Exercises for Treating and Preventing Runner’s Knee (Patellofemoral Syndrome)

Runner’s knee, or patellofemoral syndrome, is an injury that can cause a dull, achy pain at the front of the knee and around the kneecap. It’s common for runners, cyclists, and for those who participate in sports involving jumping.

Runner’s knee symptoms may improve after resting from exercise and icing the area. At-home stretching and strengthening exercises may also help.

Read on to learn exercises and other home remedies you can try. If the pain doesn’t go away after a few weeks of home treatment, or you experience sharp pain, see your doctor.

For runner’s knee pain, try a variety of exercises that focus on strengthening the knee, hips, and quadriceps. You can also stretch out your hip flexors and hamstrings.

Strengthening will help to keep the knee stable while running, as well as help to increase leg flexibility and reduce tightness.

Most of the exercises below can be performed on one or both legs. If you feel knee pain on either side, back off the stretch and skip that exercise.

For best results, try performing each exercise daily for six weeks.

1. Standing quad stretch

Areas worked: quadriceps and hip flexor

1. Stand upright.
2. Reach behind your body to grab your left foot with your left hand. Bring your left heel up to your glutes, or as far as it doesn’t cause pain. You can use the wall or a hold a friend’s shoulder for balance.
3. Keep your left knee in close as your stretch.
4. Hold for 15 seconds, then switch to the right leg.
5. Repeat the stretch on the right side.
6. Perform 2-3 sets on each leg.

If this version hurts your knees, you can do the stretch lying on your belly instead and reaching behind you for your knee. You can also use a yoga strap or towel to gently bring your knee up to your glutes.

2. Standing hip flexor stretch

Areas worked: hip flexors, psoas

1. Start in a split stance, with the left foot forward and right leg back.
2. Drop your back knee and tailbone slightly so they’re an inch closer to the floor while you tuck your pelvis forward.
3. Keep your spine in a neutral position. Don’t arch or round your back.
4. Hold for 10 seconds, then repeat on the other side.

3. Straight leg lift

Areas worked: quadriceps, hips

1. Lie down on your back with one knee bent at a 90-degree angle and the other leg extended straight out on the floor.
2. Using the extended leg, tighten up your quadriceps (thigh muscle) and raise the leg until it’s at a 45-degree angle.
3. Hold your leg up for 2 seconds at this angle before slowly lowering it to the ground.
4. Repeat 20 times. Switch legs. Perform 2-3 sets.

4. Standing calf stretch

Areas worked: calves, shins

1. Stand facing a wall. Put out your arms so your hands are pressing the wall at a comfortable distance. Hands should be placed at eye level.
2. Keep the heel of the leg with the injured knee flat on the ground.
3. Move the other leg forward with the knee bent.
4. Turn the unbent leg (the one with pain) slightly inward and slowly lean into the wall until you feel a stretch in the back of your calf muscle.
5. Hold for 15 to 30 seconds, then stand back upright.
6. Repeat 3 times.

5. Step up

Areas worked: glutes, quads

Equipment needed: box step or flight of stairs

1. Place your left foot on the step.
2. Lift your right leg in the air and hold for a second as your left leg straightens and tightens.
3. Slowly lower the right leg back to the ground.
4. Repeat 10 times, then switch legs, putting the right leg on the stair.

Steps can be painful if you’re experiencing an injury. If steps irritate your knees, skip this exercise. After you recover, this exercise can be a good way to strengthen your legs and glutes and reduce risk of injury.

6. Clam exercise

Areas worked: hips, glutes

1. Lie on one side with your hips and knees bent and your feet stacked on top of one another.
2. Slowly raise your top leg to the ceiling while your heels continue touching, forming a clam shape.
3. Hold for 2 seconds, then lower the top leg slowly.
4. Perform up to 15 reps. If it isn’t painful, switch sides and repeat. Do 2 sets per side.

7. Wall slide

Areas worked: quads, glutes, and calves

1. Begin standing with your back against a wall. Your heels should be around 6 inches in front of your hip bone, and your feet should be around shoulder-distance apart.
2. Moving slowly, slide your back and hips down the wall until your knees are bent around a 45-degree angle.
3. Hold this position for around 5 seconds, then stand back up.
4. Repeat the slide 10-15 times. Perform 2-3 sets.

8. Donkey kick

Areas worked: glutes

1. Start on a yoga mat, towel, or blanket on all fours, with arms straight, knees under hips, and shoulders over wrists.
2. Slowly lift your left leg behind you and extend it toward the back of the mat. Raise it up to hip height and keep your foot flexed.
3. Keeping your back flat, press your heel up toward the ceiling for a second, then lower it back to hip height
4. Repeat 10 times on the left leg, then switch to the right.

9. IT band stretch

Areas worked: glutes, hips, upper legs

1. Start standing, with your left leg crossed over your right.
2. With your right hand raised over your head, slowly start to lean over to the right until you feel a stretch.
3. Hold for up to 10 seconds.
4. Switch legs and repeat. Perform 2-3 times on each leg.

10. Hamstring stretch

Areas worked: hamstrings

1. Lie on your back with your right leg extended in front of you.
2. Bend your left leg. Wrap your hands around the back of your left thigh and slowly start to pull it toward you. You should feel the stretch in the back of your thigh.
3. As you pull the leg close to you, try to straighten the knee as much as possible, with your heel flexed and pointing toward the ceiling.
4. Hold stretch for 20 seconds, then switch legs.
5. Repeat up to 3 times on each leg.

Other treatments for runner’s knee may include the following:

• Ice your knee daily, or multiple times per day, if needed.
• Talk to your doctor about taking over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), if you’re in pain.
• Try low-impact activities, such as swimming and cycling.
• Foam roll areas of the legs that are tight.
• Practice knee-strengthening exercises and see a physical therapist, if needed.

In rare cases, you may need surgery if nonsurgical treatments aren’t effective. Surgery may be necessary to realign the angle of your kneecap. Your doctor can take an X-ray or MRI of your knee to view your injury and determine the best treatment option.

In many cases, rehabilitation exercises and stretches may be effective for treating runner’s knee.

According to research published in the Journal of Orthopaedic & Sports Physical Therapy, performing a series of knee- and hip-strengthening exercises three times a week for six weeks may be an effective way to decrease knee pain and improve physical activity.

Additionally, a 2007 study found that using personalized physical therapy exercises to strengthen the quadriceps and increase flexibility was more effective than knee braces or taping the knee. And, in some cases, strengthening exercises may be more effective than taking NSAIDs.

A physical therapist can help you determine which exercises will be most effective for you based on your situation. They can help you find exercises to target and stretch specific areas. They’ll also be able to observe if you have a muscular imbalance that needs to be corrected.

To recover from runner’s knee pain, you should start by resting. You may need to cut back on running or other sports, or stop entirely until you feel better. Avoid other activities that increase your pain, like going up and down stairs, as much as possible.

How long it takes to recover from runner’s knee will vary for everyone. With rest and ice, your pain may go away in two to three weeks. Or, you may need to see a physical therapist who can recommend strengthening and stretching exercises to help you get back to running.

See a doctor if your knee pain doesn’t go away after three weeks. You may need an X-ray, CT scan, or MRI to determine the cause of your pain.

It may not be possible to entirely prevent runner’s knee pain, but the following steps may help alleviate symptoms:

• Reduce high-impact physical activity. Alternate running days with non- or low-impact activities, like swimming and yoga.
• Gradually increase mileage and intensity. Running too many miles, too quickly, may lead to knee pain.
• Adopt a healthy lifestyle. Being overweight or obese can put additional stress on your knees during physical activity. If you’re concerned, talk to your doctor about a safe weight loss program.
• Stretch and warm up before and after every workout.
• Check your shoes. You may need shoes with additional support or orthotic inserts. Runners should also replace their shoes every 300 to 500 miles.

Runner’s knee is common in runners and athletes, but it can affect anyone.

If you experience runner’s knee, you’ll likely need to cut back on running and other sports until your pain subsides. You may still be able to participate in other low-impact activities, like swimming and cycling, though.

See a doctor if your knee pain doesn’t go away after a few weeks. You may need an X-ray, CT scan, or MRI to determine the cause of your pain.