Patellofemoral Pain (Runner’s Knee)
Musculoskeletal (MSK) Services
Last updated: July 2026
Review Date: July 2026
What is Patellofemoral Pain?
Patellofemoral pain (PFP), sometimes known as runner’s knee, is one of the most common causes of pain at the front of the knee. It occurs around or behind the kneecap (patella), where it moves within a groove at the end of the thigh bone (femur).
The kneecap acts as a lever for the muscles at the front of your thigh, helping the knee bend and straighten smoothly during everyday activities.
Although painful, patellofemoral pain is rarely caused by serious damage, and most people improve with exercise and self-management.
What Causes Patellofemoral Pain?
There is usually no single cause. Instead, several factors may contribute.
These include:
- A sudden increase in activity or exercise.
- Reduced strength in the thigh or hip muscles.
- Poor control of knee movement.
- Tight muscles around the hip, thigh or calf.
- Natural differences in the shape or alignment of the hips, knees or feet.
Pain can also reduce how well the muscles work, making the knee more sensitive over time.
Symptoms
Common symptoms include:
- Pain around or behind the kneecap.
- Pain when climbing or descending stairs.
- Discomfort during squatting or kneeling.
- Pain after sitting for long periods.
- Pain while walking or running.
- Clicking, grinding or catching sensations.
- Knee stiffness.
These clicking or grinding sensations are common and are not usually a cause for concern.
Treatment
Patellofemoral pain usually responds well to conservative treatment, meaning surgery is rarely required.
Treatment focuses on:
- Managing pain.
- Gradually increasing activity.
- Strengthening muscles.
- Improving movement control.
Activity Advice
It is important to keep moving, but avoid activities that significantly increase your pain.
A useful guide is the 24-hour soreness rule:
- Mild discomfort during exercise is acceptable.
- Pain should settle or remain manageable within 24 hours.
- If symptoms worsen or remain painful the following day, reduce the intensity or duration of the activity.
Gradually increase your activity as your knee becomes stronger.
Pain Relief
Pain relief may help you stay active while your knee recovers.
Options include:
- Paracetamol.
- Ibuprofen (if appropriate).
- Heat or cold packs for up to 10 minutes, several times a day.
- Anti-inflammatory gels or creams if recommended.
Always follow the advice on the packaging or speak to your GP or pharmacist if you are unsure.
Exercises
Why are these exercises important?
Strengthening the muscles around your knee and hip improves support for the kneecap, reduces strain on the joint and helps you return to everyday activities with less pain.
Perform the exercises every day or every other day, depending on your symptoms. As they become easier, gradually increase the resistance or add light weights.
Quadriceps Tightening
Lie on your back and tighten the muscles at the front of your thigh by pushing the back of your knee firmly into the bed or floor.
Hold for 10 seconds.
Repeat as many comfortable repetitions as possible.
Squats
Stand with your feet shoulder-width apart.
Slowly lower into a squat while keeping your chest upright and your heels on the floor.
15–20 repetitions for 3–5 sets.
Wall Squats
Stand with your back against a wall and your feet slightly forwards.
Slide down until comfortable, hold for 3–5 seconds, then return to standing.
10–12 repetitions for 3–5 sets.
Forward Lunges
Step forwards into a controlled lunge while keeping your body upright.
Push back to the starting position and repeat on the opposite side.
If you can comfortably complete more than 10 repetitions on each leg, consider adding light weights.
Stretching Exercises
Stretching may help improve movement and reduce muscle tightness.
Focus on:
- Quadriceps stretch.
- Hamstring stretch.
- Calf stretch.
Hold each stretch for 20–30 seconds and repeat 3 times.
Recovery
Most people notice gradual improvement within 6–12 weeks when they regularly complete their exercises and gradually return to activity.
Recovery varies between individuals, so progress at a pace that feels comfortable for you.
When Should I Seek Further Advice?
Speak to your healthcare professional if:
- Your symptoms are not improving after 6–12 weeks.
- Your pain is becoming worse.
- Your knee repeatedly gives way or locks.
- You are struggling with everyday activities despite following this advice.
Further assessment or treatment may be recommended if symptoms continue.
Further Information
Patellofemoral pain is a common and treatable condition. Most people recover successfully with exercise, gradual activity progression and simple pain management strategies. Consistency with your rehabilitation programme is the key to long-term recovery.
