Knee Problems when you run?By: John Hart

Knee Problems when you run?

Well it just may be that you have what is termed Runner’s knee or “Chondromalacia”

Chondromalacia is a term used to describe damage of the articular cartilage behind the underside of your kneecap or patella or sesamoid bone, in young woman (also males but predominately woman) exercisers. In a lot of cases it can be due to an injury such as a fall, overuse/overexercise, problems with your knee alignment, or even muscle weaknesses surrounding the knee.

There is normally a wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes rough because the kneecap is not riding smoothly over the knee joint.
There is also pain beneath or on the sides of the kneecap and a grinding noise can be felt this is due to the rough piece of cartilage that rubs against cartilage when the knee is in flexion.
Pain is most prominent when the runner is involved in hill climbs. There may be in fact some swelling taking place.  

A common cause can be over pronation where the runners feet rotate inwards when they impact the ground, which in turn causes the knee cap to move slightly sideways. This can be combined with weak quad muscles such as Vastus lateralis, Vastus medialis, Vastus intermedius and the Rectus femoris.
Weakness can also occur on the inside part of the quadriceps which can prevent the kneecap from tracking smoothly. A muscle imbalance then between weak quadriceps and tight hamstring and the “ITBS” ( Ischial Tibial band.) Other causes that need to be ruled out are poor footwear, worn shoes and overtraining.

Treatment in the first instance would be:

  • stop running,
  • a course of over the counter anti-inflammatory drugs
  • Apply ice
  • Avoid weight bearing exercise
  • Massage
  • Apply  anti-inflammatory gel
  • Check with a podiatrist to see if you need orthotics
  • Strengthen the quadriceps muscle only when pain subsides



Exercises can include:
1) Placing a roller (soft) under your knee, tighten quadriceps, push knee down into pillow and lift foot up. 15-20 times
2) Repeat exercise as above with foot turned out in order to strengthen the inside of the quadriceps muscle. Repeat 15-20 times.
3) Squats. Perform with back against wall. Bend knees slowly to between 45 – 60%. Ensure that knee travels over your foot. Hold for a count of 10 seconds. Relax repaet up to 10 times concentrating on the eccentric movement.
4) Box step ups. Stand on a box. Tighten quadriceps and lower opposite leg slowly to the ground. Ensure that knee travels between big and second toes. Then raise the leg back up onto the step. Repeat 10 times. Increase when you are feeling stronger.

Massaging and stretching of the quadriceps, hamstring, hip flexors and ITBS.along with the gluts.

If injury doesn’t respond to self-treatment see a physiotherapist or your doctor. Also consult with a podiatrist for custom-made orthotics. Don’t waste your time with Cortisone injections as in these cases they seem to be worthless. You may want to do other forms of exercises if this becomes a constant problem. Rowing, swimming and cycling may be an alternative as an aerobic activity for you.


John Hart

“Master’s In Education” (Disability) Newcastle University Australia

“Grad Cert Education” Newcastle University Australia

“Diploma Fitness/Recreation”

“Diploma of Sport and Recreation”

“Cert 4 Personal Training”

“Level 1 Strength and Conditioning Coach”

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