Knee Injuries & Pain from Running

Common Knee Injuries from Running

When most people think of running, they view it in the light of something that is beneficial for your body. While that is true in that it can improve your heart health, help with weight loss and provide a boost in mood or self esteem, there is also a downside to running. Namely, the repetitive motions and impact of “pounding the pavement” can take a toll on the body.

For this reason, it is important to pay attention to any foot, hip or knee pain from running and to take steps to address any such pain. It is also important to engage in “safe practices,” if you will, relative to running. I will go into more detail on how to relieve knee pain from running and how to ward off future injuries momentarily. But first, I will detail a few common running knee injuries.

Runners’ Knee Pain

The term “runners’ knee” is a general term for knee pain associated with running. (This condition is similar to Jumper's Knee.) Typically, this includes knee pain while running and in some cases knee pain after running in the vicinity around or behind the patella (kneecap).

Runners’ knee, also known as patellofemoral pain syndrome, can be brought on by a number of things. For one, overuse can irritate the nerves of the knee and overstretch the tendons, resulting in running knee pain.

Besides knee pain, running injuries of the patellofemeroal pain syndrome variety can also cause tenderness, cracking sensations or knee instability. There are a number of knee braces for runners that can help ease knee pain and provide support. 

Misalignment of the bones can also cause knee pain when running as this can result in too much weight or force being put on areas of the body that are not equipped to handle it. This, in turn, increases one’s risk of damaging the knee joint.

Misaligned bones can be due to misshapen or ill-fitting bones in the knee joint, or an abnormally high or flat arch of the feet. Knees that bow out or bend in can also result in abnormal weight distribution on the bones that leads to runners’ knee injuries.

Runners’ knee is estimated to be up to two times more common in women than men, according to the British Journal of Sports Medicine. This is largely due to the greater angle between the thigh bone and the knee that results from the wider hips of the female sex. This puts more stress on the knees. 

Muscular issues can also cause the patella to mistrack. Weak quadriceps muscles or especially tight leg muscles that cause one to run with some of the aforementioned atypical forms are associated with running and knee pain. BraceAbility offers knee braces specifically designed to improve the tracking of the patella, such as the Bauerfeind GenuTrain P3 Patella Knee Support.

Running can also cause cartilage of the knee to wear down. This can result in knee pain with running, often in the area just below the knee cap. 

Knee Joints affected by Running


Outside Knee Pain: Running with ITBS

Another fairly common source of runner knee pain is iliotibial band syndrome (ITBS). This injury is especially common among distance runners and it typically causes lateral knee pain when running. ITBS is thought to be the most common source of outer knee pain from running. The pain in knee when running associated with ITBS typically fades quickly once one stops the activity.

So what causes ITBS? Well, the iliotibial band is a thick band of tissue that runs along the outside of the leg from the hip to the top of the shin bone. Its primary function is to control abduction of the thigh.

When one is running, the IT band slides back and forth over a bony structure known as the lateral femoral epicondyle (the bump in the thigh bone near the knee). Too much of this action can cause the band to become inflamed, resulting in painful friction on the lateral part of the knee as one is running.

There are a number of factors that can increase one’s likelihood of experiencing this type of runner knee pain, including major foot pronation (see “Pronation, Explained”), running in worn-out shoes, differing leg lengths, tight leg muscles or being bow-legged.

The Ilotibial Band in the Knee


Inner Knee Pain: Running & Plica Syndrome

Plica syndrome is much harder to diagnose than the aforementioned conditions. The quick definition of plica syndrome is that this refers to irritation of the lining of the knee joint that often results in running knee problems. Plica refers to thin remnants from the fetal stages of one’s early developments that are located in the sleeves of the synovial folds; more specifically, these appear as an extension of the synovial capsule.

When the synovial capsule is irritated from activities such as running, plica thicken, making it more likely to get caught on the femur (thigh bone) or pinched between the femur and the patella. This typically causes medial knee pain with running, along with a catching, locking or a crackling sensation/sound of the knee.

Overuse as well as tight hamstrings and/or weak quadriceps muscles can increase one’s likelihood of developing plica syndrome.


Running Injuries: Knee Bursitis

The knee has 11 bursa, or small lubricating sacks. Irritation of the bursa can also cause knee pain. One of the more common running injuries to the knee is pes anserine bursitis. This refers to irritation of the bursa located between the tibia (shin bone) and the three tendons of the hamstring muscle at the inside of the knee. This irritation can stem from overuse and friction, resulting in inside knee pain with running and other repetitive activities. 

The source of bursitis in the knee

Again, tight hamstrings and being bowlegged can increase one’s risk of developing this injury, as can obesity or osteoarthritis. Suddenly increasing one’s distance or the amount of hills in one’s run can also increase one’s risk of bursitis-related pain in knee after running.

Bursitis knee pain from running typically develops gradually inside the knee and/or near the center of the shinbone a few inches below the knee joint. The intensity of the pain often increases with activity or climbing stairs.

Knee Pain Running Treatment

BraceAbility offers a wide selection of Knee Injury Treatments, including treatments for general knee pain and treatments for jumper's knee or runner's knee. You can likely infer a number of the knee pain treatment and preventative steps from the descriptions of the risk factors for developing runner’s knee pain. First, it is important not to “muscle through” knee pain. Pain is a red flag that something is wrong. Heed it and seek the help of a professional.

Most instances of knee pain and running can be remedied by conservative treatments. The first line of defense is often engaging in the steps of RICE—rest, ice, compression and elevation—possibly with the use of an over-the-counter anti-inflammatory medication. A doctor can recommend a number of knee injury stretches and exercises to strengthen and improve the flexibility of key leg muscles.

When one gets back to running, it is important to always stretch and warm-up before a run. The use of proper running shoes for knee pain avoidance is also important. This includes wearing shoes that are supportive and suited to your foot and gait.

Wearing an appropriate amount of clothing for the weather is also important for preventing sore or tight muscles. Use of a knee brace for runners or a runner's knee band may also provide some useful extra support and a boost in circulation that can promote healing as one eases back into training.

When in recovery mode from a knee injury, one should avoid hilly, uneven terrain. And when one does begin working hills back into a workout, this should be done gradually with attention to form. The same can be said for adding miles to one’s run. Watch this video on proper, safe and efficient running form:

Strength training and cross-training for more balanced strength throughout the body is also important for knee injury prevention.

Unfortunately, there are times when conservative methods are not effective. In such cases, more invasive methods such as injections or surgery may be needed to relieve knee pain from running.

View our related blog posts on this topic:

Patellar Tendonitis Treatment and Surgery

Bauerfeind Genutrain Knee & Patella Supports for Athletes

What is Jumper's Knee and how is it Caused?

Treatments for Knee Joint Pain