A Self-Directed Web-Based Education for Boston Marathon Runners With Patellofemoral Pain

Running Informed, Not Just Trained: A Self-Directed Web-Based Education for Boston Marathon Runners With Patellofemoral Pain

Runners experience diverse lower extremity injuries, and the most common is patellofemoral pain (PFP)-commonly known as "runner's knee" and characterized by pain around and/or behind the kneecap. The aim of this study is to evaluate the effectiveness of a 6-week, self-directed, web-based education program for runners competing in the 2026 Boston Marathon. The study will evaluate outcomes, including pain, function, and marathon performance, in runners who use a web-based educational program designed to help them understand and manage knee pain. There will be two groups: Group 1 will receive the 6-week web-based educational program prior to the 2026 Boston Marathon, while Group 2 will serve as the wait-and-see control group (no intervention) prior to the marathon and then receive the same program 6 weeks after completing the marathon.

Inclusion Criteria:

• Insidious onset of peripatellar and/or retropatellar pain ≥3 months
• Worst pain level in the previous week ≥3/10 on the numeric pain rating scale
• Pain during at least two of the following tasks: prolonged sitting, kneeling, squatting, walking, running, jumping, and stair negotiation.
• All participants must have access to an internet-enabled device (e.g., computer, tablet, smartphone) equipped with audio capabilities sufficient to engage with the web-based education platform

Exclusion Criteria:

• History of lower extremity surgery
• History of lower extremity pain or injury (other than patellofemoral pain) in the previous six months
• History of patellar dislocation or subluxation
• Internal derangement (e.g., meniscal lesion)
• Ligamentous instability
• Other sources of anterior knee pain (e.g., patellar tendinopathy, bursitis)