As a recreational runner who recently had to quit running for several months because I experienced “runner’s knee” pain, I personally know how unpleasant the condition can be—not only do you have to experience chronic kneecap pain, but you also have to deal with living without running until the pain goes away.  That’s probably the hardest part!

Runner’s knee (or patellofemoral pain syndrome) is one of the most common overuse injuries a runner can incur, but comparatively few runners are probably aware of how the syndrome develops on a biomechanical level.  The patella (kneecap) is a floating bone that connects to the other leg bones through cartilage and tendons, and it mostly “rests” in a groove between the femur and the lower leg bones.  As you use your leg, the patella moves or “tracks” in this groove, and if it doesn’t track smoothly it can irritate the cartilage and other tissues within the groove causing increasing pain.

When I started experiencing runner’s knee I was running about 20 miles per week and walking an additional 15, as well as working on my feet about 35 hours per week.  While this level of mileage is potentially above average for hobby joggers, it’s certainly quite far away from the mileage logged by competitive runners and professional athletes.  When the pain became more than a slight irritation, I begrudgingly decided to take a few weeks off.  When I returned and the pain hadn’t gone away, I gave up running for the foreseeable future and went to the doctor. 

After a (in my opinion) cursory examination, my GP informed me I had runner’s knee and gave me a fat booklet of physical therapy exercises to do “every day.”  Of course, thinking I knew better than the doctor, I decided the good-old RICE method was all I needed.  When—obviously—a couple months of rest didn’t rid me of my pain, I decided to give the physical therapy a try.  Here are the exercises that worked best for me:

Straight leg lift: Lie on your back, with your uninjured leg bent straight up and its foot on the floor.  Raise your straightened injured leg 10 inches above the floor, hold for two seconds, and slowly lower it back to the ground for about 10 seconds, keeping the toe pointed straight up and the quadriceps engaged.  Do three sets of 10.

Side leg lift: Lie on your uninjured side with both legs straightened.  Lift your injured leg 10-12 inches away from the floor, hold for two seconds and slowly lower it back to your other leg for about 10 seconds, again keeping the quadriceps engaged.  Do three sets of 10.

Clam exercise: Same as the side leg lift, except you bend both knees a little less than 90º and keep your heels touching the entire time: lift your injured knee about 10 inches up, hold for two seconds, and slowly lower it back to the other knee.  Do three sets of 10.

Inner leg lift: Lie on your injured side.  Lift your uninjured leg over the top of your injured leg and place the foot flat on the floor above your injured knee.  Lift your injured leg as high as you can within the space between your uninjured thigh and the floor, hold for 2 seconds and slowly lower to the ground over 10 seconds.  Do three sets of 10. 

After only two weeks of doing these exercises once a day, my lingering pain magically disappeared.  What a surprise!  Since returning to running and gaining back a reasonable level of conditioning, I’ve found that the pain occasionally returns, but that the exercises aid in continually managing the potential for further injury—I can tell that the muscles affecting my knee cap are stronger, which changes the mechanics of my stride but is probably better overall for my form.  If you’re returning from runner’s knee and experience a bit of pain when starting to run again, I recommend you listen to your body—a slow warmup and hamstring stretches mid-run have made a big difference in any recurrence of the pain for me.