Dr James Tan
Senior Consultant Knee Surgeon
Orthopaedic Surgery, Sports & Exercise Medicine
MBBS (S’pore), MRCS (Edinburgh), MMed (Orthopaedics), FRCS Orthopaedics & Trauma (Edinburgh)
Runner's knee, medically known as patellofemoral pain syndrome (PFPS), is a common knee condition that causes pain around the front of the knee or behind the kneecap. Despite its name, this condition can affect not only runners but also anyone who participates in activities that put repeated stress on the knees, such as cycling, jumping, squatting, or climbing stairs.
This condition occurs when the kneecap (patella) does not move smoothly along the groove of the thigh bone (femur) during movement, leading to irritation of the surrounding tissues. While runner's knee is not usually a serious condition, it can interfere with daily activities and sports performance if not managed properly.
The knee joint is a complex structure made up of bones, cartilage, muscles, tendons, and ligaments. The patella sits in a groove at the end of the femur and moves up and down as the knee bends and straightens. In patellofemoral pain syndrome, the patella may shift slightly out of alignment or the surrounding tissues become irritated, causing pain.
Runner's knee is classified as an overuse injury because it commonly develops after repetitive activities that stress the knee joint. It is one of the most frequent complaints among athletes and active individuals.
Runner's knee can result from several contributing factors, and often more than one factor is involved. Common causes include:
Individuals who are physically active, particularly runners, cyclists, or those participating in sports requiring frequent jumping, are at higher risk of developing patellofemoral pain syndrome.
The hallmark symptom of runner's knee is pain around or behind the kneecap. The pain is often described as dull or aching and may worsen with:
Other possible symptoms include a popping, grinding, or crackling sensation in the knee, known as crepitus, particularly during movement. Swelling is less common but may occur in some cases.
Diagnosing runner's knee typically involves a physical examination and a review of the patient’s activity history. A knee doctor may perform the following:
Accurate diagnosis is needed to rule out other causes of knee pain and develop an effective treatment plan.
Most cases of patellofemoral pain syndrome can be treated successfully without surgery. Non-surgical treatments focus on relieving pain, correcting underlying causes, and preventing recurrence.
Surgery for runner's knee is rarely required and is only considered in severe or persistent cases where conservative treatments fail. Surgical options may include:
Even in surgical cases, physiotherapy and rehabilitation remain crucial for a successful recovery.
Prevention focuses on reducing stress on the knees and maintaining proper biomechanics. Strategies include:
By combining proper conditioning with awareness of early warning signs, most cases of runner's knee can be prevented or managed effectively.
While runner's knee can be frustrating for active individuals, it is typically manageable with conservative treatment. Recovery timelines vary, but many patients experience improvement within 4 to 6 weeks with consistent therapy and activity modifications.
Long-term management may include cross-training with low-impact exercises like swimming, cycling, or elliptical workouts. Returning to running or high-impact sports should be gradual and guided by a doctor or physiotherapist to prevent recurrence.
Most cases improve within 4 to 6 weeks with rest, physiotherapy, and activity modifications. Chronic or severe cases may take several months for full recovery.
It is best to reduce or stop high-impact activities until the pain improves. Continuing to run through pain may worsen the condition. Cross-training with low-impact activities is often recommended during recovery.
Runner's knee rarely causes permanent damage if managed early. However, ignoring symptoms can lead to chronic pain or cartilage wear over time.
Yes, stretching tight muscles, especially the hamstrings, calves, and IT band, can relieve pressure on the kneecap and reduce symptoms when combined with strengthening exercises.
Seek medical advice if the pain persists for more than a few weeks, worsens despite rest and home care, or is accompanied by significant swelling or instability.
Dr James Tan is a skilled orthopaedic surgeon specialising in knee injuries, including cartilage and meniscus surgeries. Dr Tan is a graduate of the National University of Singapore and a fellow of The Royal College of Surgeons in Edinburgh. He has also received specialist training at the Department of Sports Orthopaedics, Technical University of Munich. With extensive experience treating athletes from Singapore's national teams and professional leagues, Dr Tan is committed to achieving optimal outcomes for his patients.
Camden Medical
1 Orchard Boulevard, #09-06, Singapore 248649
Mount Alvernia Hospital
820 Thomson Road, Medical Centre D #05-60, Singapore 574623
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