Knee Pain and Running: What’s the Connection?

Knee pain is such a common occurrence that many runners see it as an inescapable consequence of good health.

In reality, basic preventative and treatment measures can keep even the most active runners pain-free and running longer. There is a strong connection between knee pain and running, but knee pain most often comes simply from overuse and poor preparation.

If you struggle with hip and knee pain, running can be more of a chore than anything. This article will show you how running contributes to knee pain and what you can do to keep the enjoyment in your running routine.

Knee Pain and Running: Why We Hurt

Pain can come from several different types of knee injuries. The common denominator between them is that they all arise mainly from overuse. Friction between bones, cartilage, tendons, and other tissues causes wear, leading to pain and swelling.

Other risk factors that can increase the chances of developing knee pain while running include the following:

  • Being overweight
  • Above-average height
  • Old age
  • Poor running style and lack of experience
  • Prior injuries
  • Medical conditions, e.g. arthritis

Here is a breakdown of common knee injuries from running.

Runner’s Knee

The most frequent kind of knee pain results from runner’s knee, or patellofemoral pain syndrome. This is general aching or stabbing pain at the kneecap. 

Pain can erupt while running, but it can also occur while stressing the knees during everyday activity. Descending stairs, walking on hard surfaces, or even getting up from sitting too long can activate pain.

Although runner’s knee is the most common knee injury, individuals with weak muscles in their quadriceps, flat feet, and muscle tightness are more susceptible to developing it. Studies have also shown strong connections between weakness in the hips and knee pain from runner’s knee.

Iliotibial Band Syndrome

Iliotibial band syndrome, or IT band syndrome, is closely tied to runner’s knee, as tightness and aggravation of the IT band can cause both problems. The IT band runs along the outer thigh to the hip, connecting and stabilizing the knee and the hip. 

IT band syndrome causes an acute stabbing sensation or inflammation on the outside of your knee, often just above or to the side of the kneecap. Long-distance runners are prone to the condition because of the constant friction between the IT band and the leg. Weak muscles, weak hips, and a lack of core strength can also increase the risk of this injury.

Patellar Tendinitis

In contrast to IT band syndrome, patellar tendonitis, or jumper’s knee, is felt just below the knee, where it meets the shin. The patellar tendon is responsible for range of motion, allowing your knee to fully extend. You are at a greater risk of developing patellar tendinitis if you suddenly increase your running distance, speed, or frequency.

Repeated strain on the patellar tendon can cause gradual weakness and potential tears. You may only notice initial signs during running. Over time, pain and swelling may be felt throughout the day, even while you’re relaxing.


The bursa is a small sac filled with fluid positioned near the knee joint. Its role is to cushion impacts and minimize damage from friction between bones, muscles, and other knee tissue.

Bursitis occurs when bursae become inflamed from overuse. Pain and swelling on the interior or top of the kneecap are common symptoms of bursitis. As with the IT band with IT band syndrome, the bursa may also be tender to the touch.

Meniscal Tear

Another cushion in your knee, the two menisci in each knee absorb shock between the two leg bones, the tibia and the femur. A tear in the interior meniscus, or medial meniscus, happens frequently from sharp stress to the knee, such as a sudden direction change or twisted knee. Older runners are susceptible to tears as they often have weaker menisci.

The “pop” of a torn meniscus as it happens is the most obvious sign of an issue. Other symptoms include limited joint movement, stiffness, and general pain and swelling all over the knee.

Managing Knee Pain from Running

The common symptoms of the main knee injuries mentioned are pain and swelling. You should stop running and apply the R.I.C.E. method to reduce inflammation and ease knee pain and stiffness:

  • Rest your knee
  • Ice to bring down swelling and dull pain
  • Compress to stop swelling
  • Elevate to reduce blood flow and inflammation

The R.I.C.E. treatment should be applied immediately after running. In most cases, an OTC pain reliever like ibuprofen is helpful for reducing swelling and pain.

Stretching and strengthening routines are important to relieve the tightness and weakness that leads to many knee injuries. Hip, hamstring, and quad stretches are all crucial parts of PT programs to manage knee issues.

By using the R.I.C.E. method and exercise for stretching and strength after running, you can heal from everyday overuse injuries in a day or so. If pain persists for a week or two, you should see a doctor who can perform a physical, X-ray, or MRI to identify the exact problem and formulate a recovery plan.

Furthermore, if you are concerned about a torn meniscus, patellar tendinitis, or other severe injuries, you need to contact your doctor immediately for a diagnosis.

Preventing Knee Pain

You may not be able to affect risk factors like age, gender, or height, but you can help to prevent knee pain by making smarter exercise decisions. Fortunately, you can avoid most knee problems with the same approach — avoid overuse, tightness, and stress.

While exercising, you need to pay attention to your body and your limits. Many injuries come from runners making drastic leaps in running distance or frequency.

Gradually increasing your distance and running schedule will keep your knees from becoming overexerted. When you’re not running, strength training for your thigh muscles and stretching your hips and legs will prepare your body for more work. 

Aside from preparing your body, you also need to optimize your running gear. You need the best running shoes to cushion the impact of running and overcome any particular foot or gait defects. More than comfort, choosing the right shoe depends on your running style, unique body traits, and terrain.

Your running posture and technique can have a huge impact on your whole body, contributing to neck, shoulder, hip, knee, and ankle pain after running.

It’s common to develop knee pain if your heel strikes the ground first, for instance, because your leg is often completely straight. This forces all of your moving body’s weight right into your knee.

Fixing your running form will reduce wear on your knees, preventing pain and increasing your endurance.

Run Smarter, Not Harder

It’s an athlete’s imperative to push limits, but pushing too hard may do more harm than good. Knee pain and running do not have to go hand-in-hand if you remain committed to better technique and slowing down at the first sign of strain.

Ready to maximize your running potential? The experts at ReVITALize Rehab Club work with serious runners to improve their technique, routine, and strength. Contact us today to learn how we can keep you running better, longer, and faster.