9 Tips For Running Knee Pain

Although it seems like the once-common concern that “running is bad for your knees” has been debunked, the truth is that knee pain can still be quite prevalent among runners.

Knee pain from running can take on any number of forms or presentations, from the lateral knee pain associated with IT band syndrome to the pain at the front of the knee with runner’s knee, along with several others.

Obviously, no runner wants to deal with knee pain after running, but the good news is that as with most running injuries, running knee injuries can be mostly avoided or rehabbed with a few adjustments to your training and strengthening programs.

Keep reading for some of the best tips for running knee pain, including tips to prevent knee pain from running and exercises and tips to reduce running knee pain once it’s already bothering you.

Common Running Knee Injuries

Knee pain is unfortunately common, and although there’s a good chance that there’s a non-runner in your life who tries to insist that running is bad for your knees, the truth is that knee pain can affect anyone, runner or otherwise.

For example, a 2018 article in American Family Physician noted that 25% of adults in America suffer from knee pain, which is a 65% increase in the past 20 years.

With that said, because running is a high impact activity, the knees do take on quite a lot of force during your workout. Some of the most common causes of knee pain in runners include the following:

• Patellofemoral pain syndrome (runner’s knee)
• Iliotibial band syndrome
• Patella tendinitis (jumper’s knee)
• Osteoarthritis of the knee
• Baker’s cyst
• Pes anserine bursitis
• Meniscus tears
• Ligament tears and sprains (ACL, MCL, LCL, PCL)
• Knee bursitis

Of these, runner’s knee and IT band syndrome are the most common causes of running knee pain.

In fact, studies show that runner’s knee is actually the most common overuse running injury, with an incidence of about 19–30% in female runners, and 13–25% in male runners.

Moreover, this running knee injury can strike beginners and advanced runners alike, as the risk factors for runners knees are multifactorial.

Runner’s knee, which is technically referred to as patellofemoral pain syndrome (PFPS), is characterized by pain at the front of the knee located at, under, or right around the knee cap (patella).

In addition to having knee pain while running, if you have runner’s knee, you may also experience knee pain during activities that load the flexed knee, such as hopping, squatting, and climbing stairs, as well as after prolonged sitting, kneeling, or when pressing directly on the knee cap.

Some runners also complain that there is a clicking, popping, or grinding sensation in the knee with this running knee injury.

IT band syndrome, or Iliotibial band syndrome, is characterized by pain on the outside of the knee.

The iliotibial band is a thick, fibrous band of connective tissue that runs from the side of the hip joint to just below the knee on the shin.

RELATED: 4 Tips to Reduce Stress on Sore Knees

9 Tips For Running Knee Pain

Treating knee from running is a matter of correcting whatever has caused the injury, and preventing running knee pain is largely a matter of doing the best you can to do an audit of the common risk factors for running knee injuries and trying to correct them before a problem ensues.

Here are some tips for knee pain from running:

1: Pay Attention to Your Body

Knee injuries from running, such as IT band syndrome, runner’s knee, and pes anserine bursitis, often begin as just a niggle in the knee that you can run through, perhaps with little to any necessary modifications to your training.

However, running knee injuries can quickly escalate into frustratingly persistent problems that are difficult to rehab.

For this reason, as soon as you start noticing knee pain while running or knee pain after running that lingers a few hours. It’s important to start addressing the issue right away.

Don’t just bank on the hope that it was a fluke.

Implement RICE (rest, ice, compression, and elevation), and consider taking a couple of days to do low impact cross training such a cycling, swimming, pool running, the elliptical trainer, or rowing to give your knee a break from the stresses and forces of running, and to vary the type of repetitive motion you’re subjecting the joint to.

2: Stretch Your Hips, Hamstrings, and Calves

After running, perform stretches such as Pigeon pose, the figure-4 stretch, the frog stretch, the butterfly stretch, and a piriformis stretch for the glutes and hips.

Stretch your hamstrings and IT bands by bending down to touch your toes, and then doing the same thing with one leg crossed over the other to stretch the IT band.

Additionally, stretch the calves.

3: Work On Your Mobility

Excessive tightness in your hamstrings, quads, IT band, or calves, or poor mobility in your hips or ankles, as well as the knee joint itself, can increase the risk of knee pain from running.

Poor mobility in the hips is one of the leading causes of both IT band syndrome and runner’s knee, so focusing on foam rolling the glutes, hip flexors, hamstrings, quads, and IT bands can provide myofascial release to loosen tight tissues.

4: Address Muscular Imbalances

One of the best tips for preventing and rehabbing running knee pain is to address muscle imbalances and strengthen the glutes, hips, and quads.

Knee pain from running and running knee injuries are often due to muscle imbalances. For example, evidence suggests that runner’s knee is usually caused by either weakness in the quads, specifically the vastus medialis obliquus (VMO) or weakness in the hip abductor and external rotators. These muscle imbalances misalign the patella, leading to abnormal tracking when you run.

Essentially, when the IT band or the vastus lateralis (lateral quad muscle) are relatively stronger than the VMO, they pull unevenly on the patella, tilting it and taking it outside of the groove.

Similarly, weak hip abductors and external rotators allow your femur to rotate inward relative to the knee cap at heel strike when you run, which can also cause abnormal tracking of the patella.

In either of these cases, the abnormal tracking leads to pain and grinding.

Examples of strengthening exercises to prevent knee pain from runner’s knee include the following:

• Resisted glute bridges: Place a resistance loop band around your thighs just above the knees and keep tension on it over the duration of the exercise by pushing out with your legs. Squeeze your glutes.
• Single-leg glute bridges: Engage your glutes.
• Straight leg raises
• Side-lying leg lifts: Keep your knee straight. Progress to using an ankle weight.
• Quad sets: Lie on your back with a towel under one knee and an ankle weight on. Bend the other leg with your foot flat on the floor. Engage your quad to lift your heel off the ground. Hold 5 seconds.
• Donkey kicks: Keep your core tight and engage your glutes.
• Clamshells with a resistance band lying on your side, knees bent, and lifting your top leg like opening a clamshell.
• Single-leg mini squats
• Resisted band walks: forward, lateral, and backwards

A good running knee pain prehab/rehab program includes 2-3 sets of 15-30 reps of each exercise. If you have knee pain with any of the exercises, do not do them.

5: Warm Up Thoroughly

Warm up for at least 5-10 minutes prior to settling into your run. This will increase circulation, increase your range of motion, and loosen tight muscles before you put your body through the paces at a faster pace.

6: Be Mindful of Your Training

Training errors, such as overtraining, ramping up your mileage or speedwork too quickly, switching terrain suddenly, running on cambered roads or excessive downhills, can definitely contribute to knee pain while running.

Be careful not to change anything about your running too quickly—whether into a new type of shoes, to sand or grass instead of road, or to track workouts instead of only distance runs.

Heed the 10% rule in terms of increases in mileage from week to week.

7: Run On Softer Surfaces

Surfaces like grass, tracks, trails, and cinder are more forgiving and can reduce the impact on your joints compared to running on hard surfaces like asphalt and concrete.

8: Try a Knee Brace

If you already have knee pain running, you might be able to find some relief by wearing a patella strap knee brace or using some kinesio tape to help support optimal patella tracking.

While not ideal as a long-term solution, these aids can support the patella in the trochlear groove while you run.

9: Consider Physical Therapy

If you notice issues with your stride, or detect muscle imbalances or weaknesses, work with a physical therapist to address the issues before they escalate.

Remember to listen to your body and adjust your training as necessary. You’ll get back out there healthy and strong!

RELATED: Got IT Band Pain? Try These 6 Warm Up Exercises