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Patellofemoral Syndrome in Runners

by Nora Gilman, MS, LAT, ATC

The Rundown:

Patellofemoral syndrome is also referred to as “Jumper's knee” and although runners never jump, runners can still have this pathology. The primary problem is with the patellar tendon but the cause is likely due to something else, such as weak muscles or improper running mechanics.


Pain over and/or under the knee cap with walking, running, or going up stairs.

My Clinical Experience:

(Note: this experience has not been clinically trialed and are theories only)

Knee pain is never because of a problem with the knee, rather, a problem with above or below the joint, such as the hip and foot. The knee is placed in between these two really important joints and can become injured without proper training. With patellofemoral syndrome, a common problem is weakness and strength imbalances in the quad. There are four quad muscles which are prone to imbalances. The largest quad called the rectus femoris and the inner quad called the vastus medialis are weak in most cases.

What you can try:

  1. Modify running: If you find running makes your symptoms worse, try to find an intensity or amount of running that you can sustain without making the condition worse.

  2. Strengthening: A strengthening program focused on strengthening the quad muscles (without pain).

  3. Cross-train: You can find other activities to engage in to keep your aerobic fitness while you turn down your running volume. Some alternatives are biking, swimming, or water jogging. These activities can strengthen other muscles that you may not be using in running. If any of these activities make your symptoms worse, try a different activity.

  4. Knee brace: A knee brace with an ‘open patella’ can provide your knee support and manage pain while you strengthen and cross train.

When to contact an athletic trainer:

  • If you need help and advice on properly modifying your activity, an AT can provide you with ongoing support.

  • If you need direction with the right stretching and strengthening protocol, an AT can get you started on effective exercise progression and regressions.

  • If you need help finding and ordering the right knee brace.

  • If your pain persists, despite the efforts above, an AT can advise the proper next steps.

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