6 Causes of Knee Pain After Running + How to Fix Them

Knee pain after running is a common running injury. In fact, research shows knee injuries account for up to half of all running injuries. 

Why? Because knees bear a large brunt of our impact when we run. The most common knee injuries are IT band syndrome, runner’s knee, patellar tendinitis, knee bursitis, a torn meniscus, and osteoarthritis. 

Don’t be disheartened if you have one of these common causes of knee pain after running. There are ways to prevent knee pain and treat it so that you can get back on the roads and trails

In this article, we will look at:

  • The common causes of knee pain
  • Why your knee hurts when you run
  • Why running is NOT bad for your knees
  • The six common reasons why your knee hurts when you run, and
  • How to fix these common knee injuries!
  • What to do if you have knee pain

If you experience a sore knee from running, let’s get you better!

6 Causes Of Knee Pain After Running How To Fix It

4 Training Mistakes That Cause Knee Pain After Running

There are four main causes of knee pain after running. 

1. Training regimen

Many runners, especially beginner runners, will increase their mileage too quickly before a runner’s joints and connective tissues are strong enough to handle the load.  

“Our cardiovascular and muscular fitness improves more quickly than the conditioning of our cartilage, ligaments, tendons, and bone. As a result, runners are more susceptible to overuse injuries,” says Dr. Joe Norton, doctor of physical therapy. 

2002 review of 2002 running injuries found that 80 per cent of the injuries were overuse-based. Runners, particularly new runners, who progress their mileage by more than 10 per cent per week are at a greater risk for injury than those who don’t.  

Related: The 10% Rule: Is it a Valid Way to Increase Mileage?

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2. Weakness

A lack of strength and flexibility are also risk factors for running injuries. Because the body is complicated, a health care professional is best to assess what areas may need to be strengthened or stretched, and how. 

3. Poor form

Runners’ feet should land softly under their centre of gravity. Studies show many running injuries can be attributed to poor pelvis and lower extremity alignment while running. If you’re having recurring injuries, it’s possible your running form may need to be assessed and altered. 

Related: Here’s What Bad Running Form Looks Like

4. Running shoes

Running shoes can have a powerful impact on how our body moves when we’re running and how much force it impacts. How our feet land on the ground ripples up through the kinetic chain. 

If you are in the wrong shoes, or old shoes, you may be putting too much stress on one area, such as your knees, leading to irritation. 

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Is running bad for the knees?

While we discuss knee pain when we run, it’s important to note that running is NOT bad for your knees. In fact, regular running actually strengthens the knee and protects against arthritis later in life, says Todd Buckingham, lead exercise physiologist at Mary Free Bed Rehabilitation Hospital.  

“Just as lifting weights makes your muscles adapt and become bigger and stronger, running makes your knees and joints stronger by causing the bone and cartilage (the connective tissue separating your lower leg to your upper leg) to adapt and become stronger,” he explains. 

But this doesn’t mean the more you run, the stronger your knees with be. And, it doesn’t mean that you should run through knee pain. In fact, you should do the opposite. Stop, treat, and proceed cautiously. 

Related: Is Running Bad for Your Knees?

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The 6 Common Sources Of Knee Pain After Running:

1. (Iliotibial) IT Band Syndrome

Where it hurts

IT Band Syndrome hurts on the outer part of your knee.

What causes it

IT Band Syndrome occurs when the IT Band, which runs along the side of your thigh and glides over your knee, gets tight, creates friction, and begins to swell.

Buckingham says many runners get IT Band Syndrome by running along the same side of the road because most roads slope to allow rainwater to drain. 

“This causes the outside leg to be lower than the inside leg. Even if it is just a few millimetres, taking thousands of steps with your legs at ‘different’ lengths will cause the pelvis to tilt to one side and add stress to the iliotibial (IT) band,” explains Buckingham. 

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How to fix it

Runners should aim to run on a flat surface such as a paved trail, sidewalk, or track

Manage symptoms of IT band syndrome by avoiding doing anything that irritates it, applying ice and heat in 15-minute intervals, and strengthening the muscles of the core, hip, and knee.

See also: Do Copper Knee Braces Work? + The 5 Best Copper Knee Braces 

2. Runner’s knee (aka chondromalacia patellae)

Where it hurts

Runner’s knee hurts behind the kneecap. Signs of runner’s knee are pain behind the knee after running, pain when squatting, walking up and downstairs, kneeling, or sitting for a prolonged period.

What causes it

Runner’s knee is caused by many things such as weak quadriceps muscles, overpronation while running or increasing mileage too quickly. 

How to fix it

To treat runner’s knee, avoid doing anything that causes it to hurt (including running), ice and heat, and strengthen the muscles of the core, hip, and knee.  A runner’s knee brace may also provide relief. 

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3. Patellar Tendinitis (aka jumper’s knee)

Where it hurts

Patellar tendinitis hurts below the knee in the patellar tendon which connects the kneecap and shin and allows you to fully extend your knee. When the tendon is overworked, tiny tears and inflammation will form leading to pain.

What causes it

Patellar tendinitis is most often caused by increasing mileage and/or intensity too quickly. It is also caused by having weak or tight quadriceps muscles or hamstrings which can add extra stress to the tendon. 

How to fix it

Once again, don’t do activities like running that aggravate patellar tendinitis. Ice and heat the hurt area, and strengthen and stretch your quads and hamstrings. You can also wear a patella brace to reduce stress on the patella. 

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4. Knee bursitis 

Where it hurts

Knee bursitis can hurt in any of the knee bursae which are situated above and inside your knee and on your kneecap. It could be characterized by inner knee pain after running.

However, the most common pain is over the kneecap (Prepatellar bursitis) or the inner side of your knee below the joint (Pes Anserine bursitis

What causes it

A bursa is a small fluid-filled sac that reduces friction and cushion pressure points between your bones and tendons, muscles, and skin. When they become irritated, they swell causing pain. Irritation is usually triggered by increasing mileage or intensity too quickly. 

How to fix it

You guessed it—rest, ice, and heat, and you can also take anti-inflammatories for pain. You can resume running when the swelling has subsided but if the pain and swelling continue, seek the help of a healthcare professional. Treatment such as cortisone shots and physical therapy may be needed.

Related: Ibuprofen and Running: Negative Side Effects and Substitutes 

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5. Meniscus tear

Where it hurts

A meniscus tear is when a piece of cartilage (on each side of the knee) between your shin and thigh bones rips. A torn meniscus hurts and usually swells around the knee in which you can’t fully extend your leg.  

What causes it

A torn meniscus usually occurs from overuse or sudden movements like twisting or changing directions.  

How to treat it

You don’t always need surgery with a torn meniscus. If you’ve torn your meniscus, stop running until the pain and swelling subside. Ice, heat, and take medication for pain as the meniscus heals. Resume running carefully. 

Even if the meniscus doesn’t repair itself, it’s possible to resume running without aggravation

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6. Osteoarthritis

Where it hurts

Osteoarthritis makes your knee feel stiff and it hurts to move it in even daily activities. It may also swell. 

What causes it

The lining of your knee joint called the hyaline cartilage (which separates the bones) begins to wear away causing the bones to grind together. 

How to fix it

While it may hurt to move, movement keeps the joints lubricated and mobile which can lead to less pain over time. You can also take anti-inflammatories for pain. Run on soft surfaces and avoid sudden movements and hills

See a doctor if you need more pain management. There are treatments like hyalulonan or cortisone injections that can alleviate pain. Strength training of the muscles around the knee and core can also alleviate pressure on the joint. 

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When should I see a doctor for my knee pain? 

If your knee pain doesn’t improve after a week or more of rest and at-home treatment, it’s time to seek the help of a medical professional to get you back to doing what you love—running! 

Do not run through pain as that can make your knee injury worse, and lead to a longer recovery time! 

Also, while recovering at home, focus on sleep and a balanced diet as these two factors are crucial for healing! If you’d like help reaching your goals, be sure to check out my marathon training master class!

Photo of author
Whitney Heins is the founder of The Mother Runners and a VDOT-O2 certified running coach. She lives in Knoxville, TN with her two crazy, beautiful kids, pups, and husband. She is currently training to qualify for the 2024 US Olympic Trials marathon.

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