What it feels like
- A dull ache around or behind the kneecap.
- Pain when running, going down stairs, squatting or after sitting for a long time.
- Sometimes a grating or clicking feeling without swelling.
Why it happens
The kneecap glides in a groove at the front of the thigh bone. When the load on that joint rises faster than the tissues can adapt, the area becomes irritated. Common triggers are a sudden jump in mileage, hills or stairs, new shoes or a change of surface, and returning to sport after time off.
Weakness around the hips and thighs, particularly the quadriceps and glute muscles, is often part of the picture. The knee tends to get blamed for what the hip and thigh are not coping with.
Do you have to stop running?
Not necessarily. Complete rest sounds sensible, but it also lets your strength drop. A better approach is to reduce what provokes the pain, keep it to a level you can tolerate and recover from by the next day, and build back gradually.
- Swap some runs for cycling, swimming or walking while it settles.
- Shorten stride length and run on flatter routes for a few weeks.
- Avoid long periods of deep knee bending, such as repeated deep squats, until symptoms ease.
The rehab that works
Studies show that strengthening the hips and thighs, with exercises such as sit-to-stands, step-ups and glute work, reduces pain and improves function. The key is gradually progressing the difficulty rather than doing the same easy exercise forever.
At Castle Therapies we start with a consultation and screening, look at how you move, then build an exercise plan around your sport and your week. Hands-on treatment to tight thigh and hip muscles can help you move more comfortably while you build strength.
Building back up
- Start with walking and strength work until daily activities are comfortable.
- Try short, easy runs on alternate days, with pain no higher than mild and settled by the next morning.
- Add distance or intensity, never both in the same week.
- Keep the strength work going. It is your long-term protection.