True Form Therapy | Dorset Sport Injury clinic

If you’re a runner, rugby player, footballer, or someone training for events like HYROX or a marathon, you may have experienced pain around the front of your knee at some point.

One of the most common causes of this is Patellofemoral Pain Syndrome, more commonly known as Runner’s Knee.

Despite the name, this condition doesn’t just affect runners. It frequently appears in athletes who perform repetitive lower body loading such as running, squatting, lunging, and jumping.

The good news is that with the right assessment and rehabilitation plan, Runner’s Knee is very manageable and most people can return to training pain-free.

What Is Runner’s Knee?

Runner’s Knee refers to pain that develops around or behind the kneecap (patella). This occurs when the patella does not move smoothly within the groove of the thigh bone (femur) during movement.

Instead of gliding evenly, the kneecap can track slightly off line, creating irritation within the joint and the surrounding soft tissues.

This often develops gradually and tends to worsen during activities that place repeated stress on the knee joint.

Common Symptoms

People experiencing Runner’s Knee often report:

• Pain around the front of the knee or behind the kneecap
• Discomfort when running, squatting, or climbing stairs
• Pain when sitting for long periods with bent knees
• A clicking or grinding sensation during movement
• Symptoms that gradually worsen with training

In many cases the pain initially appears during exercise but can eventually begin to affect daily activities if left unaddressed.

Why Runner’s Knee Happens

Runner’s Knee rarely develops from a single cause. Instead, it is usually the result of several contributing factors affecting how the knee moves and loads during activity.

Weak Glutes and Hip Muscles

The glutes play a crucial role in controlling the position of the femur during movement. When these muscles are not providing adequate support, the knee can collapse inward during running, squatting, or jumping.

This change in alignment increases stress on the kneecap.

Exercises such as the Glute Bridge and Clamshell Exercise are often used to improve hip stability and reduce strain on the knee.

Poor Movement Mechanics

Movement patterns such as the knee collapsing inward during squats, lunges, or running can gradually overload the patellofemoral joint.

Over time this repetitive stress can irritate the tissues around the kneecap.

Training Load Errors

A common trigger for Runner’s Knee is increasing training volume too quickly.

This might include:

• Increasing running mileage rapidly
• Introducing hills or speed sessions suddenly
• Adding extra gym sessions without adequate recovery
• Returning to sport too quickly after time off

The knee joint needs time to adapt to increased loading.

Tight Muscles

Tight quadriceps, hip flexors, and calves can alter how forces are distributed through the knee joint.

Reduced mobility in these areas can contribute to abnormal tracking of the kneecap and increase irritation around the joint.

Why Runner’s Knee Is Common in Marathon Training, HYROX, and Team Sports

Certain training phases can significantly increase the likelihood of developing Runner’s Knee.

Marathon Training

During marathon preparation, weekly mileage gradually increases as runners build endurance.

While this progression is necessary for performance, it can lead to repeated stress on the knee joint if strength training and recovery are not prioritised.

As fatigue builds during longer runs, movement quality can deteriorate. This often results in increased inward knee movement, placing additional stress on the patellofemoral joint.

HYROX Training

HYROX events combine running with functional strength movements such as lunges, sled pushes, and wall balls.

These exercises place significant demand on the knee joint, particularly when performed under fatigue. Repeated deep knee bending combined with high running volume can increase irritation around the kneecap if the surrounding muscles are not providing adequate support.

For many HYROX athletes, improving glute strength, hip stability, and lower limb control is key to reducing knee discomfort.

End of Rugby and Football Season

Toward the end of a rugby or football season, many players begin to notice knee pain that wasn’t present earlier in the year.

This can occur due to:

• Accumulated fatigue from a long competitive season
• Reduced recovery between training sessions and matches
• Minor injuries that have been compensated for
• Increased gym training as the off-season approaches

Sports involving frequent sprinting, cutting, and changes of direction place significant forces through the knee joint. Over time, this can lead to irritation around the kneecap if strength and recovery are not well balanced.

How Sports Therapy Can Help

Effective treatment for Runner’s Knee focuses on addressing both the symptoms and the underlying cause.

Sports therapy treatment may include:

• Soft tissue therapy to reduce muscular tension
• Mobility work to improve joint movement
• Strength exercises targeting the hips and glutes
• Movement analysis to identify biomechanical issues
• Gradual return-to-training programmes

The aim is not only to reduce pain but to improve how the body moves and handles training load.

Exercises That Can Help

Several strengthening exercises are commonly used in rehabilitation for Runner’s Knee.

Glute Bridges help develop posterior chain strength.

Step Downs improve knee control during single-leg loading.

Side-Lying Clamshells target the hip stabilisers that control knee position.

These exercises aim to improve hip and pelvic stability, which plays an important role in reducing stress on the knee.

When Should You Get It Checked?

If your knee pain:

• Lasts longer than two to three weeks
• Continues to return during running or training
• Begins to limit your ability to exercise

It may be beneficial to have it assessed by a sports therapist.

Early assessment often leads to quicker recovery and helps prevent the issue from becoming long-term.

Final Thoughts

Runner’s Knee is one of the most common overuse injuries in active individuals. Whether you are preparing for a marathon, training for HYROX, or coming to the end of a demanding rugby or football season, knee pain is often a sign that the joint is being overloaded relative to its current capacity.

With the right combination of strength training, movement assessment, and load management, most people can return to full training without persistent pain.

If you’re currently struggling with knee pain during running, training, or sport, it may be time to have it assessed.

At True Form Therapy Injury Clinic, I help runners, athletes, and active individuals identify the root cause of their pain and return to training with confidence.

Book an appointment today and start your recovery journey.