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Runner's Knee

Mark decided to try out for the varsity cross country team. Over the summer he bought a pair of running shoes and took up jogging. He started with short distances, but soon started increasing his mileage in an effort to get up to race distance in time for tryouts.

After a few weeks, though, Mark began noticing swelling and pain in his right knee. He went to see a doctor and was told he had runner's knee.

What Is Runner's Knee?

Runner's knee is the term doctors use for a number of specific conditions affecting the knee, such as patellofemoral pain syndrome and chondromalacia of the patella, to name just two. It's the most common overuse injury among runners, but it can also strike other athletes who do activities that require a lot of knee bending, such as biking, jumping, or skiing.

Runner's knee happens when the kneecap (patella) tracks incorrectly over a groove in the thighbone (femur) known as the femoral groove when you bend and straighten your knee. In healthy knees, the patella rests in the femoral groove and slides easily up and down when you use your knee. But when the patella is out of place, it can irritate the femoral groove and wear away the cartilage beneath the patella, leading to knee pain.

Symptoms of Runner's Knee

The most common symptom of runner's knee is tenderness or pain behind or on the sides of the patella, usually toward the center or back of the knee where the thighbone and kneecap meet. In addition, the knee might be swollen.

The pain will generally feel worse when bending the knee — when walking, kneeling, squatting, or running, for example. Walking or running downhill or even down a flight of steps also can lead to pain if someone has runner's knee. So can sitting for a long period of time with your knee bent, such as in a movie theater.

In some cases, someone with runner's knee may notice a popping or cracking sensation in the knee, as well as a feeling that the knee may be giving out.

If it goes untreated for a long period of time, runner's knee can damage the cartilage of the knee and hasten the development of arthritis.

How Is Runner's Knee Diagnosed?

If you see a doctor about pain in your knee, he or she will review your medical history and ask you questions about your symptoms and the activities you are involved in. Be sure to tell your doctor if you've increased how much time you spend at a certain activity or how often you do it.

The doctor will probably check the alignment of your kneecap, thigh, and lower leg, as well as look at your range of motion. Your doc will also check your kneecap for signs of tenderness or dislocation. You may be asked to squat, jump, or lie down so your doctor can assess your knee's strength and mobility.

In some cases, your doctor may order imaging tests like an X-ray or MRI to see if there is any damage to the structure of your knee or the tissues connected to it.

What Causes Runner's Knee?

Runner's knee can happen for a variety of reasons, many of them having to do with the muscles and bones of the leg. Some of the more common causes are:

Preventing Runner's Knee

The good news about runner's knee is that you can take precautions to protect yourself against it. If you're going to be doing an activity that puts a lot of stress on your knees, follow these tips:

How Should I Treat Runner's Knee?

Treatment for runner's knee depends on the specific problem that is causing the pain. Fortunately, runner's knee rarely requires surgery, and most cases heal in time. Regardless of the cause of your particular case of runner's knee, here are some things you should do at the first sign of pain:

On rare occasions, someone might need surgery for runner's knee. If your doctor decides this is your best option, he or she may recommend one of two surgeries:

  1. Arthroscopy allows surgeons to remove fragments of damaged kneecap through a small incision.
  2. Realignment is when the surgeon opens the knee to manually realign the kneecap and reduce pressure on the cartilage and other supporting structures.

Surgery is only used as a last resort, though. Most cases of runner's knee get better through routine care and rest.

Date reviewed: June 2013

Note: All information on TeensHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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