We have a secret for you: Runner's knee can happen to anyone. "You don't have to be a runner to have runner's knee," says Eric Ullman of ReThrive Wellness, a physical therapist in Scottsdale, Arizona.
"It is called runner's knee because it is commonly experienced by people who participate in sports that specifically involve running, although it can occur with any activity that involves repeated stress to the knee joint," Ullman says.
So how do you know if you have it — and is it preventable? We talked to experts to find out the symptoms and treatment options, including runner's knee exercises you can do to strengthen your knees and prevent knee pain.
What Is Runner's Knee?
Though runner's knee has a medical name — patellofemoral pain syndrome (PPS) — the injury is a general term used to describe pain in the patella, aka your kneecap. One October 2017 study in Open Access Journal of Sports Medicine even referred to the term as a "wastebasket," since it's such a catch-all term.
Because of this, being diagnosed with PPS can be a bit frustrating. "No one actually knows what exactly causes patellofemoral pain syndrome and it's associated knee pain," says Lindsey Plass, a physical therapist based in Chicago.
Though a single cause hasn't been identified, Ullman notes that the pain comes from the kneecap rubbing against areas of the rest of the knee it isn't supposed to. Because of this, symptoms can include a dull ache or sharp pain, stiffness, and/or grinding or clicking on or around the patella. The result? Pain and inflammation.
The good news is that for most people there are nonsurgical treatment options. Ullman says typical treatment involves cold packs, anti-inflammatory medications and a stretching and strengthening program from a physical therapist.
Why Is It Important to Strengthen Your Knees?
Strengthening isn't just part of a treatment plan for runner's knee; it's also important to improve the durability of your knees before injury sets in. Weak and/or tight muscles in the hip, knee and/or ankle often contribute to PPS, says Ullman, so the earlier you can address any weakness in your body, the better.
It's important to recognize that stronger knees aren't just the result of knee-specific stretches and exercises. As PPS occurs in a joint that connects your entire lower body, a good knee pain prevention plan should address the surrounding muscles and joints, as well, especially the hips.
"While strengthening the muscles around the knees, including the hamstrings and quadriceps, is important, the key areas to target are the hips," Ullman says. In fact, a 2016 study from the Turkish Journal of Medical Sciences found exercise regimens that include both knee and hip exercises rather than just the knee resulted in more effective pain management and better functional movement.
5 of the Best Runner's Knee Exercises
Whether you're a runner or not, you can benefit from the following five exercises, which strengthen the knees and hips, helping you ward off a potential case of runner's knee.
Ullman recommends this exercise, noting it primarily strengthens the glute muscles, which support the knees, while promoting hip extension (an essential part of running). Once you've mastered the move, add a resistance band around your thighs to make it more challenging.
- Lie on your back with your knees bent and slowly lift your hips up toward the ceiling, using your buttocks to stabilize.
- Hold this position, then slowly lower your hips back down to the ground.
- Make sure to keep the knees apart (but not bowed outward) and parallel to each other and in line with the shoulders. Your hips and knees should be also be aligned in the bridge position.
Reps: 2 to 3 sets of 10, holding 2 to 5 seconds at the top
Though we often associate squats with the thighs and glutes, Ullman says they're truly a total-body exercise. Runners specifically will benefit from the way the move addresses the strength and mechanics of the lower leg.
- Stand tall with feet shoulder-width apart. Keep knees centered over feet.
- Slowly bend hips and knees as if you were going to sit into a chair, until your knees reach around a 90-degree angle.
- Slowly stand back up and return to standing.
Reps: 2 sets of 10
Progress to single-leg squats by lifting one leg in the air as you squat, balancing on the other leg.
Lateral Toe Tap
Plass prescribes this move to her patients, as it addresses the hip abductors and can help you identify specific weaknesses, should one side be easier than the other.
- Standing up straight, loop a resistance band above your knees.
- Keeping one leg stable and planted, tap other leg out to the side. Try not to let the static knee collapse inward.
- Bring it back to center and repeat.
Reps: 2 sets of 10 on each leg
Lower the resistance band from your thighs to your shins, then your ankles or feet.
This exercise addresses the gluteus medius, which Ullman says plays a crucial role in hip stability (and, therefore, affects the knees). "The clamshell exercise also promotes general hip mobility, which protects the low back and knees," he says. "If the hips aren't moving, then the low back and knees get all of the stress and strain."
- Lie on your side with knees bent and one leg directly on top of the other.
- Slowly lift the upper knee while keeping the feet in contact with each other.
- Slowly lower the upper leg back down.
- Turn to other side to address the opposite leg.
Reps: 2 to 3 sets of 10 on each side
Add a resistance band around thighs to make it more challenging.
Single-Leg Bridge With Straight Leg Raise
Recommended by Plass, the single-leg bridge once again focuses on strengthening your glutes, while adding in the leg raise, which facilitates knee mobility.
- Lie on your back with your knees bent and lift your hips up toward the ceiling using your buttocks to stabilize.
- Once in bridge position, lift one leg out straight so there is a straight line from your shoulders to your toe, while keeping hips level (don't let one hip drop down).
- Hold leg out straight for 10 seconds and return to bridge position.
- Repeat on other leg, alternating sides.
Reps: 3 to 5 per side
After completing the straight leg raise, bring your knee toward your chest before returning to the straight leg raise.