Some of you starting to keep your body fit and healthy, or training for an event but your knees got crepitus and pain? Some of you may wondering, why you still get knee pain when you previously got jogging, got strengthen the lower limb muscle by doing workout/gym, got do yoga as well as keep active in sports or maintain body wellness. In this situation, you might having Runner’s Knee or in medical terms called as Patellofemoral Pain Syndrome!!! Let me tell you what’s going on in your knee~
Conditions that can cause Runner’s knee include anterior knee pain syndrome, patellofemoral malalignment, chondromalacia patella, and iliotibial band syndrome. It is the common term used to describe any one of several conditions that cause pain around the kneecap (patella). It can be caused by running or any activity that repeatedly stresses the knee joint (Complete Physio, n.d.) (Donohue, 2023).

Common Causes of Injuries
  • Overuse Injuries:
    • Account for 70-80% of running related injuries
    • Repetitive movement or activity that puts a certain tissue or body part under more stress or strain than it is able to comfortably tolerate.
  • Patellofemoral joint reaction force
ActivityLoad Across Front of knee
Walking0.9 x body weight
Going down stairs2.8 x body weight
Going up stairs3.2 x body weight
Running5.2 x body weight
  • Training load:
    • Improper rest and training duration
    • Improper Training programs: no stretching, no progressive loading
  • Improper Footwear
  • Poor Biomechanics: Flat foot or high arch foot

What does Physio can do and suggest?

The Physiotherapist will make a detailed assessment, consider your training plan and what you are aiming to achieve, and be able to assess your movement patterns, strength, flexibility, and running technique.

  1. Stretching & strength and conditioning can be a really important factor, and often overlooked.
  2. Rest can be as important as running and is an absolutely vital consideration in your training program. Some balance in the overall load to your body also is part of the running components
  3. Therapist will advice about proper running form while this can be a bit of minefield and the truth is that there is no ‘one fits all’ approach. Most appropriate shoes for you will depend on your foot shape, width, running style and the type of running and distance you want to run.


It is clear from the research that the only way to improve or change a certain running style, is by retraining the runner to use a different pattern. These gait retraining programs usually have 3 phases (Louw, 2023):

  • Phase 1: This phase takes a lot of thinking and concentrating as you learn the new pattern. You usually have to use feedback from devices or video to help keep you on track and make adjustments.
  • Phase 2: During this phase you consolidate and practice your new pattern and you usually become progressively less reliant on feedback from devices etc.
  • Phase 3: This is when the new running gait pattern has been practised so much that you can maintain it without having to think about it.



Complete Physio. (n.d.). Retrieved from Complete-physio.co.uk: https://complete-physio.co.uk/fix-knee-pain-when-running/

Donohue, M. (2023, April 17). Runner’s Knee. Retrieved from Healthline: https://www.healthline.com/health/runners-knee

Jean-Francois Esculier, L. J.-S. (2022). Running gait modifications can lead to immediate reductions in patellofemoral pain. Front Sports Act Living, 4: 1048655.

Leandro Fukusawa, R. S. (June 2020). There is no difference in footstrike pattern distribution in recreational runners with or without anterior knee pain. Gait & Posture, Volume 79, Pages 16-20.

Louw, M. (2023, May 9). Running style tips that can help patello-femoral pain (runner’s knee). Retrieved from Sports Injury Physio: https://www.sports-injury-physio.com/post/running-style-tips-that-can-help-patello-femoral-pain-runner-s-knee#:~:text=Patello%2Dfemoral%20pain%20(or%20pain,mechanics%20and%20decreased%20muscle%20strength.

Neurohr, S. M. (2019). Evidence based treatment options for common knee injuries in runners. Ann Transl Med, 7(Suppl 7): S249.


Prepared by

Teh Qi Shun

Your Physio Alam Damai

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