If you’re a treadmill or track aficionado, you’ll almost inevitably stumble into a running injury at some point. Why? Running may be straightforward, but it’s also fairly complex. You might get injuries caused by overuse, but you may also get hurt because of underuse — that is, not strengthening your muscles adequately.
As a runner, you’ve got to pay special attention to your knees. To equip you with the knowledge you’ll need to navigate any treatments you might seek out, I spoke with physical therapist Heather Asti. With two decades of experience and several degrees in physical therapy under her belt, Asti had a lot to share about why your knees might hurt when you run. Here we go.
Common Knee Injuries From Running
A round of painful knee problems can certainly derail your running regimen. But before you head to the orthopedic surgeon’s office, you might want to read up on knee joint pain.
While it’s best to see a doctor or physical therapist personally to diagnose your pain and offer formal treatment options, we talked with Asti to lay out some groundwork knowledge to help you along your journey toward pain-free running.
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The prevention and treatment tips below are provided by Asti — but again, working with a professional one-on-one is the most effective way to diagnose and treat injuries.
Runner’s Knee
“Patellofemoral Pain Syndrome (PFPS) or runner’s knee typically results from muscle weakness, specifically muscle weakness in the pelvis and ankle regions that cause improper alignment of the leg and kneecap during running,” explains Asti.
Symptoms
Pain in the front of the knee while running
Pain in the kneecap when touched
Grinding in the knee
How to Prevent It
“Strengthening the glutes, lateral hip muscles, quadriceps, hamstrings, and ankles before starting your running program.”
“Exercises like squats, lunges, deadlifts, leg extensions, and hamstring curls are all helpful to prevent runner’s knee.”
Gait analysis to determine if your present form might contribute to injury
How to Treat It
Rest
Inflammation reduction measures (ex., ice and non-steroidal anti-inflammatory medication)
Massage
Gentle stretching
“Strengthening all the muscles that support good limb alignment during running, which are the glutes, lateral hips, external rotators, hamstrings, and ankles.”
“Getting a professional running analysis to identify any breakdown in your running form that could be causing increased stress on the knee.”
“Purchase a different type of running shoe to accommodate your gait.”
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Shin Splints
“Shin splints are caused by excessive stress on the medial tibia, which is why its hallmark symptoms are tenderness of the medial tibia (inside lower leg bone), and pain whenever you run or hop,” says Asti. “The pain of shin splints can extend anywhere along the shinbone from the knee to the ankle.”
Symptoms
Pain in the shins during running
Pain in the shins when they are touched
How to Prevent It
Increase training mileage slowly
Monitor time spent running on hard surfaces
Train using a variety of different methods like swimming or cycling to reduce knee impact
Give your legs regular rest time
Make sure you have shoes that properly support your legs and feet
How to Treat It
Allow the area time to heal
Apply ice regularly
Stretch your calves frequently
Acquire shoes and/or orthotics that properly support your legs and feet
Use over-the-counter pain medication like ibuprofen or naproxen sodium
IT Band Syndrome
“Iliotibial Band Syndrome, or IT Band Syndrome, is most commonly caused by a muscle imbalance between the hip flexors and the glutes,” explains Asti. “It’s usually a weakness of the glutes that causes the hip flexors to take over the work, resulting in the IT band being pulled over your thighbone, or femur. This causes pain in both your knees and your thighs.”
Symptoms
Knee pain
Hip pain
Popping sensations in your knees
Inflammation of the knee
How to Prevent It
Strength training for your glutes using the best glutes exercises
Regular stretching for your hip flexors
How to Treat It
Rest from running
“Gentle trigger point work on the TFL muscle — located just in front of the bony part of the side of the hip — can help reduce the tension you feel in the IT band.”
“Remember, rolling the IT band itself is generally not helpful due to the thickness of the connective tissue along the band.”
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Patellar Tendonitis
“Your patella is your kneecap, and patellar tendonitis occurs when the tendon connecting your kneecap to your shin becomes inflamed,” explains Asti. “This almost always results in pain that is very precisely located in the lower part of your kneecap.”
Symptoms
Pain in the lower portion of your kneecap
Primary feeling of pain during jumping and landing movements
How to Prevent It
Resting after exercises that deliver repeated impact to the knees
Avoid dramatically increasing the duration of running or jumping exercises
Strengthening the quadriceps muscles with the best quad exercises
How to Treat It
Rest
Frequent icing
Stretching your quads
Strengthening your quads
How to Run for Knee Health
The best way to treat a knee injury is to avoid the injury altogether — and though that’s not always possible, you can take steps to make your runs less risky. Asti has offered up several tips that can help keep you on your feet before you get injured in the first place.
Get Your Gait Assessed
If you like to keep your cardio on the casual side of things, you may not think you need to solicit any expert advice. However, one of the foremost causes of running-related knee injuries is improper form. This is why Asti advises a gait analysis if you intend to spend any serious time running for your health.
“Most running knee injuries result from misalignment of the hip, knee, and foot through the gait cycle,” says Asti. “Making sure that your knee does not rotate or lean inward when it’s supporting your body weight and that your foot is in a relatively neutral position throughout is key. This can be very difficult to correct without having a professional examine your running.”
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Can’t work with a coach right now? Some high-end running shops offer a gait analysis in the store — check that there are no purchases required and see what you can learn.
Strength Training
In theory, it sounds nice that your different muscle groups will take up the slack for one another if one group is feeling weak. Yet, too much of this compensation can be one of the primary sources of knee injuries. Spend time in the weight room building strong, well-balanced legs to avoid nursing a knee injury caused by a muscle imbalance.
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“The major key to healthier knees while running is the strength of the glute muscles, hip external and internal rotators, and hip abductors,” explains Asti. “Achieving good balance in hamstring strength, quad strength, and flexibility can help keep knees healthy, and prevent the sort of imbalance that leads to knee injuries.”
Rest When There’s Pain
There may be a difference between injury pain and training pain, but when there is any sort of pain in your legs, you may unconsciously alter your running form to work around it. This can have disastrous consequences for your knees, since the change in your form may shift the impact of the ground, putting too much pressure on your knees.
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“Pain is always your body’s way of telling you something isn’t right,” Asti explains. “Ignoring that signal in most cases just results in more pain and longer recoveries. If your knee pain is very mild and goes away after a little dynamic warm-up, then it is probably safe to continue running as long as the level of pain does not continue to increase over time. If the pain is more severe and causes you to change your running form through gait compensations, or it continues throughout the run, it is best to stop and have your injury assessed.”
Active Recovery
If you’re running for heart health and other cardiovascular benefits, remember that there are other low-impact cardio machines you can use to achieve similar results. This doesn’t mean that you need to stop running for long stretches. Still, logging a few cardio sessions on the bike or rowing machine in between your runs can help preserve the health of your knees.
“When it comes to knee pain from running, the best place to start is a short rest from running and corrective strength training for the glutes and hips,” says Asti. “Cross-training through swimming and other forms of cardio that place less impact on the joints is a great way to maintain your cardiovascular fitness during this time of running rest.”
Frequently Asked Questions
How do I stop my knees from hurting when I run?
If your knees are already hurting, your wisest initial decision will be to stop running temporarily. In the meantime, you may choose to ice your knees and take an over-the-counter anti-inflammatory medication for any lingering pain.
If pain persists, you are encouraged to contact your healthcare provider to get your injury diagnosed and establish a treatment plan specific to your circumstances.
Is it OK to run with knee pain?
Running with knee pain can be dangerous for two reasons. First, continuing to run may worsen an injury and make it more severe. Second, compensating during your run to reduce pain can cause additional problems in your form — and potentially far worse knee injuries. Consider consulting a healthcare provider before jumping back into your daily jog.
How do I strengthen my knees for running?
Since several knee injuries connected with running are the result of muscle imbalances, try taking a balanced approach to developing your leg muscles. This includes an array of the best leg exercises like squats, deadlifts, leg extensions, hamstring curls, and calf raises to fully strengthen your lower body muscles.
Does runner’s knee go away?
Runner’s knee can go away if you use a proper recovery plan. You may want to work with a physical therapist or other healthcare provider to customize the best plan for you. For some, this may include resting and icing your knees while taking anti-inflammatory medication, and then stretching and strengthening your muscles to prevent a recurrence of runner’s knee. You may also have a gait analysis performed to determine if a flaw in your running form contributed to the injury. Then, you can correct your form in the future.
Editor’s Note: The content on BarBend is meant to be informative in nature, but it should not be taken as medical advice. When starting a new training regimen and/or diet, it is always a good idea to consult with a trusted medical professional. We are not a medical resource. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional.
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