Why Do My Knees Hurt When I Run?

November 10, 2020

Sound familiar? As a physiotherapist it’s a question I hear almost every day. In fact, it’s a question I asked myself several years ago. Walking out of the house at 7:30 in the evening when three young children needed baths, stories and bed did not fit well with my regular football matches, so I made the decision to change my training regime and started running.

I was reasonably fit, did a lot of running when I was young, and had fortunately suffered no significant injuries to that point. Yet after two months of regular runs I developed pain in both knees that took a day to settle. Why was this happening? It may surprise you that, for the vast majority of us, our knees are not the problem, rather they are a symptom of other issues that cause our knees to complain.

In my case, I asked myself the question “Have I earned the right to do the volume and variety of running I’m doing?” I was doing 3-4 runs per week, rapidly increasing my long run up to 10km and including hill climbs and one faster session. I realized I was a victim of the terrible toos, I was running too often, too fast and too long, with too little rest – I hadn’t earned the right to do so and my body was letting me know that it hadn’t had time to adapt to the loads I was putting it through.

Volume and type of training are key considerations for runners, but in the absence of pre-existing injuries or trauma another major factor is our biomechanics, or HOW we run. I’ve listed below a few of the most common culprits that, if left unaddressed, can have a significant impact on or running pleasure and efficiency:

  • Poor running form
  • Muscle imbalance
  • Incorrect shoes
  • A lack of muscle strength
  • Foot mechanics

They’re all correctable, but running is a sport that requires muscle groups to repeat the same action thousands of times - a small anomaly gradually becomes magnified and over time leads to problems. Very commonly we feel pain in our knees but the origin of the problem is elsewhere, normally a joint above (the hip and pelvis) or a joint below (our feet).

Whether we’re competitive or recreational athletes, most of us will experience a running injury at some point. Every one of us has our own style of running and in order to settle the injury and return us to optimal running, there is no ‘one size fits all’ recipe.

It is important to assess posture, flexibility and strength statically, but most of us don’t get pain standing still! So, it’s vital to see what happens dynamically, and that means looking at our running. In the clinic we use software to capture video clips that allow us to analyse a runner in slow motion or even freeze frames, looking at them from their feet to their shoulders. This allows us to highlight any biomechanical issues they might have, and from there we will create a programme tailored to the individual needs of that runner.

If your knees complain during or after running, give us a call, we may be able to help!

This post has been written by Physiotherapist Aaron Smith BSc PgD.

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