Runner’s knee: returning to sport step by step

Why it happens

Increase in volume, downhills, lack of strengthening of the hip and thigh, too fast a return.

Coming back in four stages

1. 1

   Flat walking or easy cycling for 20 to 30 minutes, without pain.

2. 2

   Hip and thigh strengthening prescribed or approved by your physiotherapist.

3. 3

   Alternating walking and running on flat ground, avoiding repeated downhills and stairs.

4. 4

   Easy continuous running, then gentle slopes, keeping the downhills for last.

Move on to the next stage after 2 sessions in a row with discomfort of 2 out of 10 or less and no pain the next day. Each stage usually lasts 1 to 2 weeks, depending on your healthcare professional’s advice. For runner’s knee, test the stairs the next day: if they bother you more than the day before, stay at this stage.

Movements to postpone

• côtes et descentes from stage 4
• sauts from stage 4

Strengthening exercises

• Chair squat

  from stage 1 of the plan

  Sit down onto a chair then stand up slowly, range limited to what is pain-free, knees in line with the feet.

  To start: 3 sets of 10, 3 seconds down, every other day.

  Variations, mistakes and progression

  Easier

  Higher chair, hands on your thighs to help.

  Harder

  Lower chair, without touching the seat, then holding a weight against your chest.

  Common mistakes

  • Knees caving in.
  • Dropping onto the chair.

  Moving on

  When 3 × 12 is easy on a low chair, with no discomfort the next day.

• Glute bridge

  from stage 1 of the plan

  Lying on your back, knees bent, lift the hips squeezing the buttocks, hold 2 seconds, lower slowly. Later: on one leg.

  To start: 3 sets of 12, 2 seconds at the top, every other day.

  Variations, mistakes and progression

  Easier

  Smaller range, feet closer to the buttocks.

  Harder

  On one leg, then with your shoulders on a sofa.

  Common mistakes

  • Arching the lower back instead of squeezing the glutes.
  • Letting the knees drift apart or together.

  Moving on

  When 3 × 12 on one leg is easy, with the pelvis staying level.

• Clamshell

  from stage 2 of the plan

  Lying on your side, knees bent, feet together: open the top knee without moving the pelvis. Add a band later.

  To start: 3 sets of 15 per side, every other day.

  Variations, mistakes and progression

  Easier

  Smaller opening, no band.

  Harder

  Band around the thighs, then a 2-second hold at the top.

  Common mistakes

  • Rolling the pelvis back to open wider.
  • Going fast and feeling it in the back rather than the buttock.

  Moving on

  When 3 × 20 with a band is easy: move on to the side plank or band walks.

• Low step-up

  from stage 2 of the plan

  Step up onto a 10 to 20 cm step with the affected leg, come down slowly, pelvis steady.

  To start: 3 sets of 10 per leg, slow on the way down, every other day.

  Variations, mistakes and progression

  Easier

  10 cm step, one hand on the rail.

  Harder

  Higher step (20 to 30 cm), then with weights in your hands.

  Common mistakes

  • Pushing off with the leg on the floor.
  • Knee drifting inwards.

  Moving on

  When 3 × 12 on a 20 cm step is clean and causes no discomfort the next day.

• Wall sit hold

  from stage 3 of the plan

  Back to the wall, knees at about 60 degrees, hold 30 to 45 seconds. 4 repetitions with 1 minute rest.

  To start: 4 holds of 30 to 45 seconds, 1 minute rest, daily or every other day.

  Variations, mistakes and progression

  Easier

  Less bend (knees at 30 degrees), 20-second holds.

  Harder

  Deeper bend (90 degrees), or on one leg.

  Common mistakes

  • Letting the knees go far past the toes.
  • Pushing with your hands on your thighs.

  Moving on

  When 4 × 45 seconds causes no discomfort during or the next day, and tendon pain is easing.

• Side plank

  from stage 3 of the plan

  On your elbow, knees bent (later legs straight), hold 20 to 30 seconds with the pelvis aligned.

  To start: 3 holds of 20 seconds per side, every other day.

  Variations, mistakes and progression

  Easier

  Knees bent on the floor.

  Harder

  Legs straight, then lifting the top leg.

  Common mistakes

  • Letting the hip sag towards the floor.
  • Leaning the trunk forward.

  Moving on

  When you can hold 45 seconds with straight legs and the pelvis aligned.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

Rehab’s advice

First limit downhills, stairs and long outings on slopes. Increase duration before intensity.

What the Rehab plan does for this injury

The plan starts at 35% of your previous training volume and builds up to 85%, with a consolidation week every three weeks. If your discomfort reaches 5 out of 10, it stops and refers you to your doctor or physiotherapist.

In which sport?

• RunningLimit descents and long runs at first, and favour a short, quick stride.
• HikingLimit descending elevation at first and choose even trails.
• Indoor cyclingLower the resistance, keep the knees in line and check saddle height.