If you've been dealing with a persistent, achy pain around the front of your knee — especially after a run — you're likely dealing with what's commonly called runner's knee. It's one of the most frustrating overuse injuries out there: you feel fine during your warm-up, and then somewhere around mile two, that familiar throb starts creeping in.
The good news is that runner's knee is very treatable, and you don't have to bench yourself indefinitely to recover. At Golden Bear Chiropractic in San Leandro, we work with active people every day to address the root causes of knee pain, not just mask the symptoms.
Here's what you need to know.
What Exactly Is Runner's Knee?
"Runner's knee" is the common name for patellofemoral pain syndrome (PFPS) — a condition that causes pain around or behind the kneecap. It happens when the cartilage under the patella becomes irritated, usually because the kneecap isn't tracking smoothly in its groove with each step.
Despite the name, you don't have to be a runner to develop it. Hikers, cyclists, basketball players, and people who work on their feet for long hours can all experience it. But runners are especially susceptible because of the repetitive, high-impact nature of the sport. Every mile puts your knee through hundreds of flexion-extension cycles — and if something is even slightly off in your mechanics, that adds up fast.
Common symptoms include:
- Dull, aching pain at the front of or around the kneecap
- Pain that worsens when running, squatting, going downstairs, or sitting with bent knees for a long time
- A grinding or clicking sensation in the knee joint
- Mild swelling or a feeling of stiffness after activity
What Causes Knee Pain in Runners?
Understanding the "why" behind runner's knee is crucial for treating it properly. The most frequent culprits are:
Training errors. Bumping mileage up too quickly is one of the most common causes. Your cardiovascular system adapts faster than your joints and connective tissue — so what feels manageable from a fitness standpoint can still overload the knee.
Weakness in the hips and glutes. This is one of the biggest and most underappreciated contributors. When the hip abductors and external rotators are weak, the thigh tends to collapse inward during each stride, causing the kneecap to pull off-course. Hip strength plays a far bigger role in knee health than most people realize.
Poor movement mechanics. Overstriding, excessive forward lean, and heavy heel striking all change the forces going through your knee. Taking slightly quicker, shorter steps — even a small adjustment to your cadence — can meaningfully reduce the load on your patellofemoral joint with every stride.
Tight muscles and restricted joints. Tightness in the IT band, hip flexors, quadriceps, or calf muscles can pull the patella out of alignment. Restricted movement in the hip or ankle joints can also force the knee to compensate in ways it wasn't designed for.
Footwear. Worn-out shoes or footwear that doesn't match your foot type can alter your gait subtly but significantly over thousands of steps.
Is It Runner's Knee — or Something Else?
Not every knee problem in a runner is PFPS, and getting the right diagnosis matters because the treatment differs. Other common causes of knee pain after running include:
- IT band syndrome — sharp, burning pain on the outer knee that often hits at a predictable point in each run
- Patellar tendinopathy — pain just below the kneecap, usually worse after activity or the next morning
- Meniscus irritation — often involves joint-line tenderness, catching, or locking sensations
- Bursitis — localized swelling and tenderness from inflammation of the fluid-filled sac around the joint
At Golden Bear Chiropractic, we always start with a thorough assessment before recommending any treatment plan. The right care for IT band syndrome looks quite different from the right care for runner's knee.
How Chiropractic Care Helps Runner's Knee
Chiropractic is often underestimated as a treatment for knee problems — people tend to think of it as back-and-neck care only. But the knee doesn't function in isolation. The way your hips move, the alignment of your pelvis, how your ankle and foot mechanics work — all of these affect what happens at the knee with every stride.
A chiropractic approach to runner's knee typically includes:
Joint assessment and adjustment. Restrictions in the hip, sacroiliac joint, or ankle can alter how load is distributed through the knee. Restoring proper joint motion takes pressure off the patellofemoral joint and allows the knee to track more naturally.
Soft tissue therapy. Techniques targeting the IT band, quadriceps, hamstrings, and calf muscles can release tension that's pulling the kneecap out of alignment. This hands-on work complements the joint care and speeds up recovery.
Corrective exercise. Targeted strengthening of the hip abductors, glutes, and VMO (the inner quad muscle that stabilizes the kneecap) is foundational to long-term recovery. Without addressing the underlying muscle imbalances, pain tends to return.
Gait analysis and movement coaching. Identifying and correcting the mechanics contributing to your knee pain helps you run more efficiently and reduces injury risk going forward.
Load management guidance. You may not need to stop running entirely — but knowing how to modify your training while you heal is critical. We'll help you figure out what's safe and what's not during your recovery.
When Should You See a Chiropractor for Knee Pain?
If your knee pain has lasted more than two weeks, is getting progressively worse, or is starting to affect your daily activities beyond running — don't wait. Early intervention leads to better, faster outcomes.
Patients throughout San Leandro, Oakland, and the East Bay come to Golden Bear Chiropractic for sports injury care that's thorough, evidence-informed, and genuinely personalized. We're proud to serve a diverse community, including LGBTQIA+ individuals who may not always feel seen or comfortable in traditional healthcare settings. Everyone deserves care that's welcoming and effective.
Keeping Runner's Knee From Coming Back
Once you're feeling better, the real work is staying that way. A few habits that make a big difference:
- Progress your running volume gradually — no more than a 10% increase in weekly mileage is a reliable guide
- Build hip and glute strength into your regular training routine, not just when things hurt
- Replace running shoes every 300–500 miles
- Warm up dynamically before runs (leg swings, hip circles, bodyweight squats)
- Address muscle soreness and tightness early — don't let minor issues become chronic ones
Ready to Stop Running Through the Pain?
Runner's knee is frustrating, but it's also highly treatable with the right approach. If knee pain is slowing you down, the team at Golden Bear Chiropractic in San Leandro is here to help you figure out what's going on and build a plan to get you back to doing what you love, pain-free.
