Runner’s Knee Physiotherapy
Runner’s knee, or patellofemoral pain, is pain around or behind the kneecap that shows up with loaded bending — running, stairs, squatting, long sitting. It is common, it usually responds to strength and load planning, and it rarely means the knee is being damaged.
Individual rehabilitation plan — shaped by the assessment, reviewed as you progress
We assess your situation first, explain what the assessment shows, and agree a suitable rehabilitation direction with you. WhatsApp us to book, or ask first.
Patellofemoral pain describes symptoms at the front of the knee where the kneecap glides on the thigh bone. It is generally understood as a load-tolerance problem: the amount and type of loading has outpaced what the knee is currently prepared for. It is not proof of cartilage damage, and imaging rarely settles it. Symptoms described online cannot diagnose your knee — an in-person examination is what separates this from tendon, meniscal, hip-related or joint-surface problems.
Typical reports are an ache around the kneecap that builds during a run, pain going downstairs or downhill, discomfort after sitting with the knee bent, and soreness after squats. Symptoms often follow a jump in mileage, a new hill session, or a return after a break. Other possible causes should stay open: patellar tendon problems, fat pad irritation, early joint surface changes and referred hip pain can look similar, and it is common for more than one to contribute.
- Ache around or behind the kneecap that builds during a run
- Pain going down stairs or downhill more than going up
- Discomfort after sitting with the knee bent for a long time
- Soreness with squats, lunges or getting up from a low seat
- Symptoms appearing after a jump in mileage or a new hill session
For a running-related knee, the training history is half the assessment: weekly distance, pace, surfaces, shoes, hills, and what changed in the four to six weeks before symptoms started. The physical part looks at knee and kneecap movement, thigh and hip strength, calf capacity, single-leg control, and how you squat, step down and run. We also check the hip and lower back, because both refer pain to the front of the knee.
- Your symptoms: where around the kneecap, when in a run, and how long they last after
- Daily activities and function: stairs, sitting tolerance, squatting, walking
- Work or study demands, including sitting hours and time on your feet
- Sleep: whether the knee aches at night or in certain positions
- Load and injury history: weekly mileage, pace and hill changes, previous knee injury
- Movement: knee and kneecap range of motion, hip and ankle mobility
- Strength and control of the quadriceps, gluteal and calf muscles, plus single-leg balance
- Neurological and general screening: sensation, muscle power, general health, nutrition and medicines
Most plans combine two things: a training adjustment that brings the load under your current threshold, and progressive strengthening for the quadriceps, hip and calf so the threshold rises. Depending on the assessment we may look at running cadence or footwear, and add taping, hands-on treatment or acupuncture where you consent and they may make training more comfortable. Your race plans and preferences shape the timeline. There is no fixed protocol here, and we adjust according to how you respond week to week.
Runners rarely need to stop completely; they need a version of running the knee can currently absorb. That usually means shorter, flatter, more frequent runs for a period, with strength work on the days between. We use pain during the run and the next 24 hours as the dosing guide, and we plan for a flare-up week so one bad session does not derail the block. Each visit reviews your activity and load tolerance, strength markers and running comfort before the next step up.
Patellofemoral pain is well suited to a physiotherapy assessment and a load-based plan. Arrange a prompt medical review instead if the knee locks or gives way repeatedly, if it swells substantially or quickly, if it is hot and red with a fever, or if pain is sharply localised over bone and worsening with every run despite reducing your mileage, which can suggest a bone stress problem. Go to an emergency department the same day if the knee was injured and you cannot put weight through the leg, if the joint looks out of shape, or if the lower leg becomes cold, pale or numb.