How to Prevent Runner’s Knee Syndrome

If you’re a runner (and even if you’re not), you may have run into Runner’s Knee. It’s technical names are Patellofemoral Syndrome or Chondromalacia Patella – terms often used for pain on the front of or under your knee cap (patella).

Runner’s Knee affects about 25% of all physically active people and can be a frustrating thing to overcome. While the Internet has been the great democratizer of information, it has also created a lot of confusion for people who are trying to both diagnose and treat themselves. If you Google Runner’s Knee, you’ll get over 685,000 results and hundreds of opinions and treatment approaches.

But is there anyway you can prevent getting Runner’s Knee in the first place?

According to research, there are four biomechanical “faults” that appear highly correlated with the onset of Runner’s Knee and all four of them can be prevented.

  • Weak hamstring muscles
  • Weak quadriceps muscles
  • An overly pronating foot (foot collapses to the floor with weight bearing)
  • Failure to bend the knee sufficiently during tasks like running or jumping

Over the four, people with weak quadriceps are 5.5 times more likely to get Runner’s Knee.

Here’s the problem though. It takes several years to develop Runner’s Knee and you may not have any significant symptoms over that time. So, even though you may not have a strong enough leg to prevent the onset of Runner’s Knee, you may be able to  run just fine. And by the time you’ve developed the symptoms, strengthening your muscles is tough because the force required is too great for your joint and you hurt.

Here’s how to know if you have weakness in the quadriceps. Try hopping off a step or bench – one about 12 inches in height – landing on one leg. When your feet hit the ground, allow your knees to bend 20 to 30 degrees as you absorb the impact. If you find it difficult to land and control the bending of the knee or if your knee moves inward, your quadriceps muscles are weak and you lack sufficient control over the movement. And, if you find yourself hesitant to hop off the step, then there’s a very good chance your muscles are weak (the mind has a great way of just knowing when something is too hard).

If your muscles are weak and you’re currently running, you may want to re-think that strategy and instead of running use some other, lower impact form of aerobic exercise (such as elliptical or cycling) while you work on strengthening your muscles.

For anyone who has Runner’s Knee, you get a ton of information in my book, The Runner’s Knee Bible. Click here for more information.


Doug Kelsey, PT, PhD  writes about “active aging” –  how to overcome aches & pains, get strong, flexible, agile and stay as healthy and fit as possible over your lifetime. If you enjoyed this article, join his free newsletter.

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