10th March 19

It’s marathon season, and it’s been a busy time at The Carter & George Practice!

The start of March is often the time when runners begin to ‘ramp up’ their mileage, with just under 7 weeks until the marathon. Unfortunately, this is also the time when it dawns on most people that they have to start progressing quickly in order to cover the 26.2 miles.

One of the most common injuries we see in runners at this time of year is Patello-femoral pain, affectionally known as ‘Runners Knee’.

This is a generic term we use to describe pain at the front of the knee or around the kneecap. It doesn’t just affect runners though – we see it in jumping athletes, teenagers, older adults, manual workers and non-athletes too! It is the most common form of knee pain and can be caused by trauma, overuse, muscle imbalances and kneecap alignment problems.

Read on for more info, or scroll to the bottom to see out Top 5 tips for preventing it!

The Facts:

  • It is usually caused by a mismatch in strength vs output (we call this a ‘load deficit’)
  • The symptoms are often a dull, achey pain at the front of the knee
  • It is easily diagnosed by physiotherapists (even easier when using ultrasound scans!)
  • It very rarely requires surgery


  • Pain that worsens with squatting, kneeling, going up/down stairs, long periods of sitting
  • Occasionally, swelling is present
  • A sensation of grating/grinding when moving the knee
  • General lower limb weakness

Risk Factors

  • Age – adolescents are the most likely to get anterior knee pain
  • Sex – women are more likely than men to suffer
  • High impact activities – running or jumping sports put a high stress on the knee and can overload the surrounding tissues, which can cause pain
  • Flat feet – or ‘over-pronating’ feet cause in increase in stress through the front of the knee


  • RICE – try ‘Rest, Ice, Compression and Elevation’ as the first option
  • Some people respond well to over the counter anti-inflammatories
  • Physiotherapy – which can include strengthening, taping, shockwave therapy, acupuncture or massage
  • Activity modification – reducing the pressure going through your knee (and then gradually increasing once symptoms have improved) is a great way to reduce knee pain

Our Top 5 tips for Preventing Knee Pain

  1. Don’t just run! The biggest mistake we see is a lack of strength training to supplement running training. It is no good if your lungs can run the distance, but your legs aren’t strong enough to get you there!
  2. Weight control. Nobody likes to hear it, but losing weight significantly reduces the stress going through the knee.
  3. Mix up your training! People who train in a variety of ways, on a variety of surfaces, are less likely to get injured.
  4. If you feel pain, see a Physiotherapist! These problems are often MUCH easier to treat if you get them seen early!
  5. Speak with professionals about designing your programme. If you are unsure of the best way to improve your running, our team can help! Check out Paul’s profile for more info.

If you have any questions about how we can help with knee pain, or you have any concerns at all – let us know!

Email us on: help@carterandgeorge.co.uk

Speak to us on social media: @carterandgeorge

Or Call us on 01992 446725