What's Happening

Patellofemoral pain syndrome ("runner's knee") is a dull, poorly localized ache around or behind the kneecap, usually caused by how the kneecap tracks and loads within its groove rather than by any single structural injury. It's typically worse with running, squatting, stairs — especially downhill or down stairs — and prolonged sitting with the knees bent.

By the Numbers

25–40%

of sports-medicine knee visits are PFPS

2:1

women affected more often than men

1 in 5

teens experience it during adolescence

What Contributes to It

  • Hip and quad weakness — a weak hip lets the thigh drift inward (dynamic valgus), changing how the kneecap tracks and loads

  • Tight hamstrings and calves, which add compressive force across the joint

  • Training errors — a rapid jump in mileage, intensity, or training volume is one of the strongest predictors

  • Foot mechanics — an overly flattened or rolled-in arch can affect the whole chain up to the knee

How We Treat It

  1. Calm the irritation — activity modification and, short-term, taping to offload the joint while you rebuild capacity.

  2. Combined hip and knee strengthening — the single most effective intervention; hip work addresses the dynamic valgus driving the problem.

  3. Improve mobility — hamstring and calf flexibility to reduce compressive load.

  4. Rebuild training load gradually — matching mileage and intensity increases to what the joint can currently tolerate.

Bottom line: A structured strengthening program — hips included, not just the knee — meaningfully improves both short- and long-term pain. Most people see real progress within 6 to 8 weeks of consistent exercise.