Knee pain when running or walking downstairs

Runner’s knee is characterised by an aching pain around the kneecap, pain when bending the knee, swelling, a popping or grinding sensation in the knee, and knee pain when walking down stairs. There may be pain in one knee or both knees after running.

It is one of the most common bone and joint injuries in otherwise healthy, active adults and is most often experienced by people involved in regular activity such as running, walking or swimming. It is also commonly referred to as either Chondromalacia patellae (CMP) or patellofemoral pain syndrome (PPS). Although the terms are used interchangeably, there are some slight differences: CMP is characterised by a softening of the patellar articular cartilage, whereas PPS applies only to individuals who experience pain without cartilage damage.

What causes runner's knee?

There are a number of different potential causes associated with the condition, such as weak thigh and hip muscles, the kneecap not being in the correct position, unusually short muscles, having one leg longer than the other, overuse or repeated tendon strain (often as a result of overtraining), core instability, and bursitis.

Strategies to manage knee pain when running

There are a number of strategies that may assist people who are experiencing runner’s knee or downhill walking knee pain. 

• Taping the knee. Techniques such as taping the knee may help decrease overall pain and provide structural support.
• Specific exercises to enhance knee stability are recommended as first-line treatments. A combination of knee and hip exercises to increase strength, mobility and function may also help. Ensure you seek out a healthcare professional for exercises for your individual needs. 
• Rest. Evidence suggests that a period of rest and not over-exerting the knee may help ease some symptoms. 
• Orthotic supports in shoes. Some studies have found wearing orthotic supports in shoes may be helpful. 
• Good quality footwear. Much of the advice regarding runner’s knee is preventative in nature, with those regularly exerting pressure on their knees encouraged to avoid running on hard surfaces and wearing good quality running shoes.
• Running Style. Modifying the running gait may help impact symptoms and help reduce pain. 

The evidence for invasive and non-invasive measures for runner’s knee remains relatively small and inconclusive. While some studies have potentially important repercussions for the future treatment of runner’s knee, better-designed studies are required in order to make recommendations for treatment with a greater degree of confidence. If you are concerned about the health of your knees, seek out a healthcare professional for further advice. 

Related reads:

• How much exercise do I really need?
• 10 ways to increase your incidental exercise
• Does warming up really prevent sporting injuries?

References

1. Hryvniak, D., Magrum, E. M., & Wilder, R. P. (2014). Patellofemoral pain syndrome: an update. Current Physical Medicine and Rehabilitation Reports, 2(1), 16–24. https://doi.org/10.1007/s40141-014-0044-3
2. Kayll, S. A., Hinman, R. S., Bryant, A., Bennell, K. L., Rowe, P. L., & Paterson, K. L. (2023). Do biomechanical foot-based interventions reduce patellofemoral joint loads in adults with and without patellofemoral pain or osteoarthritis? A systematic review and meta-analysis. British Journal of Sports Medicine, 57(13), 872–881. https://doi.org/10.1136/bjsports-2022-106542
3. Esculier, J.-F., Bouyer, L. J., & Roy, J.-S. (2022). Running gait modifications can lead to immediate reductions in patellofemoral pain. Front Sports Act Living, 4, 1048655. https://doi.org/10.3389/fspor.2022.1048655