The phrase “runner’s knee” is one of those catch-all terms for knee pain, covering several injuries such as quadricep tendonitis (felt above the kneecap) or IT band syndrome (which affects the iliotibial band, a thick band of connective tissue going from the pelvis and over the hip to the knee). But most often there are a number of causes for the pain of runner’s knee and treatment fails because people look for only one cause and focus on that one thing.

Something every runner who has knee pain seems to have in common that when they feel it, they stop running. Some may even have been told to stop running by a medical professional. But stopping running without treatment is the worst thing you can do.

Unfortunately, we see a lot of this in our practice. Runners in pain stop running, pop a pain reliever, wait two weeks, go back out running again and feel great -- and then, shortly after, find the pain has gotten worse. This cycle can be repeated several times. Eventually the pain gets to a point where no matter how many days a runner takes off, it will not subside. Taking time off from running without getting treatment is a huge mistake and may end up with the runner having to give up the activity altogether.

The truth is, most people can continue to run while they are being treated for runner’s knee because we are actively finding the cause of the problem and eliminating it while you are still running.

So, what are the causes of runner’s knee?

In IT band syndrome the muscle on the outside of the leg becomes inflamed because of overuse. This has a lot to do with muscle imbalances throughout the hip and core.

Runner’s knee could also include hamstring trigger points -- tender points in the back of the leg -- or it could be overuse of the quadricep muscle which is caused by weaker hips. There could also be problems with the foot. Identifying all causes of runner’s knee is imperative for the pain to be eliminated.

Another factor to be considered is determining how many muscles are affected. By starting with the hip, and going from the back over to the IT band, the hamstring, and all the way down the leg, it is possible that every muscle has been affected and will need to be addressed.

What can you do to treat runner's knee?

First, you should be icing for about 15 minutes every day.

Second, you should foam roll. There are several foam-rolling videos on the Total Performance Physical Therapy YouTube channel that shows you how to roll each muscle. The video below will show you just a few you can do on the legs. You should concentrate on your hamstrings, piriformis (a small muscle located deep in the buttock, behind the gluteus maximus), and IT band.

Foam rolling may hurt, but this indicates that you need to be doing it even more and working on the trigger points in the legs. Without getting rid of these trigger points, you may not be able to ever run without pain.

You should foam roll for about 10 minutes a day.

Then you should begin strengthening using a few basic exercises such as front-hold planks, side planks, and reverse planks. You should hold each of these for one minute and perform three sets. These are just basic exercises; once it’s determined which muscles are affected, we can better form an exercise program that will eliminate your knee pain.

Heather Moore, PT, DPT, CKTP, is the owner of Total Performance Physical Therapy in North Wales, Norristown, and Hatfield.