am a firm believer that listening to your body is the best place to start.  If you are having a ‘2 out of 10’ knee pain that does not worsen with running and goes away after running, then I think you can continue.  However, any pain that is persistent or worsening should give you pause and prompt an evaluation from a sports medicine specialist.  It is much easier for us to deal with problems when they are starting then when it is chronic.”