Anterior knee pain, patellofemoral pain syndrome or runners knee …. these are all terms for pain felt at the front of your knee joint, under or around your knee cap.

Your knee cap sits in a groove on the thigh bone. If it moves out of the groove when you straighten your knee (maltracking), this can cause irritation and knee pain during everyday activities like walking and climbing stairs.

First aid for runners knee

In the early stages of healing, it’s important to reduce all activities that cause pain to a level where you can do them comfortably. For some activities, you might need to stop altogether for a short period. This is to allow your symptoms to settle.

During this phase, ice and taping can be helpful and your GP may recommend a course of anti-inflammatories.

Assessment of the underlying causes

Once your symptoms have settled the next step is to make sure that all the factors that contributed to your symptoms have been clearly identified. A comprehensive physiotherapy assessment will look at:

  1. Muscle weakness – in particular the thigh muscles (Quadriceps) and hip muscles (Glutes).
  2. Flexibility
  3. Control, balance and the way you move
  4. Running analysis
  5. Training patterns


Rehab for runners knee


Once all the factors contributing to your condition have been identified, a targeted rehabilitation programme can be prescribed according to your own specific physical issues. Alongside this, your physiotherapist will be able to help plan a gradual build-up of the activities you had to reduce or stop.

In this blog post, we’re just going to focus on muscle weakness and the types of strengthening exercises that might be recommended to you for the quadriceps and glutes. However, it’s worth bearing in mind that the key to effective treatment really is a full assessment because strengthening exercises might not work for you if the underlying cause is more to do with the way you move or training error, rather than muscle weakness.

Quadriceps and glutes strengthening exercises

For some people, strengthening the thigh muscles will be helpful to guide the knee cap smoothly in the groove of your thigh bone when you straighten your leg. Don’t bother trying to isolate one part of the quadriceps muscles, it’s best to work them together as a group. These four exercises are for early stage rehab when your knee is sore:

  1. Isometric quadriceps tightening

Exercise to strengthen your thigh muscles to prevent knee pain

Sit with your leg out straight. Tighten your thigh muscles and hold for 30 seconds. Repeat 5 times.

  1. Inner range quadriceps strengthening

Thigh strengthening for knee pain

Sit with your leg out straight and a rolled up towel or foam roller under your knee. Tighten your thigh muscle and lift your foot up off the floor. Hold steadily for 10 seconds and lower slowly. Repeat 10 times.

  1. Straight leg raise

Straight leg raise for knee pain

Sit with your legs out in front of you. Tighten your abdominals and your thigh muscles. Breathe out to lift your leg and hold reaching it away from you. Count to 6 seconds and lower slowly. Repeat 10 times.

  1. Clam

Clam exercise for strengthening your glutes

Lie on your side with your knees bent to 90 degrees and your hips slightly bent. Breathe out to lift your top knee, keeping your heels together. Breathe in to lower again. Repeat 15 times on each side.

As quickly as you are able, without making your pain worse, you need to move on to strengthening your muscles while standing, like this:

Mini squat

Mini squat - knee rehab exercise

Stand with your feet at hips’ width apart and bend your knees slightly in a comfortable range. Make sure your knees stay in line with your toes. Repeat 15 times without provoking pain

When this exercise starts to feel easy then move onto lateral band walking. This exercise strengthens your quadriceps and glutes together:

Knee strengthening with resistance band

Tie a band around your knees, just above the knee joint. Tighten your abdominals and bend your hips and knees slightly, keeping your back straight. Breathe out and step sideways with one foot. Breathe in to follow it with the other. Breathe out to step back again and in to finish. Repeat 10 times without straightening up.

Once a strengthening programme has been implemented it’s important to keep up with your exercises for at least 8-10 weeks in order for the muscles to become stronger. A physiotherapist will make sure they are progressed gradually and safely to allow you to get you back to your sport as quickly as possible.


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