The most common symptoms and signs of runner’s knee are acute pain and/or increased pressure in front of the knee. The pain is diffuse and cannot be pinpointed to a specific location.

The pain is felt at the front of the knee, at the patellofemoral joint, and medical practitioners call it patellofemoral pain syndrome.

The symptoms peak when the knee is bent at 60° to 90° - such as while performing a deep squat or sitting on a chair. Pain is alleviated by straightening out the knee, relieving the pressure and stress on the kneecap.

Common Signs and Symptoms of Patellofemoral Pain Syndrome

The pain is felt in one or both knees and causes some combination of the following symptoms:

  • Pain in the front of the knee: A dull, aching pain, sharp stabbing sensation, or feeling of pressure or fullness is felt in the front part of the knee – around and/or behind the kneecap.
  • Pain worsens when the knee is bent: Activities and movements that involve bearing weight on a bent knee, such as descending stairs, squatting, kneeling, doing lunges, or pedaling a bike increase stress on the kneecap.
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  • Knee stiffness after inactivity: Extended periods of sitting, such as during car rides or sitting at a desk, lead to knee stiffness and exacerbate pain symptoms.
  • Knee crepitus after rest: A popping, grinding, or crunching sensation, called knee crepitus, may occur inside the knee. Knee crepitus is common after periods of rest, such as when getting out of bed in the morning, and reduces or disappears during activity. Read about Crepitus in the Knee on Arthritis-health.com
  • Tenderness at the kneecap: Pressing on the skin over the kneecap may cause discomfort or pain.
  • Knee swelling: The front of the knee may swell, indicating inflammation and causing reduced mobility and soreness. This swelling is sometimes referred to as "water on the knee." Read about Water on the Knee on Arthritis-health.com

The symptoms of patellofemoral pain syndrome tend to interfere with everyday activities that involve bending and straightening the knees, as well as recreational activities or sports such as running, biking, or skiing.

If left untreated, runner’s knee pain tends to get worse over time.

Dr. Michael Khadavi is a sports medicine physician specializing in spine care, musculoskeletal ultrasound, regenerative medicine, and sports-related injuries. He practices at Apex Orthopedics & Sports Medicine. Dr. Khadavi is an educator in regenerative medicine and has been an invited lecturer at the American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Major League Soccer, and Stanford University.

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