Runner’s knee, or patellofemoral pain syndrome, is an unfortunately common running injury that can strike both beginners and experienced runners alike.
In fact, studies show that runner’s knee is actually the most common overuse running injury, with an incidence of about 19–30% in female runners and 13–25% in male runners.1Bump, J. M., & Lewis, L. (2023, February 13). Patellofemoral Syndrome. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557657/
Runner’s knee often begins with just a niggle in the knee but can quickly escalate into a frustratingly persistent injury.
Runner’s knee recovery time can vary widely depending on the severity of the injury and how promptly it’s addressed. On average, recovery may take 4-6 weeks, but it could be shorter with early intervention or longer if the injury is severe.
For this reason, taking your runner’s knee recovery treatment plan seriously becomes all the more important.
What Is Runner’s Knee?
Runner’s knee, technically referred to as patellofemoral pain syndrome (PFPS), is a common knee injury marked by pain at the front of the knee located at, under, or right around the knee cap (patella tendon).
The pain typically increases during activities that load the flexed knee, such as running, hopping, squatting, and climbing up and down stairs.
Pain can also be exacerbated after prolonged sitting, kneeling, or when pressing directly on the knee cap. Some runners also complain of clicking, popping, and grinding.
Although patellofemoral syndrome can occur in any type of athletic population, it is particularly common among runners, hence the usage of the common name, runner’s knee, rather than PFPS.
How Long Does Runner’s Knee Last?
If you’ve received an official diagnosis of a runner’s knee from your healthcare professional, like a physiotherapist or sports medicine doctor, you’ll want to know what treatment options there are and what recovery time looks like.
How long does runner’s knee last? What is the runner’s knee recovery time frame?
As with most overuse running injuries, your trajectory for recovery from runner’s knee is highly individualized, depending on numerous factors.
The average amount of time you can expect it to take to recover from runner’s knee is 4-6 weeks, but your healing time may likely fall way outside of that window.
In the short term, runner’s knee pain can be quite severe, although it will often present as an aching pain
Factors Affecting Runner’s Knee Recovery Time
The primary factors that affect runner’s knee recovery time include the following:
#1: Severity of Your Injury
The severity of your case of runner’s knee is among the top factors that will dictate your recovery time.
If you catch the injury early, make immediate modifications to your training, and start addressing both the causes of your injury as well as the symptoms, you can significantly truncate the anticipated time frame for most runner’s knee recovery estimations.
Some runners who are very diligent and aggressive in their treatment are able to almost sidestep the injury after the first initial signs, getting back to full pain-free training in a week or so.
Even if you’ve had some pain for several days, you might be able to feel pretty much back to normal in two weeks, provided you properly identify and address the cause of runner’s knee in your personal situation.
On the other hand, if your knee pain is pretty severe and sharp, and/or you’ve been trying to run through it for a couple of weeks (during which it has felt progressively worse), recovery will take much longer.
Runner’s knee recovery for runners who have let the injury escalate substantially can be upwards of 2-3 months or more, depending on what type of treatment is implemented once the injury is taken more seriously.
#2: The Cause of Runner’s Knee
There are several potential causes of runner’s knee, and the length of time it takes to heal from the injury can be dependent upon how treatable or modifiable the initial cause is.
Abnormal Patellar Tracking
Usually, runner’s knee occurs because of abnormal tracking of the patella (knee cap) in the trochlear groove of the femur (knee joint). Still, research suggests that the actual reason that this misaligned tracking occurs is variable and often multifactorial.
Malalignment and Muscular Imbalances
Frequent causative factors for a runner’s knee include malalignment of the knee and/or lower extremity, muscular imbalances in the muscles of the leg, excessive tightness, and, most importantly, overtraining.
In terms of misalignment of the patella on the femur, any sort of structural alignment issues of the lower extremity or muscular imbalances can pull the patella one way or another relative to the groove, causing pain, friction, and debility.
Muscle Weakness and Imbalances
Based on the evidence to date2Mellinger, S., & Neurohr, G. A. (2019). Evidence based treatment options for common knee injuries in runners. Annals of Translational Medicine, 7(S7), S249–S249. https://doi.org/10.21037/atm.2019.04.08, some theories regarding the most common causes of runner’s knee are that either weakness in the quads, specifically the vastus medialis obliquus (VMO), or weakness in the hip abductor and external rotators
This can lead to abnormal tracking when you run.
Essentially, when the IT band or the vastus lateralis (lateral quad muscle) is relatively stronger than the VMO, they pull unevenly on the patella, tilting it and taking it outside of the groove.
Alternatively, weak hip abductors and external rotators allow your femur to rotate inward relative to the knee cap at heel strike when you run, causing abnormal tracking. In either of these cases, abnormal tracking leads to pain and grinding.
The good news is that muscular imbalances can be remedied with targeted strengthening exercises. Weight-bearing exercises prescribed by a healthcare provider will help strengthen the thigh muscles and patellar tendon, helping to prevent runner’s knee in the long run.
Tight Tissues
The third primary cause is tight tissues, such as the hip flexors, quads, IT band, and tensor fasciae latae, as well as potentially the hamstrings.
It is possible that decreased flexibility and myofascial tightness in these muscles and tissues can lead to runner’s knee by placing undue compressive stress on the kneecap in the trochlear groove of the femur, leading to knee pain when running.
Overloading the Knee
Lastly, and by far the most common reason is overloading the knee by increasing your mileage or training volume too aggressively, which can cause a runner’s knee, particularly if you have a high BMI.
If you have suddenly increased your training volume, the ligaments and tendons within your knee will need time to adjust to the new level of physical activity.
Backing off your training and replacing some or all high-impact running with cross-training or mileage on soft surfaces can help the injury calm down while you address any other contributing factors.
#3: Your Training Modifications
The extent to which you modify your training after you start experiencing knee pain will influence how quickly you heal from runner‘s knee.
If you are experiencing common symptoms of runner’s knee but ignore them, you’ll likely take longer to recover.
#4: The Effectiveness of Your Runner’s Knee Treatment Plan
In most cases, just taking time off and resting to allow your knee pain to go away and then hopping right back into training is a recipe for a lingering injury and a poor recovery.3Johnston, R., Cahalan, R., Bonnett, L., Maguire, M., Glasgow, P., Madigan, S., O’Sullivan, K., & Comyns, T. (2020). General health complaints and sleep associated with new injury within an endurance sporting population: A prospective study. Journal of Science and Medicine in Sport, 23(3), 252–257. https://doi.org/10.1016/j.jsams.2019.10.013
In other words, if you don’t address the cause and don’t do anything to address the symptoms other than rest, recovery from runner’s knee will take longer than it will if you focus your efforts on correcting the cause and healing the damage.
Tips For How To Get Back To Running With Runner’s Knee
What is the fastest way to heal runner’s knee?
Recovery from runner’s knee is best served by a two-pronged approach: treating the symptoms and treating the cause.
In terms of treating the symptoms, this involves reducing the loading on the knee while it heals and trying to manage inflammation.4Patellofemoral pain syndrome (runner’s knee): How can you relieve pain at the front of the knee? (2020). In www.ncbi.nlm.nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK561504/
How long should I rest my runner’s knee? Depending on the severity of your symptoms you may be able to continue running at a reduced level of volume. However, if symptoms are severe, you would likely need to stop running for a few weeks.
Replace some or all of your running mileage with low-impact cross training (biking, swimming, deep water running), or run on soft surfaces like grass and trails as long as it does not elicit pain.
In the short term, employ the RICE protocol (rest, ice, compression, and elevation) and consider going to physical therapy for ART, Graston technique, dry needling, and other healing modalities.
Most importantly, a knowledgeable physical therapist can help you properly address the cause of runner’s knee—whether overuse, muscle imbalances, tightness, overpronation5Chan, Z. Y. S., Zhang, J. H., Au, I. P. H., An, W. W., Shum, G. L. K., Ng, G. Y. F., & Cheung, R. T. H. (2017). Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial. The American Journal of Sports Medicine, 46(2), 388–395. https://doi.org/10.1177/0363546517736277, or otherwise.
If pain is severe, the use of NSAIDs (anti-inflammatory medication) such as ibuprofen may help alleviate some pain.
They may also prescribe orthotics, a knee brace, or taping to help with pain.
Building strength in your VMO or weak hips is one of the best strategies for healing runner’s knee.
Examples of exercises to perform to treat the causes of runner’s knee include clam shells, side-lying leg raises, resisted glute bridges with a resistance band around your thighs, single-leg mini squats, donkey kicks, straight leg raises, and quad sets.
If you have tight muscles, try self-myofascial release with a massage gun, foam roller, or lacrosse ball, and stretch your quads, calves, hamstrings, and IT bands after warming up and again after your workout.
A full recovery from runner’s knee is possible; just take your rehab seriously. You’ll get back out there, even if you have to dial things back for a few weeks.
If you need to take a break and are looking for some cross training ideas, take a look at our low-impact cross-training alternatives for runners:
