Runner's Knee Treatment in Canary Wharf
Pain around or behind the kneecap, worse on stairs, squatting, running, or after a long stretch at a desk. Common in runners and in anyone whose training load climbed quickly. Hip and thigh strengthening is what changes it.
Overview
Understanding patellofemoral pain
Patellofemoral pain is pain around or behind the kneecap, where it sits against the thigh bone. It is one of the most common presentations in runners, and it accounts for a large share of knee pain in active adults generally. Most people describe it as a dull ache rather than a sharp pain, and can rarely point to one exact spot.
The classic aggravators are stairs, particularly going down, squatting or kneeling, running, and long periods sitting with the knee bent, which is why it turns up so often in people who train hard and then spend the day at a desk.
It is a load-distribution problem rather than joint damage. The kneecap runs in a groove, and how it is loaded depends on the strength and control of the muscles above and around it, particularly the quadriceps and the hip and gluteal muscles. When those cannot control the leg well under load, the joint takes more than it is comfortable with. Imaging is rarely needed and rarely changes what we do.
Treatment is hip and thigh strengthening, plus adjustments to the training load that provoked it. We assess through sports physiotherapy to confirm the source and find the specific weakness, then progress you back to running or your sport through return-to-sport rehabilitation.
Physiotherapy for patellofemoral pain can help you to:
Confirm what is actually causing it
Pain at the front of the knee can come from the kneecap joint, the tendon below it, or the outer thigh, and each needs different loading. We assess first, so the programme targets the right structure.
Build the strength that unloads the joint
How the kneecap is loaded depends on the hip, gluteal and thigh muscles controlling the leg. Strengthening those is the intervention with the best evidence behind it, and it is the part that lasts.
Keep training through it
You rarely need to stop. We set the volume and surface that stay within what the knee tolerates, using how it feels the next morning as the guide, so your fitness holds while the strength builds.
Make desk days less provocative
Long stretches with the knee bent load the joint statically, which is why it often hurts more after a day at a desk than after a run. Small changes to how often you move make a disproportionate difference.
Why it happens
What causes patellofemoral pain?
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A rapid increase in running volume, or the addition of hills or speed work
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Weakness in the hip, gluteal and thigh muscles, so the kneecap is loaded less evenly
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Poor control of the knee under load, where it drifts inward on landing or squatting
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Long periods sitting with the knee bent, which loads the joint statically
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A change of running surface, footwear, or a jump into a new type of training
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A previous knee injury after which strength was never fully rebuilt
Treatment approach
How do we treat patellofemoral pain?
Sports Physiotherapy
On enquiryConfirms the kneecap is the source rather than the tendon or the outer knee, identifies which muscles are not controlling the leg well, and builds the hip and thigh strengthening programme that is first-line treatment.
See treatment detail →Return-to-Sport Rehabilitation
On enquiryProgresses loading through running volume, hills and change of direction with strength compared against the other side, so the return is based on what the leg can do rather than how many weeks have passed.
See treatment detail →Sports Massage
On enquiryAdjunctive soft-tissue work for quadriceps and lateral thigh tension during a strengthening block. Useful for comfort alongside the loading programme, not a treatment for the underlying weakness.
See treatment detail →FAQ
Frequently asked
questions
What is the best treatment for runner's knee?
Progressive strengthening of the hip, gluteal and thigh muscles, combined with sensible adjustment of the training load that brought it on. That combination has the strongest evidence behind it. Rest alone tends to settle symptoms temporarily and leave the underlying weakness unchanged, so the pain returns when you resume.
Do I need a scan for pain around my kneecap?
Usually not. Patellofemoral pain is diagnosed clinically from your history and examination, and scans often show age-related changes that are equally common in people with no pain at all. Imaging is reserved for a knee that locks, gives way, or follows significant trauma.
Can I keep running with patellofemoral pain?
Usually yes, at a reduced volume. A practical guide is that pain during the run stays mild and has settled by the next morning. Flat surfaces tend to be better tolerated than hills, and shorter more frequent runs better than long ones, while you build strength alongside.
Why does my knee hurt more after sitting than after exercise?
Holding the knee bent for long periods keeps the kneecap loaded against the thigh bone without the movement that normally distributes it. It is a recognised feature of patellofemoral pain, sometimes called the cinema sign. Standing and moving every half hour usually helps noticeably.
How is patellofemoral pain rehabilitated?
By building what the knee and hip can tolerate, then reintroducing the thing that provoked it, in that order. Quadriceps and gluteal strength do most of the work and load management does the rest. Canary Wharf Physio runs the strength side in the club gym, because those loads do not fit in a treatment room.
Get Started
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Book today.
Canary Wharf Physio • Unit 7, 30 South Colonnade, London E14 5HX
BookAppointments typically available within 1–2 weeks