You know the pattern. Mid-run, mid-squat, mid-lunge, the front of the knee starts talking. For a while you push through, then the modifying starts: squat depth goes first, then run distance, then leg day altogether. Patellofemoral pain syndrome, usually called runner's knee, is one of the most common knee presentations we see at ActiveX Physio in Singapore, and despite the name it shows up in lifters and CrossFitters just as often as in runners.
Where does runner's knee actually come from?
If you have been foam rolling your quads and sleeping in a knee sleeve, you have been managing the symptom from the wrong end. PFPS is almost always a hip problem expressing itself at the knee: when the hip stabilizers stop controlling the femur under load, the knee drifts inward and the kneecap tracks badly against the groove it is meant to glide through. So we assess how your hip, glutes, and quads share the work through the exact movements that provoke your pain, whether that is a barbell squat or a 10k. The knee is where you feel it. The hip is usually where we fix it.
How do you fix runner's knee?
Treatment builds hip stability and quad capacity through loaded movement. Split squats and lateral step-downs force the hip to control what happens at the knee, and single-leg work makes that control stick under fatigue. If running is part of the picture we look at cadence and landing mechanics; if squatting is the trigger we look at depth and stance and how the knee tracks under the bar. The rehab is progressive and exercise-based, built so the pain stops dictating what you can and cannot do.
Who can help
Any of our physiotherapists can assess and treat PFPS. It is one of the most common injuries we treat. If your pain is specifically showing up during squats, lunges, or gym training, TJ Chen can assess how your lifting mechanics are loading the patella. If you are a runner, Nicholas Ho and Isabelle Chow both work with runners and can assess the hip-knee pattern. For persistent or complex cases, Ivan Tam or Helen Nguyen can look at the broader picture.
Go deeper
Our guide for endurance athletes covers runner's knee in detail, alongside IT band syndrome and the case for strength training in runners. Read the full guide for runners →