Runner's Knee Recovery Time

If you're dealing with that nagging pain around your kneecap that's forcing you to cut runs short or skip training sessions altogether, you're probably wondering the same thing every runner asks: "How long until I can get back out there?" Runner's knee, or patellofemoral pain syndrome, has a frustrating way of derailing your running routine just when you're hitting your stride.

The truth is, recovery time isn't a one-size-fits-all answer. Some runners bounce back in a few weeks, while others find themselves sidelined for months. The difference often comes down to understanding how different activities impact your knee, how you approach treatment, and whether you're making the common mistakes that can turn a minor setback into a chronic problem.

In this post, we'll break down what influences your runner’s knee recovery time, from the severity of your symptoms to the specific factors that can speed up or slow down your healing. We'll also walk through the typical stages of recovery so you know what to expect, share practical strategies to get you back to running safely, and help you recognize when it's time to see a professional. Most importantly, we'll cover how to prevent runner's knee from coming back once you've finally kicked it to the curb.

What is Runner’s Knee?

Runner’s knee, or patellofemoral pain syndrome, is characterized by pain at or under the knee cap that doesn’t fit the pattern for other types of knee pain. It typically has a gradual onset, it’s 2.23x more likely to occur in females, and it’s more likely to occur in those who specialized in one sport growing up. Another reason to play a variety of sports growing up!

Its symptoms can look similar to other types of knee pain, especially patellar tendinopathy. But one of the symptoms that is more common in runner’s knee than patellar tendinopathy is pain with prolonged sitting. If you’ve been trying to figure out which one is the source of your knee pain and you have pain with prolonged sitting, it’s more likely to be runner’s knee.

Other indicators of runner’s knee include:

• Pain with squatting

• Pain with resisted knee extension

• Pain with ascending/descending stairs

• Recent spike in training intensity, especially of downhill running

Check out this great graphic to help identify different types of knee pain from Tom Goom, a physiotherapist who specializes in running injuries:

How To Treat Runner’s Knee

I was curious what google was telling people to do to treat their runner’s knee, and the amount of hits that said to “ice your knee” was shocking! Ice might feel good temporarily, but it won’t do much to solve your problems. 

The best treatment approach for runner’s knee takes a stepwise approach to building capacity:

Step 1: Calm Down Symptoms

If you have a very irritable knee, the first step has to be getting your symptoms under control. Patellar taping and orthotics can sometimes be effective strategies, and some people might respond well to massage, cupping, dry needling, or other modalities. 

It’s equally important to modify your activities to take some pressure off of your knee. Avoiding downhill walking and running and focusing on lower impact cardio like uphill walking, cycling, or the elliptical are good ways to stay active while putting less stress on the knee.

Step 2: Build tolerance to heavier loads

It’s generally easier to start by building up tolerance to load magnitude (amount of weight moved) before you start building up load rate (how quickly the weight is moved). For example, you’d probably do better with building up your squat capacity before adding  jumping exercises to your workouts. 

Which muscles should you focus on? Surprisingly to some, hip muscle weakness does NOT cause runner’s knee. In fact, the inverse might be true! (2) However, hip weakness is often associated with runner’s knee. Therefore, it’s still productive to work on building back up your hip strength in addition to quad and hamstring strength. 

To start working on building up your capacity, you need to find entry points, which are exercises that you can perform that are challenging without causing more than 2/10 pain. Here are some common exercises that I might prescribe for people with runner’s knee:

Step 3: Build tolerance to Faster loads 

After building up your load magnitude tolerance in step 2, you have to eventually start building up your loading rate because running is a high loading rate activity. Just like returning to any sporting activity, it’s best to break the activity down to work on its components before you jump all the way in.

The best way to accomplish that in a gradual way in this case is plyometric exercises. You can start small and simple, and then build up to mimicking what you would experience when you run. This is a great way to determine if you are ready to run. Here is an example plyometric exercise progression:

Runner’s Knee Recovery Time

Runner’s knee recovery time can vary depending on a few factors, one of the most important being the duration of symptoms. Prognosis for recovery worsens with symptom duration longer than 2 months before starting treatment. (3) That means that early detection and treatment are key!

While cases that are detected early and have lower baseline pain scores can improve within 6 weeks, cases with worse prognosis due to duration of symptoms and higher baseline pain scores can take 6-12+ months to recover. (4) 

Controlling your risk factors can be a helpful strategy to prevent runner's knee before it starts. Research shows that controllable risk factors may include quadriceps and hamstring strength, and sudden increases in training volume or intensity. (5) This is why it's so important for runners to include strength training in their routine!

At Alterra, we specialize in helping runners get to the root cause of their injuries so that they can stay on track with their training and enjoy running without pain. If you're a local runner in Boston's Back Bay and are experiencing runner’s knee, we'd love to help! Book a free discovery call to chat with a therapist today.

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Next on your reading list:

1. Is Running Gait Analysis Worth It?

2. How To Treat Patellar Tendinopathy

3. Physical Therapy Treatment for Runner's Knee

Disclaimer: The information in our blog posts is not a substitute for professional medical advice. Consult a healthcare provider before making decisions related to your health. Use our content at your own risk.

Sources

1. Willy, RW., et al. (2019). Patellofemoral pain: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American physical therapy association. JOSPT, 49(9), CPG1-CPG95.

2. Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A Prospective Investigation of Biomechanical Risk Factors for Patellofemoral Pain Syndrome: The Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) Cohort. The American Journal of Sports Medicine. 2009;37(11):2108-2116. doi:10.1177/0363546509337934

3. Lankhorst NE, van Middelkoop M, Crossley KM, et al. Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. Br J Sports Med. 2016;50(14):881-886. doi:10.1136/bjsports-2015-094664

4. Collins, N.J., Crossley, K.M., Darnell, R. et al. Predictors of short and long term outcome in patellofemoral pain syndrome: a prospective longitudinal study. BMC Musculoskelet Disord 11, 11 (2010). https://doi.org/10.1186/1471-2474-11-11.

5. Waryasz, G.R., McDermott, A.Y. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med 7, 9 (2008). https://doi.org/10.1186/1476-5918-7-9