One of the most common injuries in running is commonly known as Runner’s Knee.

Also referred to as Patella Femoral Syndrome, Runner’s Knee is the result of damage to the cartilage on and/or the under the knee cap. Symptoms include pain just below the kneecap and/or along the inner (medial) side of the knee. The pain is generally most pronounced when running up or down hills, climbing stairs or first standing after sitting with knees bent for prolonged periods. The pain is commonly more of an ache than a sharp pain and may be accompanied by a grinding sound. It is not uncommon to feel as if the knee wants to lock, catch or give out.

While there are a number of different factors that contribute to Runner’s Knee, one of the most common is excessive pronation. Pronation is a normal movement of the foot that allows the arch to flatten to a degree.   If the foot is weak or tired and/or the footwear is not supportive, then the arch can flatten more than normal, resulting in excessive pronation. Excessive inward pronation of the foot causes rotation to occur at the knee. This additional inward pressure contributes to alignment issues between the knee cap and the femur. You can easily determine the degree to which your foot pronates by visiting any Dave’s location for a free gait analysis from one of our experienced team members.

Other contributing factors include weakness of the muscles running along the inner (medial) thigh connecting at the knee, mechanical conditions including wide hips (females), knock knees, high or subluxating and hill running or stair use.

Repetitive, excessive pronation is a common or leading contributor to many lower extremity, overuse injuries.

So what to do about it?

Supporting the foot with proper shoes and/or insoles, can prevent or help to eliminate the vast majority of stresses on the lower extremities including Runner’s Knee. Most common footwear has more than enough cushion but very little support for the arch and heel. As with most lower leg issues, proper footwear with appropriate support is critical to the proper alignment of the knee cap and the treatment and prevention of Runner’s Knee. The solution for your injury may be a shoe with added stability or motion control. Another solution is to add a simple over the counter medical grade insole that provides appropriate support for the arch and heel. We recommend visiting one of our convenient locations for a professional shoe fitting and free gait analysis.

Stretching, strengthening and supporting, along with ice and rest, have been found to be effective treatment for these injuries. Stretching of the hamstring, quad, calf and iliotibial band will help to decrease pressure at the kneecap. Strengthening of the vastus medialis oblique muscle will help the kneecap to glide more correctly through the groove at the knee joint. Avoid downhill running or going up/down stairs. Avoid exercises done with the knee bent unless being done as an isometric and under direction of a medical professional. Physical Therapy including ultrasound, iontophoresis, patellar mobilization, and exercise play a very important role in recovery.


We’ve learned a thing or two about injuries in the last forty years but that doesn’t make us doctors. This material is offered for informational use only and should not be taken as medical advice. Only you can decide when it’s time to talk to a doctor. Generally speaking any time an injury persists or worsens it’s time to seek help from a medical professional. Until then we’re happy to share our experience with you to use as you see fit.