Runner’s Knee: How TCM & Acupuncture Can Help

Runner’s Knee is a set of symptoms most commonly seen in long-time runners. It is characterised by pain in front of the kneecap, sometimes spreading to the sides or the back of the knee, which worsens when walking downhill or down the stairs. 

The pain can also manifest as a sharp “clicking” pain while bending and straightening the knees especially during exercise. With the introduction of more trendy aerobic exercises like HIITs, spin classes, MMA gyms and the like, there has been a significant increase in patients suffering from Runner’s knee.


Causes of Runner’s Knee

Runner’s knee can be caused by both pre-existing conditions or acquired factors. Some people are born with weaker knee joints, causing misalignment of the bones. This can lead to uneven distribution of body weight during strenuous exercises. As time passes, this can lead to subluxation of the knee joints and cause chronic pain that worsens especially after exercising.

Other acquired factors are listed as below:

1. Repetitive bending of the knees during strenuous exercises.

Repeated bending of the knees can cause the muscles and soft tissues surrounding the knee joints to become irritated and inflamed.

2. Direct trauma to the knee

A direct hit to the knee can happen during a fall or a blow (e.g. a low kick to the knee during muay thai). Pain from traumatic forces may or may not be accompanied by swelling in the knee joints.

3. Asymmetrical development of thigh muscles

Unbalanced development of thigh muscles may cause the position of kneecaps to differ on both knees. This will lead to uneven distribution of body weight in both knees and cause one side of the knee joint to suffer from more wear and tear.

4. Difference in leg length or rotation

A difference in leg length or rotation can be caused by various factors such as flat feet, misaligned hip joints or SI joints, uneven tension of back and gluteal muscles and so on. Uneven distribution of body weight arises from such factors and may cause pain in the knees.

5. Chondromalacia patella

Chondromalacia patella (CP) is a condition where the cartilage beneath the kneecap breaks down. CP can both be a cause for runner’s knee or as an end result from Runner’s knee.

Prevalence of Runner’s Knee



Runner’s knee can be present in all age groups with a higher prevalence among athletes and middle-aged women. 



Some growing children will go through a stage of “growing pains” associated with Runner’s knee as the muscles and joints develop. 



In young adults, Runner’s knee usually manifests as pain on the kneecaps which worsens with strenuous exercise.



For middle-aged women, due to rapid loss of calcium from the bones and gradual degeneration of the lumbar and hip bones, Runner’s knee can manifest in simple movements such as squatting or walking down the stairs. 



Once chondromalacia patella begins, most people with runner’s knee begin to experience pain even while resting and especially at night, leading to restless sleep and perhaps even depression. “Clicking” pain and swollen knee joints may also be present at this stage.



Medical Treatments for Runner’s Knee


Non-surgical options include oral painkillers and physiotherapy. Painkillers can help with the painful symptoms but they cannot remove the root cause. Physiotherapy and muscular strengthening can fully reverse the symptoms of early to mid-stage Runner’s knee.

TCM Treatments for Runner’s Knee

Chinese medicine (TCM) treatments of Runner’s knee revolve around:
1. Promoting better blood circulation to the knee joints to promote natural healing, and
2. Stimulation of nearby muscles. 

acupuncture on the knee


Acupuncture treatment can be used to either loosen up the tightened muscles around the knee joint or to directly stimulate the removal of inflammatory materials within the joint. Stimulation of certain acupoints can promote more blood flow towards the knee joint and nearby muscles, directly promoting soft tissue repairs to happen.

Tuina therapy may be included as a supplementary treatment for acupuncture for more serious cases of Runner’s knee.

Herbal Medication
Certain Chinese herbs may also be used orally (e.g. herbal prescription) or externally (e.g. ointments, dressing) to reduce inflammation, promote blood circulation, or further improve the efficiency of treatments.

Link to a page on TCM treatments for pain & injury

D-I-Y Exercises for Runner’s Knee

Below are a few simple exercises that you can do at home to strengthen the muscles around the knee joints.

1. Single leg knee raise

Stand with both legs shoulder width apart and lift one knee. Maintain a 90° angle at the hip and knee joint and hold for 1 minute. Repeat for both legs.


2. Double calf raises

Stand with both legs shoulder width apart and lift both heels up. Engage the calf muscles while keeping both legs straight. Maintain the position for 1-2minutes.


3. Lying quad squeezes

Lie down with both legs straight. Engage the quadriceps for both legs and “squeeze” the kneecap downwards. Squeeze for 2 seconds and release slowly for 2 seconds. Repeat for at least 20 times per side.


Late-stage runner’s knee is usually associated with chondromalacia patella. Surgery may be required to restore functions to the knee joints.


Prevention Tips for Runner’s knee

1. Prioritise correct form and posture while exercising. (Don’t geh kiang)

2. Do not neglect strength training for lower body muscles. (Don’t skip leg day)

3. Maintain a healthy body weight. (Time to lose those extra kilograms, refer to our weight loss program)

4. Understand that certain exercises can no longer be performed after a certain age and look for safer alternatives. (Don’t haolian)

Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.

If you are suffering from runner’s knee and would like to manage it naturally through acupuncture and TCM methods, we can help. Book an appointment with a PULSE physician for your first consultation.