Runner's knee: causes, fixes and when to see a physio

By Geoff Scott, Founder & Senior Physiotherapist, Hauora

Pain around the front of the knee, often worse on stairs or after a long run, is one of the most common complaints we see in runners. It is usually not serious, but it is a clear signal that something in your training or mechanics needs attention. This is the classic pattern of runner’s knee, and it responds well to the right approach.

What is actually going on

Runner’s knee is typically an overload problem. The tissue around the kneecap is being asked to handle more than it is currently prepared for, whether through a spike in mileage, weak supporting muscles, or movement patterns that load the joint poorly.

What helps with runner’s knee

• Reduce mileage temporarily rather than stopping completely
• Build strength in the hips, glutes and quads
• Check your running cadence and form
• Progress your training load gradually, not in jumps

When to see a physio

If the pain persists beyond a couple of weeks, worsens, or keeps returning, get it assessed. A targeted plan will get you back to running faster and stop it coming back.

Backed by evidence: managing runner’s knee

This is not guesswork. The NHS advises building up activity gradually and addressing muscle weakness to ease knee pain. In fact, many runners recover fully with a structured plan rather than complete rest. If symptoms persist, the same graded approach we use for returning to play after injury applies here too. Consistency with strengthening work is often what makes the biggest difference over time. Most people with runner’s knee improve within six to eight weeks when they follow a sensible plan. Avoid rushing back to full training too soon, as this often causes the same pain to return. Warming up properly before every run also helps to protect the knee joint over the long term.