Every runner dreads the day their joints may begin to ache, particularly if it’s knee pain after running since it can hinder your training. However, in reality, your destiny isn’t predetermined: In a research study published in Arthritis Care & Research, older individuals who had been runners in their youth were not at any greater risk of knee pain later in life than those who never tied their sneakers. Additionally, those who had accumulated the most miles throughout their lifetime actually experienced the fewest knee aches, regardless of age.
The key to preventing knee pain during or after running: You must safeguard your joints from the beginning. “While it is a common misconception that running is detrimental to your knees, running is still a repetitive motion, so many injuries originate from muscle imbalances that accumulate over time,” explains Ian Sharman, a USA Track & Field certified coach and head coach at Sharman Ultra Endurance Coaching.
Below, you will find some of the most prevalent reasons why you experience knee pain after running, along with what to do about it and how to prevent it from worsening. (More: The Best Free Running Apps for Any Type of Training).
Why You Might Experience Knee Pain After Running
IT Band Friction Syndrome (ITBFS)
IT-band complications are one of the most common irritations that afflict runners. ITBFS occurs when the tendon connecting your hip to your outer knee becomes tight and consequently inflamed, irritating the outer knee bone. If you feel knee pain while running and experience tightness on the outside of your knee, ITBFS may be the reason.
Fix it: Unfortunate news: To alleviate severe ITBFS pain, you must completely rest the tendon (meaning, stop running), according to Leon Popovitz, M.D., the founder of the New York Bone and Joint Specialists in New York. Physical therapy may also be necessary to reduce the inflammation. For milder cases, using a foam roller to stretch after your run will quickly become your closest companion. (These are the best foam rollers for muscle recovery.)
If you have recently increased your mileage or intensified your training in a short period of time, the overuse of your knee can strain and inflame the surrounding tendons. This overuse is referred to as tendonitis and can make your morning runs quite miserable.
Fix it: Tendonitis problems can usually be resolved with rest, ice, compression, and gradually returning to your regular routine.
Scott Weiss, Doctor of Physical Therapy, licensed physiotherapist, certified athletic trainer, and exercise expert also suggests eccentric workouts that prioritize elongating the muscle fibers for delicately extending the tendons and averting knee discomfort during jogging.
Similar to ITBFS, runner’s knee occurs when the cartilage in the kneecap is irritated, resulting in mild to moderate discomfort when engaging in running activities. With this condition, your knees experience pain when running, ascending and descending stairs, or after sitting for extended periods. In contrast, the sensation of tightness implies the presence of ITBFS.
Fix it: According to Dr. Popovitz, performing hamstring stretches and leg lifts can alleviate patellar tendonitis. Incorporate these post-run stretching exercises to enhance leg strength and prevent discomfort while running. (If you encounter knee pain during running, you may consider trying pain-relieving cannabis creams – but do they truly provide relief?)
Your meniscus is located on both the inner and outer sides of your knees, contributing to stability and the distribution of weight-related pressure on your joints. Even a single awkward movement or fall can lead to a tear in the meniscus, often resulting in slight swelling of the knee (either immediately or within an hour) and discomfort during knee flexion.
Fix it: To confirm a meniscus tear, it is necessary to consult a doctor who will likely recommend an MRI. While some outer tears may heal with rest, larger tears may require surgical intervention.
ACL or MCL Rupture
Ligament tears can occur due to various factors, such as twisting the knee (for example, stumbling on an uneven surface or pothole while running), hyperextending the knee, or abruptly stopping during a stride. The ACL (anterior cruciate ligament) connects the thigh bone to the shin bone on the outer side of the knee, while the MCL (medial collateral ligament) performs the same function on the inner side of the knee.
Fix it: Although uncommon for casual runners, if you experience a loud popping sound, sudden or intense pain, or have difficulty bearing weight on your leg, it is possible that you have suffered an ACL or MCL tear. It is crucial to promptly seek medical attention in order to determine the best course of action and develop a rehabilitation plan.
If you feel stiffness and tenderness in your knees accompanied by pain after running, it is a sign that your knees are enduring excessive stress. This may be due to running additional miles or experiencing a fall during the final lap on the track. In such instances, the knee surpasses its range of comfort and becomes strained. (Additionally, Is It Detrimental to Exercise Daily?)
Fix it: It is crucial to consult a medical professional to receive proper evaluation. Additionally, prioritize rest, icing, and elevating your knees whenever feasible. Applying compression is also important, but avoid wrapping your knee too tightly, as this may exacerbate swelling. Over-the-counter medications can aid in reducing inflammation and pain, facilitating a faster recovery.
What Steps to Take If Running Causes Knee Pain
If you encounter knee pain during or after running, consider implementing these eight expert recommendations to expedite the healing process (or prevent knee pain altogether).
Wear Appropriate Running Footwear
“The foot is composed of 26 bones, 33 joints, 19 muscles, and 107 ligaments, and these bear the brunt of the impact with each step throughout the day,” elucidates Pamela Kopfensteiner, D.P.T. at Professional Physical Therapy in New Jersey. You require running shoes that provide support for your natural structure-high arches, pronation, supination-and disperse the shock transmitted up the rest of your leg. Visit your local running store and request a gait analysis, which will accurately determine the support you require, recommends Kopfensteiner.
Running shoes are specially crafted to absorb the shock each time your foot strikes the pavement. However, the more you utilize them, the more the shock absorption diminishes, amplifying the forces transmitted to your joints — a potential cause of knee pain, according to Kopfensteiner. (You may also find benefit in trying one of the finest shoe insoles in your sneakers.)
Although it is true that shoes deteriorate over time, it remains uncertain how many miles or months precede their demise, adds Williams. Expert opinions differ, with suggestions ranging from replacing your shoes every 300 miles to every 600 miles — a considerable disparity. “Some runners are hard on their equipment while others are not, but most runners will sense when they require new shoes,” he adds. If you experience knee pain while running, inspect the bottom of your shoe. If the tread is noticeably worn, if there are creases in the midsole, or if you can flex the shoe more easily, it is perhaps time for a new pair.
Strengthen Your Hips and Core
By now, you have probably heard that even if you are a runner, you should engage in strength training (after all, it can bring you one step closer to a personal record). Yet, there are specific areas to focus on when it comes to preventing knee pain. A study of 400 healthy female runners published in Medicine & Science in Exercise & Sports discovered that, over two years, women who developed runner’s knee exhibited significantly greater pelvic instability — which equates to weakness in their hips — compared to runners who did not encounter knee problems. Additionally, a study in the Journal of Athletic Training revealed that almost 80 percent of sore runners who engaged in strength training focused on their hips and core or knees and thighs reported significantly reduced knee pain while running after only three or four weeks of lifting.
Women should primarily concentrate on strengthening their hips and core, advises D. S. Blaise Williams III, Ph.D., director of VCU RUN LAB at Virginia Commonwealth University. Kopfensteiner concurs: “Running is distinctive in that there is a ‘flight’ stage — a moment when neither foot is in contact with the ground,” she elucidates.
While in transit, it is the responsibility of your central body to govern the tempo at which your appendages descend back to the earth’s surface. By enhancing this regulation, the intensity surging through your articulations upon touchdown is diminished, thereby averting harm to the knee articulations.
Strength train once or twice a week. (This novice strength training guide is a good place to begin). Or create your own plan with planks, side planks, medicine ball core rotations, clamshells, fire hydrants, and open chain hip abduction. Then progress to plyometric exercises such as jump squats, jumping lunges, and single-leg landings. Once you overcome this, add uphill sprints to your training schedule, says Williams.
Don’t Hurry Training
Once enrolling for a race, your instinct may be to increase your mileage immediately — but that’s actually one of the worst things you can do — especially if your knees hurt when running. “It takes time for the body to adapt to training, and your ligaments and tendons improve slower than the muscles since they receive less blood flow,” explains Sharman. “Even if your muscles feel ready to take on more and more, it’s important to allow enough time for the support around the joints to catch up.” A good rule of thumb: Don’t increase mileage by more than 10 percent each week. (
“Running on trails and hills can increase the variety of movement and build up a more even level of strength and stability through the legs and joints,” says Sherman. While there isn’t a big difference among pavement, track, gravel, or trails as far as knee torque and impact are concerned, there are variables for how unstable the surface is or how much you need to pay attention (think: roots, curbs, cars), adds Williams. “All of these conditions result in the muscles contracting for stability, which results in shorter, more controlled steps — which is why many runners report more comfortable runs on trails or grass,” explains Williams. (Here are the top trail running shoes for women)
Aim to veer onto different terrain at least once a week. (The closer you get to the event, though, the more you should train on that terrain — so pavement for a road race, trails for a trail race, adds Sherman.) The one terrain to stay away from if your knees hurt when running? Sand. “A run on the beach sounds romantic but it results in a substantial load on the calf muscles that you may not be ready for,” adds Williams, which can impact all of the surrounding joints, too.
“The way the foot hits the ground when running contributes to forces which impact the knee joint,” says Kopfensteiner. Leaning slightly forward while running can decrease these forces. And in fact, research has proven that leaning slightly forward during a run transfers your weight from your knees to your hips, thereby reducing pain. Try it: Flex more at the hip and allow your torso to come forward seven to 10 degrees. (
Increase Your Stride Rate
“Stride rate is likely the most important factor we know of right now that is easily changeable and reduces both acute and cumulative load on the knee,” says Williams. Shorter steps that propel you to a faster pace decrease the force the quadriceps place on the knee cap, he explains
And in reality, a tiny study in the Journal of Orthopedic and Sports Physical Therapy discovered that when joggers go at a slow pace, they do decrease the burden on their knee per stride, but they actually increase the burden over their entire run since each stride accumulates. When the study participants ran faster, they decreased the overall tension on their knees by 30 percent compared to their leisurely pace. There is no single ideal number, but if you are below 160 steps per minute, you should attempt and enhance that by five to 10 percent, says Williams.
And that’s far simpler to do than it seems. Give this a try if your knees ache while running: Determine your steps per minute by getting on a treadmill and having your friend keep track of how many times your right (or left) foot hits the ground in 60 seconds. Double that number. If it’s above 160, you’re in the clear; if it’s below, calculate a five percent increase, then turn to Spotify’s playlist listed by BPM that matches that goal rate. Your brain and legs will automatically aim to match the new cadence, though it’ll take about four to six weeks of practice to make it habitual, adds Williams.
Maintain Control Downhill
“The inclination when running downhill is to over-stride or reach out,” points out Williams. Remember, you want shorter steps to decrease the force on your knees, so maintain your stride rate when going downhill, he suggests. Plus, it’s a quad killer if you sprint down the hill too fast —so stay in control.