Raasay Waters Sports Therapy Cape Town

Patellofemoral pain syndrome (PFPS)

Runner's Knee or Patellofemoral pain syndrome (PFPS)

What Does Runner's Knee Feel Like?

Patellofemoral pain syndrome, otherwise known as anterior knee pain and runner’s knee, is the most common running injury, accounting for roughly 20 percent of all running injuries. It usually causes aching pain around the kneecap, that is generally mild at first and experienced only during running which becomes progressively more intense during running and also increasingly felt at rest if training continues. It can also strike any athlete who does activities that require a lot of knee bending, like walking, cycling, and jumping. Runner's knee isn't really a specific injury. It's a loose term for several specific disorders with different causes.

Patellofemoral pain syndrome can occur in non-athletes, as well. The pain and stiffness it causes can make it difficult to climb stairs, kneel down, and perform other everyday activities. Many things may contribute to the development of patellofemoral pain syndrome. Problems with the alignment of the kneecap and overuse from vigorous training are often significant factors. Symptoms are often relieved with conservative treatment, such as changes in activity levels or a therapeutic exercise program.


  • Pain behind or around the kneecap, especially where the thigh bone and the kneecap meet.
  • Pain when you bend the knee, when walking, squatting, kneeling, running, or even rising from a chair.
  • Pain that's worse when walking downstairs or downhill.
  • Swelling, Popping or grinding sensations in the knee.

Runner's knee can result from:

  • Overuse. Repeated bending or high stress exercises such as lunges and plyometrics can irritate the kneecap joint (patellofemoral joint).
  • Overstretched tendons (tendons are the tissues that connect muscles to bones) may also cause the pain of runner's knee. Direct trauma to the knee, like a fall or blow.
  • Malalignment. If any of the bones are slightly out of their correct position, or misaligned, physical stress won't be evenly distributed through your body. Certain parts of your body may then be subjected to higher stresses. This can cause pain and injury to the joints. Sometimes, the kneecap itself is slightly out of position.
  • Problems with the feet. Runner's knee can result from hypermobile feet (a condition in which the joints associated with the feet can be move more than what's normal), fallen arches, or overpronation (flat feet). These conditions in which the impact of a step causes the arches of your foot to collapse, may excessively stress joints and tissues of the knee.
  • Weak thigh muscles or muscle imbalance. Weakness in thigh muscles causes a disproportional load on isolated sections of the knee cap leading to abnormal wear patterns and pain.
  • Treatment:

    Treatment would involve assessment of the hips and knees to find the cause of the problem. Quite often the problem can come from the hips or sacroiliac joint that are not aligned properly and so there are imbalance problems in the glutes, pelvis and quadriceps.

    Massage works well to release tight muscles and improve the flexibility of the muscles round the knee followed by stretching and strengthening of the quadriceps muscles to improve the balance of the quadriceps, including strengthening of the glutes and core.

    We offer treatment for Patellofemoral Pain Syndrome in Cape Town