Runner’s Knee (PFPS): 5 Exercises for Runner’s Knee
In this continued deep dive on Runner’s Knee (PFPS), we will now move on to specific exercises that you can perform to get you back on the road to running. As we have discussed in previous posts, PFPS is a complex condition that is multifactorial in nature. It is normally related to an overload of your knee’s capacity (exceeding its envelope of function), weakness around the hip and knee, your body’s pain response, stress, sleep, and more!
Though the exercises outlined below are specific to address the typical deficits related to runner’s knee in general, it is important to remember that there are no “magical” exercises that fix runner’s knee. Further, you will need to manage more than just your strength when treating runner’s knee. You need a full treatment plan that includes appropriate strength training, load management, a progressive return to run program and addresses systemic factors.
With all that being said, there are a few factors to consider when selecting exercises to treat runner’s knee. The gold standard of treatment is a combined approach for both hip and knee specific exercises. These exercises are meant to be performed with symptoms < 4/10 and performed at specific angles to help avoid excessive knee load. The ones outlined below will focus on the early to middle stage of rehab but this can vary depending on a person's specific case.
Exercise 1: Seated Knee Extensions (Knee focus)
Target Muscles: Quadriceps (vastus lateralis, medialis, intermedius, and rectus femoris)
Purpose: to improve strength of quad muscles
How to Perform: Sit using an exercise band around the ankles or at a knee extension machine. Complete slow and controlled knee extension through a tolerable range of motion.
Exercise Prescription: 3 sets of 6-8 reps with 4s concentric and 4s eccentric phases. Moderate weight or resistance band
Video Link: Seated Knee Extension
Modifications: Early on the knee may not be able to tolerate a full range of motion as peak compressive forces occur from 0-30 deg of knee flexion. Modifying to a reduced motion of 90 to 50 deg of flexion (bottom half of the movement) can be used to still load tissue without causing knee pain.
Exercise 2: Sidelying Hip Abduction (Hip focus)
Target Muscles: Lateral hip stabilizers with emphasis on gluteus medius
Purpose: to improve lateral hip strength and proximal control to potentially reduce contralateral hip drop and hip adduction without loading the knee joint.
How to Perform: Sidelying on the unaffected side, complete slow and controlled leg raises about 1.5-2 feet into the air while keeping your knee straight and in line with your hips.
Exercise Prescription: 3 sets of 10-12 reps. Moderate to moderate heavy resistance band around ankles
Video Link: Sidelying Hip Abduction
Modification: Move band to around knees to reduce intensity.
Exercise 3: Glute Bridge (Hip focus)
Target Muscles: Posterior Chain with emphasis on gluteus maximus and hamstrings
Purpose: to improve posterior hip strength and proximal control to improve force absorption during contact phase while minimally loading the knee joint.
How to Perform: Lie on your back with knees bent to about 90 degrees. Then lift hips until your hips and thighs are parallel.
Exercise Prescription: 3 sets of 2 reps with 20-40s hold.
Video Link: Glute Bridge
Modification: Modify foot positioning to bring feet closer to glutes to emphasize glute muscle work or move feet further away from glutes to emphasize hamstrings. Consider progression to single leg if too easy.
Exercise 4: Single Leg Box Squat (Knee focus)
Target Muscles: Multi joint coordination with emphasis on quadriceps and glute max
Purpose: to build multi joint capacity and replicate running movement without impact load on knee joint
How to Perform: Stand on the affected leg with a bench, chair, or box behind you. Slowly bend your knee and lower down to tap the bench then stand up. Keep your hands on your hips and your opposite leg held a few inches off the ground the entire time.
Exercise Prescription: 3 sets of 6-8 reps with 2-3 second eccentric and concentric phases
Video Link: Single Leg Box Squat
Modification: Consider holding onto a support surface or dowel to aid with balance. Reduce the range of motion by adding pillows or increasing the height of the surface you are squatting to if you are unable to maintain form throughout the movement. Reduce to a double leg box squat if the single leg squat causes symptoms to exceed 4/10.
Exercise 5: Lateral Step Down (Knee and Hip focus)
Target Muscles: Multi joint coordination with emphasis on quadriceps and lateral hip stabilizers
Purpose: to improve hip and knee coordination and control through the eccentric phase
How to Perform: Stand on the affected side on a small step. Keeping the opposite leg straight, slowly bend your stance knee and gently tap your opposite heel onto the floor, then push through the stance leg to stand up.
Exercise Prescription: 3 sets of 8-10 reps with 2-3s eccentric and concentric phase. Use 4-6 inches step to start
Video Link: Lateral Step Down
Modification: Consider holding onto a support surface or dowel to aid with balance. Increase forward trunk lean at hips to reduce load on knee joint if painful.
Rehab for PFPS isn’t about isolating one muscle group, it’s about a progressive program that improves the capacity and control of the entire leg. These exercises can be a great starting point but are not the end all be all. A complete program that is holistic and specific to an individual is the best way to return to running pain free.
Are you in the CSRA and looking for a rehab program that is specifically designed for you? Set up an appointment on our booking page today!
Disclaimer: This information is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or health-related goals.
References
Dye, S. F. (1996). The knee as a biologic transmission with an envelope of function: A theory. Clinical Orthopaedics and Related Research, 323, 10–18. https://doi.org/10.1097/00003086-199604000-00003
Esculier, J.-F., Maggs, K., Maggs, E., & Dubois, B. (2020). A contemporary approach to patellofemoral pain in runners. Journal of Athletic Training, 55(12), 1206–1214. https://doi.org/10.4085/1062-6050-0535.19
Gragnani, B. C., Hart, H. F., Forsyth, A., Barton, C. J., & De Oliveira Silva, D. (2026). Patellofemoral pain is a multifactorial complex condition; are we missing a multidisciplinary approach to its management? Time for a paradigm shift. Open Access Journal of Sports Medicine, 16, 517971. https://doi.org/10.2147/OAJSM.S517971
Neal, B. S., Lack, S. D., Bartholomew, C., & Morrissey, D. (2024). Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning. British Journal of Sports Medicine, 58(24), 1486–1495. https://doi.org/10.1136/bjsports-2024-108110
Nielsen, R. Ø., Parner, E. T., Nohr, E. A., Lind, M., & Rasmussen, S. (2014). Excessive progression in weekly running distance and risk of running-related injuries: An association which varies according to type of injury. Journal of Orthopaedic & Sports Physical Therapy, 44(10), 739–747. https://doi.org/10.2519/jospt.2014.5164
Rathleff, M. S., Graven-Nielsen, T., Hölmich, P., et al. (2019). Activity modification and load management of adolescents with patellofemoral pain: a prospective intervention study including 151 adolescents. The American Journal of Sports Medicine, 47(7), 1629–1637. https://doi.org/10.1177/0363546519843915
Teng, H.-L., & Powers, C. M. (2014). Sagittal plane trunk posture influences patellofemoral joint stress during running. Journal of Orthopaedic & Sports Physical Therapy, 44(10), 785–792. https://doi.org/10.2519/jospt.2014.5249
