Once the diagnosis and underlying cause of runner’s knee have been established, a physician can prescribe a course of treatment. Most cases are treated without surgery.

Common treatments for runner’s knee include:

  • R.I.C.E. (rest, icing, compression, and elevation) may be advised to reduce the initial symptoms of runner’s knee. This protocol will be particularly important if the symptoms are manifesting for the first time.
  • Over-the-counter or prescribed anti-inflammatory medications.
  • Physical therapy to strengthen the muscles surrounding the knee and hip, stretch any tight muscles, and retrain the muscles to contract appropriately during sports and activity.
  • Shoe inserts may benefit a subset of individuals with abnormal foot structure or movement patterns while running.
  • A patellar brace or taping to maintain proper tracking of the patella during knee movement.
  • Correction of training errors, such as the rate of increase in running volume and speed. In general, up to a 10% to 15% increase in either running volume or speed is safe on the patellofemoral joint.

If non-surgical methods fail to resolve the situation, surgery may be recommended.


Surgery for Runner’s Knee

Surgery is rarely indicated for patellofemoral knee pain. If all conservative measures have failed and an individual is unable to participate in desired activities without significant pain, a surgeon may attempt to alter mechanics of the knee through a procedure such as a “lateral release.” In this procedure, the lateral patellofemoral ligament is cut to decrease the pull on the patella to the outside of the knee and attempt to improve tracking along the trochlear groove of the femur. The decision for surgery requires a lengthy discussion with the surgeon, reviewing several factors, including: the medical history of the patient; the likelihood for success of the procedure; and whether or not it will restore the individual’s ability to perform athletically.

Fortunately, with appropriate pelvic and lower limb strengthening and modification of risk factors for patellofemoral pain, the vast majority of cases resolve and individuals can return to their full athletic potential.

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.