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

March 6, 2026 updated by: Sungwan Kim, Boston Children's Hospital

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.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

104

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Massachusetts
      • Waltham, Massachusetts, United States, 02453
        • Boston Children's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

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)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Pre-Marathon Education
This group will receive the educational platform for 6 weeks prior to the 2026 Boston Marathon. Participants will have access to MyKneeCap.com, a web-based platform designed to provide runners with evidence-based education on the physical and non-physical factors contributing to patellofemoral pain, as well as strategies for self-managing symptoms tailored specifically for runners.
Behavioral: Education Platform-MyKneeCap.com
This intervention uses MyKneeCap.com, a free, web-based educational platform designed to help runners understand their knee pain. The platform provides information about patellofemoral pain and includes exercise programs aimed at reducing pain and improving knee function. This intervention does not involve any drugs, devices, or other procedural components.
Other: Wait-and-See Control / Post-Marathon Education
This group will serve as a wait-and-see control (no intervention) prior to the 2026 Boston Marathon. After completing the marathon, participants will receive access to MyKneeCap.com, a web-based platform designed to provide runners with evidence-based education on the physical and non-physical factors contributing to patellofemoral pain, as well as strategies for self-managing symptoms tailored specifically for runners.
Behavioral: Education Platform-MyKneeCap.com
This intervention uses MyKneeCap.com, a free, web-based educational platform designed to help runners understand their knee pain. The platform provides information about patellofemoral pain and includes exercise programs aimed at reducing pain and improving knee function. This intervention does not involve any drugs, devices, or other procedural components.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical outcomes (pain)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Pain will be assessed for current pain and worst pain in the previous week using a 10-cm visual analog scale (VAS; 0=no pain; 10=worst pain imaginable), a reliable, valid, and responsive tool for evaluating treatment outcomes for patellofemoral pain.
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Clinical outcomes (self-reported function)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Self-reported function will be evaluated using the 11-item Knee Injury and Osteoarthritis Outcome Score-Patellofemoral subscale (KOOS-PF; 0=extreme disability; 100=no disability), a reliable tool with the highest content validity for patellofemoral pain.
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Clinical outcomes (global rating of change)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Global rating of change will be assessed for perceived recovery using a 7-point Likert scale (much worse, worse, slightly worse, no change, slightly better, better, or much better). The global rating of change scale is a reliable, clinically relevant, and patient-centered measure for interpreting meaningful improvements.
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Psychological function (fear-avoidance beliefs)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Fear-avoidance beliefs will be quantified using the 5-item Fear-Avoidance Beliefs Questionnaire-Physical Activity subscale (FABQ-PA; 0=no fear-avoidance; 24=extreme fear-avoidance). The FABQ-PA is a reliable and valid tool and represents a key psychological profile in patellofemoral pain management.
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Psychological function (pain self-efficacy)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Pain self-efficacy will be quantified using the 10-item Pain Self-Efficacy Questionnaire (PSEQ; 0=no self-efficacy; 60=extreme self-efficacy). The PSEQ is a reliable and valid tool and represents a key psychological profile in patellofemoral pain management.
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Patient satisfaction
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Satisfaction during the preceding six weeks of marathon training will be rated on a 5-point Likert scale (very dissatisfied, somewhat dissatisfied, neither, somewhat satisfied, or very satisfied).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Marathon performance (finish time)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Finish time will be evaluated by comparing the official finish time to the participant's intended finish time (in minutes).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Marathon performance (division ranking)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Division ranking will be evaluated by comparing the division ranking to the participant's intended division ranking (in rank).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Medical service use
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Intra-event medical encounters for knee pain will be self-recorded (in count).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Secondary musculoskeletal complaints
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Lower extremity pain or injuries (other than patellofemoral pain) sustained during the race will be self-recorded (in count).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Return to running readiness
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Perceived readiness to return to competitive running will be assessed on a 5-point Likert scale (not at all, slightly, moderately, very, or extremely).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Barriers and facilitators (confidence in self-management)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Confidence in self-management ("I am confident in my ability to manage my symptoms and treatment plan on my own") will be measured using a 5-point Likert scale (strongly disagree, disagree, neither, agree, strongly agree).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Barriers and facilitators (usability of the education platform)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Usability of the education platform ("The web-based education platform is easy to use and navigate") will be measured using a 5-point Likert scale (strongly disagree, disagree, neither, agree, strongly agree).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Barriers and facilitators (treatment expectations)
Time Frame: 6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon
Treatment expectations ("I believe that the web-based education and exercise program will help improve my condition") will be measured using a 5-point Likert scale (strongly disagree, disagree, neither, agree, strongly agree).
6-weeks leading up to the Boston Marathon, or 6-weeks post completion of Boston Marathon

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Boston Children's Hospital

Investigators

  • Principal Investigator: Sungwan Kim, PhD, Boston Children's Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 20, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

November 19, 2025

First Submitted That Met QC Criteria

November 24, 2025

First Posted (Actual)

December 5, 2025

Study Record Updates

Last Update Posted (Actual)

March 10, 2026

Last Update Submitted That Met QC Criteria

March 6, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB-P00052732

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

All IPD that will be shared will be de-identified and for manuscript and publishing purposes only. PHI data will not be accessible outside of the research team, and only de-identified data will be a part of the manuscript.

IPD Sharing Time Frame

IPD will be analyzed for the manuscript, and all will be de-identified. This is approximately from the end of the study collection June 2026 to September 2026 for analysis.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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