What is Runner’s Knee?

By Sydney CBD Physiotherapist Dr Domenic Simeoni

Knee pain troubling you while running? This blog discusses all things runner’s knee! What is runners knee? Why do runners develop knee pain?  What are the symptoms of runners knee? How to treat runners knee? What can a physio do to help running knee pain? Keep reading to find out!

What is “Runners Knee?”

knee joint anatomy - used to demonstrate runners knee mechanics
Source: Blausen

The term “Runners Knee” is used to describe a variety of injuries that commonly affect runners. Pain along the inside, outside, or front of the knee is common for many runners, especially if you are new to running, or are increasing your training load. The repetitive nature of running makes many individuals susceptible to a variety of repetitive stress injuries, commonly referred to as RSI’s. As is typically the case with runners knee, these repetitive stress injuries usually develop over time and can affect a single joint or multiple joints or areas.

Why do runners develop knee pain?

physio performing wall sit for strength - how to avoid knee pain

Running is an activity that involves a high amount of repetitive movements. This means that as you run, each of your joints goes through a series of repetitive motions over and over. This high repetition of the same movement can eventually start to cause irritation and pain in a joint or area. Many times a runner has movement patterns and mobility or strength deficits that result in poor running mechanics. These poor mechanics can present at the hip, knee or ankle, and over time with repetition, these poor running mechanics result in the onset of pain and injury. As the development of the injury begins to worsen, the intensity of pain and discomfort will increase, often resulting in an inability to run for longer distances.

What are the symptoms of Runners Knee?

Runners knee is usually associated with pain in the area in and around the front of the knee along the the knee cap, also known as the patella. Depending on the severity of the injury, the pain felt can be described as dull and achy, or in worse cases as sharp or stabbing. There may also be swelling present in the injured area which is a clear sign that there is a structure in the knee that is being irritated during running.

When you develop pain associated with runners knee, it can be felt with activities such as:

physio quadricep stretching to avoind running knee pain
  • Walking
  • Squatting
  • Running
  • Going up or down stairs
  • Kneeling
  • Standing up from or sitting down into a chair

If you think you may be suffering from runner’s knee; book and assessment with a physio, osteo, or Chiro today. This will mean a tailored diagnosis, a treatment plan, and running mechanics correction advice delivered to you.

How is Runners knee treated?

Firstly, as with many repetitive stress injuries, it is always a good idea to stop or reduce the activity that is causing you the pain. This means that first and foremost, a reduction or full stop to running may be necessary to initially promote healing of your knee.

During the initial stages of treatment, following the RICE protocol is also important to promote healing and stop your injury from getting worse. RICE stance for Rest, Ice, Compression, Elevation:

Rest – Avoid the activities that cause you pain

Ice – At the painful site

Compress – Through the use of a soft wrap or brace, always best to consult a health professional to learn how to correctly apply a wrap or brace.

Elevate – Place your knee above the level of your heart to allow gravity to drain swelling or oedema away from your knee and back into your bloodstream

Treatment and management of runners knee will often require you to undergo an assessment from a sports medicine doctor, physiotherapist, podiatrist, or osteopath. A thorough assessment of your body’s strength, joint mobility, flexibility, and running mechanics will be performed to identify movement patterns that are causing the development of an injury.

What is a running assessment?

If running is what is causing your injury, it is very helpful for your physiotherapist to gain insight into your specific running mechanics. In order to do this, they may recommend that a running analysis be performed. There is more often then not a direct correlation between poor running mechanics and the development and worsening of runners knee.

During a running assessment, your physiotherapist will have you warm up on a treadmill, gradually running faster until you reach a comfortable or normal pace. Video analysis will be then used to record your running mechanics from several different angles, allowing your physiotherapist to gain insight into specific areas of strength and weakness, as well as determining how your body and joints move in space. Following the video analysis your physiotherapist will assess the videos and produce a written assessment, including photographs, that highlight any areas that they determine may be contributing to your injury.

A specific running technique exercise program can often be developed by your physiotherapist based on the information gained during the running analysis. This will help you to develop better mechanics when running, strengthen any weak areas, and stretch any tight areas that may be limiting your running. Though this combined approach, it is possible to reduce strain through an injured area and allow for continued running while going trough the rehab process.

Podiatrist and physio perform running assessment to fix knee pain

Physiotherapy treatment for runners knee?

If you are getting pain or discomfort associated with running, it is likely time to consider scheduling a physiotherapy running assessment in order to help diagnose exactly what is happening at your knee that is causing the pain, and to begin the healing process. Following the assessment, your Physiotherapist will be able to educate you on your specific areas of strength and weakness as well as any poor running mechanics that may be contributing into the problem, giving you insight into why you are having discomfort. This information will also help your Physio to develop a treatment plan aimed at addressing your individual areas of weakness, or helping guide you to improve your running mechanics. Altering running mechanics can take time and effort, but with the correct guidance you will find that running becomes easier and less taxing on your body, allowing you to exercise with less wear and tear on your body!

Physio Domenic Simeoni assessing knee joint for runners knee pain
Tags
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Nerissa D'Mello​​

Clinical Lead Physiotherapist
Nerissa’s interest in physiotherapy began after experiencing multiple injuries growing up. Being in and out of clinics sparked her curiosity about how the body heals and inspired her to help others return to what they love. Early hands-on experience with a Scottish rugby club during her masters strengthened her passion for musculoskeletal and orthopaedic rehabilitation.
 
Now the Clinical Lead Physiotherapist at Quay Health, she has a strong interest in helping patients recover without surgical intervention when possible. Her treatment style combines hands-on techniques with exercise prescription, grounded in the latest research to promote lasting recovery.
 
Some of the techniques Nerissa uses are dry needling, VALD ForceDecks and Dynamo for data-driven rehab, taping, and shockwave therapy for stubborn tendon injuries.
 
She enjoys treating a broad range of patients, regardless of age, fitness, or background, and is currently expanding her expertise in women’s health.
 
Patients can expect a thorough, personalised approach focused on understanding their goals, hands-on treatment, and education in a supportive environment.
 
Outside work, you can find Nerissa training for her first full marathon, playing tennis, smiling at your dog, and trying to keep up with all her downloaded podcasts.
 
Clinical interests include:
 
  • Shoulder injuries, including rotator cuff and instability
  • Ankle sprains
  • Tennis and racquet sports injuries
  • Neck and upper back pain
  • Rehab from postoperative hip and knee replacements
  • Women’s health 
 
Languages spoken other than English: Conversational Hindi
 
Nerissa is available at Quay Health. Call 1300 782 943 to make an appointment or book online.

Riccardo Erba​

Senior Physiotherapist

Riccardo’s passion for physiotherapy started while working with patients recovering from strokes, multiple sclerosis, and brain injuries. Seeing how vital movement is inspired him to explore the connection between the brain and body. Over seven years, he developed a holistic approach combining manual therapy, education, and sport-focused rehab.

His treatment style is evidence-based and tailored, blending hands-on therapy with corrective exercises and advanced technologies. Riccardo believes every patient deserves a personalised plan that balances pain relief and long-term improvement.

He uses techniques including spinal manipulation, mobilization with movement, dry needling, Class IV lasers, shockwave therapy, and VALD ForceDecks.

Riccardo enjoys helping clients who want to understand their bodies, relieve pain, prevent injury, and improve performance.

Outside work, he loves hiking, climbing, and following ball sports of all kinds.

Clinical interests include:

  • Headaches and neck pain
  • Shoulder and elbow conditions
  • Hip and knee rehab
  • Shockwave and laser therapy

Languages spoken other than English: Italian

Riccardo is available at Quay Health. Call 1300 782 943 to make an appointment or book online.