Why Do My Knees Hurt When I Run?
(And What To Do About It)

If you’ve ever gone for a run and felt that familiar ache in your knee, you’re not alone. Knee pain is one of the most common running-related complaints, with conditions like “runner’s knee” accounting for a large proportion of injuries.

But here’s the good news:
👉 Most running-related knee pain is not caused by damage, but by how your body is managing load.

Let’s break it down.

What Does “Runner’s Knee” Actually Mean?

The most common cause of knee pain in runners is something called patellofemoral pain syndrome (PFPS)—often referred to as “runner’s knee.”

It typically feels like:

• A dull ache around or behind the kneecap
• Pain during or after running
• Discomfort with stairs, squats, or sitting for long periods

This pain happens when the kneecap doesn’t move smoothly in its groove, leading to irritation of the joint surfaces

So… Why Does It Happen?

1. 🔁 Overuse (Load vs Capacity Mismatch)

Running itself isn’t the problem—but too much, too soon often is.

Repetitive stress on the knee joint without enough recovery can irritate tissues like the patellar tendon or joint surfaces

👉 Common triggers:

• Increasing mileage too quickly
• Adding hills or speed work suddenly
• Returning to running after a break

Your body needs time to adapt. When load exceeds what your tissues can handle, pain shows up.

2. ⚖️ Muscle Weakness & Imbalances

Your knee doesn’t work in isolation—it’s controlled by muscles at your hip, thigh, and core.

Research shows that weakness or poor control (especially in the hips) can cause the knee to move inward, increasing stress on the joint

👉 Key culprits:

• Weak glutes
• Poor hip stability
• Reduced quadriceps strength

Think of it like this:
If your hips aren’t controlling your leg, your knee takes the strain.

3. 🏃 Movement & Running Technique

How you run matters.

Evidence suggests that running technique retraining—like reducing impact or adjusting stride—can significantly reduce injury risk

👉 Common issues:

• Overstriding
• Heavy foot strike
• Poor control during landing

Small changes in how you move can make a big difference.

4. 🔄 Biomechanics & Alignment

Sometimes it’s about how forces travel through your body.

Abnormal tracking of the kneecap—often linked to muscle imbalance or movement patterns—can increase pressure in the joint

This doesn’t mean your body is “broken”—just that it may need better support and coordination.

What Actually Helps? (Evidence-Based)

Here’s where most runners go wrong:
❌ Rest alone
❌ Stretching only
❌ Ignoring the problem

Instead, research consistently supports a combined approach.

1. ✅ Modify Your Running (Not Stop Forever)

You don’t always need to quit running—but you do need to adjust it.

• Reduce distance or intensity
• Avoid aggravating factors (e.g. hills, speed work)
• Cross-train if needed

This helps calm symptoms while keeping you active

2. 🏋️ Strength Training Is Key

The strongest evidence-based treatment for runner’s knee is exercise therapy

Focus on:

• Glutes (hip stability)
• Quadriceps (knee support)
• Hamstrings & calves

Strengthening these muscles reduces load on the knee and improves movement control

3. 🧠 Retrain Movement

Improving how you move is just as important as getting stronger.

This might include:

• Shorter, quicker steps
• Softer landing
• Better alignment through hips and knees

Even small technique changes can reduce stress on the knee significantly.

4. 👐 Don’t Ignore Recovery

Pain is a signal—not something to push through.

• Allow adequate rest between runs
• Manage training load
• Gradually build back up

Recovery time varies, but addressing the root cause is what leads to long-term improvement

The Big Myth: “Running Is Bad for Your Knees”

This is one of the biggest misconceptions.

In reality, research shows that recreational running is not harmful to knees long-term—and may even be protective.

Most knee pain in runners comes from:
👉 Training errors
👉 Muscle weakness
👉 Movement patterns

—not from running itself.

When Should You Get Help?

You should consider seeing a physio if:

• Pain isn’t improving after a few weeks
• It’s getting worse
• It’s affecting your daily activities

Getting the right diagnosis matters, as knee pain can have multiple causes

Final Takeaway

Knee pain when running is common—but it’s rarely random.

It usually comes down to this:

👉 Too much load + not enough support/control

The solution?

• Adjust your training
• Build strength
• Improve how you move

Do that—and not only can you get back to running…
you’ll likely come back stronger than before.

Email: info@wellbeing-rehab.co.uk
Telephone: 0161 676 0341