What is runner’s knee?

Runner’s knee usually refers to two problems:

1. Patellofemoral Pain Syndrome (PFPS) — pain around or behind the kneecap

2. IT Band Syndrome (ITBS) — pain on the outside of the knee

Both conditions come from the same place:
your knee is taking more load than it can currently handle.

Why runner’s knee happens

Most cases come down to a few key factors:

1. Weak hip control

If your glutes aren’t doing their job, your knee drifts inward when you land.
This increases pressure on the kneecap and IT band.

2. Sudden spike in training

New shoes. More miles. Faster sessions.
Your knee gets overloaded before it has time to adapt.

3. Low cadence

If your steps per minute are too low (below ~165–170), you land heavier and farther in front of your body — increasing knee stress.

4. Tight or overworked quads

This pulls on the kneecap and creates stiffness around the joint.

5. Weakness in the foot/ankle

Poor foot stability forces the knee to compensate.

Quick self-check (at home)

Ask yourself:

• Pain during or after longer runs?

• Twinge on steps or downhill?

• Knee feels “achy” after sitting?

• Pain returns quickly when you restart training?

If yes, you’re showing classic runner’s knee patterns.

What actually helps (first 7–10 days)

1. Reduce load — don’t stop running completely

Keep easy runs, reduce hills and speed work, and drop total mileage by 20–40% temporarily.

2. Increase cadence by 5–7%

This small tweak instantly reduces knee load.

3. Add simple strength exercises

Do these 3–4 times per week:

• Side-lying hip raises

• Slow, controlled step-downs

• Single-leg RDL

• Glute bridge variations

4. Keep moving — avoid total rest

Rest alone doesn’t fix the problem and often makes the return to running worse.

The Active Rehab approach (what actually fixes it for good)

At Active Rehab, we don’t guess. We assess:

• Hip strength

• Knee tracking

• Running mechanics

• Foot placement

• Single-leg control

• Load tolerance

Then we create a plan that includes:

• Targeted hands-on treatment

• Movement pattern correction

• Personalised strength training

• Running technique cues

• Exercises delivered in the TrueCoach app

This approach doesn’t just calm the pain —
it stops it coming back when mileage increases.

Common mistakes runners make

• Foam rolling the IT band only

• Completely stopping running

• Switching shoes hoping for a “quick fix”

• Skipping strength training

• Increasing mileage too early

When to book in

Speak to a therapist if:

• Pain affects more than 2–3 runs

• Pain returns when you increase your mileage

• You have IT band pain that won’t ease

• You’re preparing for a race and need fast guidance

Final thoughts

Runner’s knee doesn’t have to derail your training.
With the right plan, you can get back to pain-free running and build the strength to stay injury-free long term.

Need help fixing runner’s knee?
Book your initial consultation in Belfast or Lisburn today.