Last updated: July 2026 • Reading time: ~4 minutes
Summer means more people lacing up and hitting the trails and roads around Fairfield County. But with more miles comes more knee pain. One of the most common complaints from runners is a dull ache around or behind the kneecap. Doctors call it patellofemoral pain syndrome. Most people just call it runner’s knee.
If you have felt this ache after a run, you are not alone. It is one of the most common overuse injuries for runners of every level, from first time 5K trainees to seasoned marathoners.
What Is Runner’s Knee?
Runner’s knee feels like a dull, achy pain around the front of your knee or behind your kneecap. It often gets worse when you run downhill, walk down stairs, or sit with a bent knee for a long time, like on a long car ride or at a movie.
Think of your kneecap like a sled that should glide smoothly in a groove every time you bend your knee. When the muscles around your hip and knee are not doing their job, the kneecap can drift off track. That small shift can rub and irritate the tissue underneath, which causes pain.
What Causes Runner’s Knee?
Runner’s knee rarely comes from one bad step. It usually builds up slowly. A 2025 study in the Journal of Biomechanics followed 83 runners and found that training habits, like weekly mileage and running speed, interacted with how the knee and ankle moved, and those combinations predicted who ended up with knee pain. Runners who ramped up their mileage too fast, especially past about 18 to 29 miles a week without building up gradually, showed patterns linked to pain.
Weak hip and thigh muscles are also a major factor. When those muscles tire out, the kneecap loses some of its natural guidance system.
How Do You Treat Runner’s Knee?
The good news is that runner’s knee responds well to the right kind of exercise. A 2024 study in Physical Therapy in Sport put 30 female runners with long-term knee pain through an 8-week home strengthening program. Their pain dropped significantly and their function scores improved by a large margin.
Rest matters too, but rest alone rarely fixes the root problem. Strengthening the hips, quads, and core helps the kneecap track properly again. Ice, taping, and supportive shoes can calm symptoms while the deeper strength work does the real repair.
For some runners, tight or misaligned joints in the hip, ankle, or spine also affect how weight moves through the leg. In those cases, a chiropractor, physical therapist, or sports medicine doctor can check alignment and movement patterns alongside a strengthening program.
Can You Prevent Runner’s Knee?
Prevention comes down to building up slowly. Increase your weekly mileage in small steps rather than big jumps. Add hip and glute strengthening two or three times a week, even if it feels unrelated to running. Replace worn-out shoes, since old shoes lose their support long before they look broken down.
A 2024 review in the Journal of Osteopathic Medicine surveyed 103 runners and found a clear pattern: many kept training through pain instead of getting it checked, which let small problems grow into bigger ones. Catching the ache early, before it becomes chronic, gives you a much better shot at a fast recovery.
The Bottom Line
Runner’s knee is common, but it is not something you have to just push through. If knee pain is a regular guest at the end of your runs, look at your training load and your hip and thigh strength first. If the pain sticks around after rest and stretching, ask a physical therapist, sports medicine doctor, or chiropractor to look at your gait and joint movement together.
If you also deal with pain at your shins, heels, or outer knee, our articles on shin splints, plantar fasciitis, and IT band syndrome cover how these running injuries connect.
Sources & Further Reading
- de Morais Machado E, et al. “Runners’ lower limb kinematics and training characteristics interactions associated with the occurrence of patellofemoral pain.” Journal of Biomechanics, 2025. Study of 83 runners; training distance and speed interacted with knee and ankle kinematics to predict patellofemoral pain groups.
- Eckenrode BJ, et al. “Effects of high frequency strengthening on pain sensitivity and function in female runners with chronic patellofemoral pain.” Physical Therapy in Sport, 2024. 30 female runners; large, statistically significant improvement in pain and function after an 8-week home strengthening program.
- Santanello A, et al. “An osteopathic assessment of lower extremity somatic dysfunctions in runners.” Journal of Osteopathic Medicine, 2024. Survey of 103 runners; many continued running through pain rather than seeking evaluation, correlating with more somatic dysfunction over time.
- Xu J, et al. “Global research trends and hotspots in patellofemoral pain syndrome from 2000 to 2023: a bibliometric and visualization study.” Frontiers in Medicine, 2024. Review of 2,444 publications identified hip and knee strengthening as the leading research focus for treating patellofemoral pain.
