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Runner's Knee: Physical Therapy in Brooklyn for Pain Around the Kneecap

By Dr. Jack Engelberg, PT, DPT · · 4 min read

If your knee aches around or behind the kneecap when you go down stairs, squat, kneel or sit through a long movie, you may have patellofemoral pain syndrome, often called "runner's knee." It's one of the most common causes of knee pain in teenagers, runners and active adults. It's also very treatable with the right exercise program.

What Is Patellofemoral Pain?

The patellofemoral joint is where the kneecap (patella) glides in a groove at the end of the thighbone (femur). When you bend and straighten your knee, the kneecap tracks up and down this groove, and the forces through the joint increase significantly with deeper bending, like squatting and stairs.

Patellofemoral pain syndrome (PFPS) describes pain around or behind the kneecap that's aggravated by activities that load this joint. It usually isn't caused by damage you can see on an X-ray. Instead, it's generally thought to result from the joint being asked to handle more load than it's currently prepared for.

Common Symptoms

  • A dull ache around or behind the kneecap
  • Pain going down stairs or hills (often more than going up)
  • Pain with squatting, kneeling or lunging
  • Pain after sitting for a long time with knees bent (the "movie-goer's sign")
  • Pain with running, jumping or sports
  • Occasional crackling or grinding sensations, usually harmless

What Causes Runner's Knee?

PFPS usually involves several factors working together:

  • Training errors — increasing running mileage, hills or jumping too quickly
  • Hip and quadriceps weakness — weak hip muscles can let the knee drift inward, and weak quads absorb less load
  • Movement patterns — the knee collapsing inward during squats, landings or stairs
  • Foot mechanics — in some people
  • Tight muscles — such as the quadriceps, hamstrings or calves
  • Growth spurts — in adolescents

How Physical Therapy Helps

Exercise therapy, particularly combined hip and knee strengthening, is the best-supported treatment for patellofemoral pain.

Evaluation

Your therapist will assess strength, flexibility, and how you squat, step down, run or land. They'll review your training and activity history to identify what changed before your pain began.

Treatment May Include

  • Activity modification — temporarily reducing aggravating activities rather than stopping everything
  • Hip strengthening — glutes and hip rotators to improve knee control
  • Quadriceps strengthening — starting in ranges that don't aggravate the kneecap and progressing gradually
  • Movement retraining — step-downs, squats, landing and running form
  • Taping or bracing — patellar taping can reduce pain in the short term for some people, making exercise easier
  • Foot orthoses — may help selected individuals in the short term
  • Graded return to running and sport with a clear progression plan

What You Can Do at Home

  • Reduce load, don't eliminate it. Cut back on hills, stairs and mileage temporarily.
  • Strengthen your hips. Side-lying leg raises, clamshells and bridges are common starting points.
  • Work your quads in comfortable ranges. Partial squats or wall sits at a pain-free depth.
  • Take sitting breaks. Straighten your legs or walk around during long periods of sitting.
  • Return gradually. When resuming running, increase distance and intensity slowly, and avoid big jumps from week to week.
  • Consider your shoes. Worn-out shoes may change how load moves through your legs.

When to See a Physical Therapist

Consider an evaluation if:

  • Kneecap pain lasts more than a couple of weeks
  • It limits running, sports, stairs or squatting
  • It keeps coming back whenever you increase activity
  • You're a teen athlete with persistent knee pain

See a physician if the knee gave way with a pop and swelled quickly, if the kneecap dislocated, if the knee locks, or if it's hot, red and swollen.

Frequently Asked Questions

Do I have to stop running?

Not always. Many runners can continue at a reduced level while doing a strengthening program. Your therapist will help find the right balance.

Is runner's knee the same as arthritis?

No. PFPS is usually not caused by joint damage, though older adults can have kneecap arthritis too. Learn more about knee arthritis.

How long does it take to recover?

Many people improve over several weeks to a few months with consistent exercise. Recurrence is common if strength work stops entirely, so a maintenance plan helps.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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