What Exactly is Runner’s Knee?

By Kara Dudley


“Runner’s Knee” is one of the most common running injuries amongst both beginner and more seasoned athletes. Let’s dive further into what this overuse injury is, how it can be prevented, and what role your shoes might play in it all.



Runner’s Knee, is technically referred to as Patellofemoral Pain Syndrome (PFPS). It is a generalized condition considered to encapsulate any type of pain that is found in the front of the knee. The term “runner’s knee” is typically used as an umbrella term for more specific knee-related running injuries. When asked about it, Kate Reese, fit expert at Brooklyn Running Co., begins by saying: “Runner’s Knee can be a tricky description for us to address with footwear in the store because the term captures so many different diagnoses and so many different kinds of pain. Conversations around this topic are some of the most challenging ones that we take on here.” If someone comes into the shop saying that they have runner’s knee, one of the first things our fit experts try to do is to drill down and identify what specific, professional diagnosis people may have received. . If they have not yet gone down the road of having it looked at by a medical professional, then at the minimum, our fit experts will try to figure out where the pain is, what elicits it, and how often it occurs. Once given those guidelines, it’s a bit easier to start to figure out what type of shoe might be best in aiding recovery. 


Although footwear changes alone will never be enough to fix nor prevent any kind of running injury, individualized and properly fitted footwear is an important piece of the puzzle when looking to promote healthy running mechanics and fix tracking issues (the misalignment of your kneecap in the groove that it’s meant to stay in). In general, it’s easier to address running-related injuries with footwear, the closer that they get to the foot. It’s important to note that although they are super smart, fit experts are not medical doctors. Kate says that the discussion about finding a doctor or physical therapist is often a part of the conversation she has with runners during fits that are experiencing pain or discomfort above the level of normal aches and pains. 


Do You Have Runner’s Knee?


I spoke with Cat Fitzgerald PT, DPT & CSCS from Custom PT to learn more about what this injury is and how you can set yourself up to recover from it successfully or even avoid it altogether in the first place. Cat says, “In terms of identifying that you have Runner’s Knee – it should be pretty easy to figure it out for yourself. If you have pain in the front of your knee, especially if it’s associated with running, it’s very likely it could be categorized as such. Usually, you’ll feel the pain during a run, but you could also potentially have residual pain after running. For example, if you’re running in Central Park and then you walk down the stairs into the subway, and that’s when it starts to hurt – that would be an example of a situation where you might be able to feel it the most.” Once you’ve detected if this is you, that’s when it’s best to go to a physical therapist to figure out exactly what your diagnosis is within this umbrella term and what you can do about it. “In a perfect world, I’d have someone come in right away,” says Cat. “If the pain starts to become consistent, and especially if you’re in a training cycle, you don’t want to take the risk of letting it get to the point where the pain is bad enough that it prevents you from doing what you want to do.”


What is the Recovery Protocol?


While an overuse injury, it’s really important to stress that every case of runner’s knee is different. It is certainly one of the running injuries that widely varies – there is no cure-all for any one person going through it. But in general, Cat says that if she were treating someone that came in with runner’s knee, she would probably focus on quad and hip flexor mobility, hip strength and stability, and core stabilization. Manual hands-on work along with targeted exercises are what will help you recover and stay injury-free. In addition to your own personalized rehab program, ideally you’ll want to work with a PT or a coach to take a look at your running mechanics to help you learn how to put your knees in an optimal landing position when you run. This way, you’ll have less of a chance of your knee problems cropping up again in the future. Cat says, “People tend to get nervous that runner’s knee is a chronic problem, but it’s very treatable. If you’re consistent with your physical therapy exercises and being smart about your training, you are going to get better… so there’s hope!”


You can be proactive in preventing the onset of runner’s knee by addressing core and hip strength and stabilization in your regular routine, in addition to foam rolling. Cat also urges runners to be aware of doing too much too soon – whether that means overall mileage or not. “A lot of runners may be careful not to increase their total mileage too quickly from week to week, but maybe their symptoms are triggered by quickly jumping up from two miles of speedwork to six, for example. Be conscious of when you’re not paying as much attention in planning your training.”



What Type of Shoe Might Help?


When it comes to Runner’s Knee, generally speaking, a more cushioned shoe works best to help with impact absorption. However, Cat says, “you want to have an expert assess your gait to see how the foot lands. If it lands in such a way that causes the knee to collapse in towards the midline of the body (i.e. “tracking issue”), you might need a more medially supportive shoe as opposed to a neutral shoe – the Brooks Adrenaline for example.”  


Kate added,  “if your knee pain is linked to your knee angulation, the softness of a padded surface becomes an unstable surface that can exacerbate some of those running mechanic-related issues.” All of this to say: footwear is a very important part of maintaining knee health, but each situation is going to be vastly different in guiding what your specific footwear needs are. Our experts highly recommend getting checked out by a doctor or a physical therapist if you think you are experiencing these symptoms before coming in to get fit for a shoe so you can get back out there and start chasing after those running goals as soon as possible.