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The knee cap (patella) is attached with ligaments to the tibia and the quadriceps muscle and normally tracks in a groove over the femur. If the knee is consistently exposed to rotational forces, the knee cap may be pulled off its centered track which leads to pain. If this problem is not corrected degenerative arthritis may cause permanent problems and pain. Initially this pain my be primarily ligament pain, but prolonged runner’s knee may cause cartilage problems.

Runners Knee is a result of a muscular imbalance in the feet and legs. It is not related to the structures surrounding the kneecap. The kneecaps need to move up and down in a smooth motion to insure a balanced running stride. When the muscles in the legs and feet are not in balance then the knees can go off track causing the cartridge to grind away on the kneecap. Weak quadriceps are usually caused by the very strong hamstrings over powering them. This causes the kneecap to be out of balance as the weaker quadriceps are not able to support the kneecap and prevent pulling and twisting. Pronation or foot imbalance can also lead to your kneecap being out of balance causing knee pain. Sometimes this condition can be made worse by a sudden increase in mileage, speed and running on uneven surfaces.

Causes Of Ruuner’s Knee:

Weak Hip Abductors:The hip abductors (muscles on the outer thigh involved in moving leg to side) also help support the knee. Strengthening these muscles may also improve runners knee.

Tight Iliotibial Band:The iliotibial band (a fibrous band of tissue on outer thigh that extends from the hip to below the knee) also affects knee stability. If too tight, this muscle/tendon of the outer thigh can pull the knee to one side. A tight iliotibial band can also cause Iliotibial Band Syndrome.

Weak Hamstrings:Another imbalance can occur when the muscles in the front of the thigh are significantly stronger than the muscles in the back of the thigh (the hamstrings). If your hamstrings are weak, your quads have to work harder. Tight hamstrings cause increased pressure between the patella and femur.

Imbalanced Quadriceps:Sometimes the quads (there are four divisions) are imbalanced. The inner quad pulls the kneecap inwards and the outer quad pulls the kneecap outwards. If the inner quad is weak, the stronger outer quad tends to pull the kneecap off center. In this case, exercises to strengthen the muscles of the inner quadriceps are particularly helpful

Weak Quadriceps:Quadriceps (front thigh muscles) strengthening exercises are considered to the most important exercise, in most cases, for correcting poor knee tracking. The quadriceps controls the movement of the kneecap. (They are attached to the kneecap and then to the top of the shine bone by tendons).

Problems With The Feet: People who have flat feet (also called fallen arches or overpronation) are at higher risk for achy knees. Over pronation causes excessive internal rotation of the lower leg and knee, stretching the muscles and tendons.

Wrong Running Shoes: Many runners are doing road running with running shoes meant for indoor sprints. A good road running shoe has a big sole to absorb the impact.

Hard Surface: Tarmac is hard, and if you are just getting started in road running your knees will feel the negative effect of running on tarmac.

Overtraining: Training without giving your body time to recover will lead to fatigue and injury of the knee muscles.

Weak kneecaps or thigh muscles: If you are a beginner runner your kneecaps are not used to the high impact nature of road running and you might soon suffer a runner’s knee.

The symptoms of runner’s knee develop when the kneecap doesn’t move properly along its normal track. The patella (knee cap) lies in a groove (called the Trochlear Groove) on the front of the femur (thighbone), just above the knee joint. Normally, when walking or running the patella moves up and down this groove vertically, with no sideways motion (just like an elevator moves). Pain occurs when the patella is not tracking vertically in this groove, but is pulled sideways. This causes the cartilage on the undersurface of the patella, and the cartilage in the Trochlear Groove to rub abnormally against each other, producing pain. If left untreated, the cartilage that is subjected to this excessive rubbing will become permanently damaged, and begin to deteriorate and break down.

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