5-Minute Foam Rolling Routine for Runner's Knee

foam rolling runners knee intro

 Nic Bartolotta, MPT, HHP

Running injuries always seem to happen at the worst times. Whether you’re training for a race or finally feeling comfortable with increased mileage, your body seems determined to stall your progress. One of the most common running injuries is Runner’s knee, a condition that affects over a quarter of amateur and professional runners.

It’s caused by overuse, something that you just can’t escape if you want to run at a high level. But instead of taking time off, you can manage your pain and even treat Runner’s knee by foam rolling.

What is Runner’s knee?

Runner’s knee, formally known as chondromalacia patella, is a dull pain caused by the weakening of the patellar tendon in the knee joint from running and overuse. It occurs when the knee cap (patella) rubs against the lower part of the femur, wearing down the tendon. There are several factors that can contribute to Runner’s knee, but the commonality is that the knee is not moving along its intended path, also known as poor tracking. This structural defect is what weakens the tendon over time. 

Runner’s knee is most commonly caused by a tight iliotibial band (IT band) as a result of overuse and/or poor mobility. The extra tension weakens the knees’ lateral stability, causing the structural issue. It can also be caused by weak thigh muscles, tightness in the Achilles tendon & hamstrings, lack of foot support, and poor running form.

But not all hope is lost. If you struggle with Runner’s knee, this 5-minute foam rolling routine will put you back on your feet in no time. Nic Bartolotta MPT, HHP, our resident physical therapist, is going to walk you through it. 

Foam rolling Runner’s knee with the Rolflex

1. Start with the mid-thigh muscles

Grab your Rolflex foam roller and sit comfortably in a chair with your knee bent. Adjust the roller to fit over your quadricep muscles, then clasp the handles to apply pressure. Move the foam roller back and forth over your middle & outer quad muscles to massage the rectus femoris and vastus lateralis, two of the muscles that make up your quads. Do this for about 15-20 seconds, making sure that you don’t roll too closely to the knee cap.  

2. Trigger point release - mid-thigh

Trigger points are areas of tension that are sensitive to the touch of the foam roller, almost painful in some cases. As you roll out your thigh, you’ll likely feel several on the outer part of your thigh near the IT band. We need to release this tension to effectively foam roll the rest of your upper leg.

Slide the roller over one of these points and apply pressure. Then without moving the roller, gently flex your quad muscles and straighten your leg. Do this for 5-10 reps on each trigger point before moving on to the next. 

These movements will break up the myofascial tissue, the hard, connective membrane that wraps around the muscle and is the primary cause of muscle tightness. This process is called self-myofascial release. It can typically can only be achieved by a licensed massage therapist, but the Rolflex enables you to give yourself a deep tissue massage at home.

3. Progress upwards to the tensor fasciae latae (TFL) muscle

The TFL muscle runs along the outside of your thigh up into your hip. It’s responsible for driving your leg forward while running and turning your leg inwards. Tension in the TFL causes the muscle to shorten and pull on the IT band, reducing its ability to stabilize your knee. So to treat Runner’s knee, we have to release this tension on the IT band. 

Slide the contoured foam roller over the center of the TFL muscle, located just a few inches below your waistline and slightly off-center of your thigh. Foam roll the area for 15-20 seconds.

4. Trigger point release - upper thigh

Keep the roller in place on the TFL and gently apply pressure as you straighten your leg. Do this for 5-10 reps. You’ll feel extra pressure as the muscle flexes into the contoured roller – this is myofascial release. The hard layer of tissue that surrounds the muscle is being broken up, alleviating the tension. 

5. Move down to the lower thigh 

Runner’s knee is caused by tension in the middle & upper thigh, which is why we began the foam roller treatment in that region. But the pain is much closer to your knee, which is what we’ll massage next.

Slide the foam roller to the lower half of your thigh, applying pressure to the muscles as you push the Rolflex down towards your knee. Massage the area for 15-20 seconds, working the roller deep into the soft tissue. Focus primarily on the center and outside of your lower quad, even twisting the roller as you massage the muscles. 

6. Trigger point release - lower thigh

Center the foam roller over your lower quad, just above the knee. Just as you did with the TFL muscle, straighten your leg while keeping the Rolflex in place, flexing the muscle into the roller to break up the myofascial tissue. Do this for 5-10 reps.

7. Massage the patellar tendon

Time to massage the area that’s causing you the most knee pain, the patellar tendon. Move the Rolflex just below your knee and gently roll the tendon to avoid damaging it further. Keep the roller in place and once again, straighten your leg to break up the damaged tissue. Do this for 5-10 reps, applying only as much pressure is comfortable.

 

foam roller on patellar tendon

 

8. Release pressure from the back of the leg

Tightness in the IT band and quad muscles are the primary cause of Runner’s knee. But to avoid creating imbalances or other issues, it’s important to treat the back of the leg as well. Tight hamstrings can create tight quads, lower back pain, and more, so we’re going to massage these muscles too. 

Flip the Rolflex around and massage the entire hamstring muscle for 20-30 seconds, working the roller deep into the tissue. 

For those actively treating Runner’s knee, repeat this foam rolling routine twice per day – you should notice results in 6-7 days. And even if your knees and hips are healthy, this routine will prevent injuries and keep you in healthy running shape. 

Frequently Asked Questions

Does foam rolling help runner's knee?

Yes, foam rolling is the most effective treatment option for Runner’s knee. It releases tension in the TFL, IT, and quadriceps, all of which play a role in the knee pain. 

What is the fastest way to get rid of Runner's knee?

As with most tendon injuries, the fastest way to get rid of Runner’s knee is a combination of rest, ice, compression, and elevation (RICE). This will reduce the inflammation in the tendon, priming it for deep tissue massage treatment with a foam roller

Should you foam roll your knee?

You should never foam roll your knee joint directly as it could cause serious injury, but foam rolling the muscles above your knee is an effective way to treat knee issues. 

How often should I foam roll as a runner?

Foam rolling is an effective way to warm up before a run and cool down your muscles afterwards, so you can foam roll every day that you run. It will keep your muscles healthy, prevent injuries, and improve your recovery time.