What is runner's knee?
Runner's knee, formally called patellofemoral pain syndrome (PFPS), is pain around or behind the kneecap. Despite the name, it's not just runners — it shows up in cyclists, hikers, lifters, and anyone whose knees take repeated load. The pain is usually dull and achy (not sharp), located vaguely 'around the kneecap,' and worse with activities that load the knee in flexion: running, stairs (especially down), squatting, or sitting with the knee bent for long periods. The cause is rarely a structural problem — it's almost always weakness or movement faults at the hip, weak quads, or training overload.
Common symptoms
- Dull, achy pain around or behind the kneecap
- Pain worse with running (especially downhill)
- Pain going down stairs
- Pain after sitting for long periods with knees bent ('movie-goer's sign')
- Pain with squatting or lunging
- Knee feels 'stiff' after exercise
- Crepitus (grinding or crunching) with knee bending
- Pain that comes on gradually rather than from a single injury
What causes runner's knee?
Runner's knee usually develops from a combination of factors. Weak hip abductors and glutes (allowing the thigh to collapse inward), weak quads, tight hamstrings or calves, sudden increases in training volume, hill running, worn shoes, and movement patterns that load the kneecap unevenly all contribute. Running form issues — overstriding, excessive hip drop, or knee valgus — are common. Less commonly, anatomical factors (kneecap tracking, alignment) play a role, but these are usually addressed through strengthening and movement retraining rather than structural fixes.
How online PT helps with runner's knee
Evaluation. Your first visit is an evaluation over video. Your PT watches you walk, single-leg squat, and (if you can do it safely) jog in place — looking for hip drop, knee valgus, and quad weakness. They ask about your training history, terrain, shoes, and what activities aggravate symptoms. Hip and quad strength testing helps identify the specific contributors.
Treatment. Your program targets the actual cause — hip and glute strengthening (lateral band walks, single-leg work, glute bridges), quad strengthening (especially the VMO and quad endurance), movement retraining for running form, and short-term load modification (reducing volume or removing aggravating activities) while you build strength. As symptoms resolve, you progress back into training with smarter mechanics.
Ongoing support. Most runners improve within 4–8 weeks with consistent strength work and training modifications. Message your PT between visits about your training, exercise progressions, or recurring symptoms. The plan adapts as you build capacity.
What to expect
Your first visit is about 60 minutes over video. Your PT watches you move, tests strength, asks about training, and identifies what's driving your knee pain. By the end, you'll have a plan with specific strengthening exercises, training modifications, and an expected timeline. Most patients are back to normal training within 6–12 weeks.
Insurance accepted for runner's knee
Online physical therapy for runner's knee is covered by most major insurance plans. You pay your normal copay — nothing extra for online visits.
MedicareBlue Shield of CaliforniaAnthem Blue CrossCignaAetnaUnited HealthcareHumana
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