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Knee Pain After Running? Here are 5 Things You Can Do

Knee Pain After Running? Here are 5 Things You Can Do

Having knee pain after running can ruin your favorite form of exercise - and even your whole day.

While having knee pain after running is never a good thing, the good news is that most of the time it can be fixed with a bit of patience and know-how.

Runner’s knee is a common issue for many endurance athletes, not just runners. To help you address the issue head on, we will do a deep dive into what may be causing your knee pain after running - and how you can solve the problem for good. 

Why do I have knee pain after running?

Runner’s knee or patellofemoral pain syndrome is a blanket term for a dull pain around the patella (the front of your knee) where it connects with the lower end of your femur (thighbone). 

It isn’t necessarily a specific injury and it could be one of many knee problems. Some typical symptoms of runner’s knee that many athletes report include: 

  • Pain in the front of your kneecap (pain can also be around or behind kneecap)
  • Pain when you bend squat, kneel, run, stand up from the chair, or walk
  • Pain that worsens when you walk down the stairs or hike downhill
  • Swelling around your knee after use (especially after physical activity like running or cycling)
  • Popping or grinding sensation in the knee when in use

But believe it or not, runner’s knee very rarely begins in the knees. 

Running is an endeavor that requires an immense amount of strain on joint structures and reliance on flexibility and strength. When your running gait is impacted by hip extension, muscle imbalances, tight muscles, or even your running stride length, a lot can go wrong. 

While there are several muscles being engaged while you run, a major player is your iliopsoas. Your iliopsoas is made of the iliacus and psoas muscles, also called your hip flexors

From the common name, you may guess that they are used for hip flexion or to move your legs up and forward from your body. But the iliopsoas is also responsible for your ability to move your trunk from side to side - and is even engaged when sitting!

When you run, the iliopsoas is used to swing the leg forward while stabilizing your spine and hips. As one leg strides forward, the other is moving behind the body in a hip extension that stretches the iliopsoas. 

With running specifically, you are in a cycle of repetitive contraction and stretching with the rule of stabilizing your spine and hips. This constant action easily fatigues and overuses the iliopsoas - further encouraging muscle tightness. 

Nearly every single runner that I’ve treated has tight hip flexors. If muscle tightness like this is left unaddressed, it can lead to pain in other areas and even cause knee pain after running

An unhealthy iliacus alone has a profound impact on the rest of your body because it connects to the pelvis and the thigh bone. The tightness in this one muscle can twist your core, causing changes all the way down to your knee and up to your shoulders.

In most cases, tightness in your iliopsoas muscle is caused by overuse or being too flexible. Overuse is not limited to running though. Your iliopsoas can be overused by excessive sitting as well. 

So, if you combine a sedentary lifestyle with frequent running, you have the perfect storm for tight muscles. If you are too flexible, specifically in your pelvic region, then your iliopsoas is working overtime to keep the body aligned and in place, especially during joint movements. 

Once you have tightness in your iliopsoas, it can become a consistent and persistent issue. It will pull on your pelvis and create a faulty movement pattern down your leg all the way to your feet and up your spine all the way to your head. The constant strain will wear away on your body, and eventually hit the weakest link causing pain. 

For many runners their weakest links are their ankles, knees, or hips. Which is why many runner’s that experience knee or hip pain also ask “why do my ankles hurt when I run?” 

While runner’s knee can be from a variety of issues, the most common I’ve seen in my practice is tight iliacus muscles. It is often the root cause of knee pain after running, lateral hip pain, and even lower back pain - but it is something that we can treat. 

5 things you can do if you have hip or knee pain after running

For most runners, hip or knee pain after running can get better on its own with some at home treatment. You may also benefit from getting a proper diagnosis from a medical professional and to ensure these five remedies for knee and hip pain from running are right for you. 

Run fewer miles and on softer surfaces

One of the best things you can do for knee pain after running is rest. How long you rest will vary according to the injury itself, but if there is pain and swelling, rest, ice, and elevation can go a long way. 

Keep in mind that while running too long can irritate your knee, sitting too long can also cause some pain. So, while you rest, try to mix in some mild movements to keep the joint awake and lubricated. 

If your knee hasn’t gotten to the point where it is swelling up or clicking, some rest will still do you good, but you may be able to do some mild runs as well. 

If running in general is bothering your knee, consider going on walks and hikes until you feel no pain in your knee during or after the activity. 

As you start to run again, ramp up your mileage slowly and try to run on routes that are flat. Running on hard surfaces or on hilly routes can easily irritate your knee joint again.

Keep in mind that continuing activity on your knee while you are in pain can cause permanent damage to the joint. So, it is better to take it slow than to require surgery down the road. 

Evaluate your running form 

If your pelvis is out of alignment because of tight hip flexors, then your running form is likely off. If your running form is not correct, this can cause a slew of issues and pain points, including knee pain after running.

You can evaluate your running form yourself by taking a video. Try to film from the front, back, and both sides to get a full body idea.

The best way to evaluate your running form is to enlist the help of a physical therapist. They’ll likely watch you while you run and walk both with and without shoes on and be able to tell you where any misalignment is happening in your form.

Do more cross training 

Knee pain after running and tight muscles can also be caused by muscle imbalances. If one muscle is much stronger than the other, it can begin to pull on the weaker muscles, further causing muscle tightness and body misalignment. 

Some examples of cross training include: 

  • Swimming 
  • Yoga
  • Pilates
  • Strength training 

Activities that have a lower joint impact, like swimming, can also be a great way to stay active if you have to take a break from running while you treat your knee injury. 

Strengthen hips, glutes, and hamstrings

Although you need to cross train and keep all of your muscles strong, because running involves your hips, glutes, and hamstrings so intensely, they need to be able to keep up. 

Begin to integrate targeted strength training in these areas of your body to prevent muscle weakness, but remember, if you are working one muscle group, you also need to work the opposing muscle group. 

Working with a physical therapist can provide you some insights as to which muscle areas need the most work and which exercises can help you build strength and balance. 

Muscle tension release 

While all of these recommendations are essential for running recovery from knee pain specifically, muscle tension release may be the most neglected and the most vital.

If tight hip flexors are causing your knee pain after running, then you need a way to release those muscles. 

You may already be using a foam roller during your post-running stretch sessions, but a foam roller can only do so much, and most definitely cannot reach your iliacus or your psoas. 

Because of their hard to reach locations, you need specialized tools or to have a physical therapist to release the muscles for you. To do what a PT can do for muscle release at home you need tools like the Hip Hook and the Hip Flexor Release Ball

The Hip Hook is the only tool specifically designed to release both the psoas and the iliacus muscle, while the Hip Flexor Release Ball offers a gentler warm-up for releasing very tight psoas muscles, as well as releasing the piriformis in the back of the hip.

As you build a running recovery program to treat your knee pain after running, you can start to build daily habits and routines that integrate muscle tension release

FAQs about knee pain after running

Is it normal for my knees to hurt after running?

While many runners have knee pain, it can be addressed by finding the root cause. Tight hip flexors are often overlooked as a cause of knee pain after running. Knee pain can be caused by misalignment of the pelvis and uneven gait or stride, creating extra pressure on the knee joint. 

How long does runner’s knee last?

For most runners it takes 4-6 weeks to recover from runner’s knee. The recovery period can lessen with rehabilitation, addressing the muscles at the root of the problem (don’t skip the hip flexors) and by reducing the load on the affected knee. 

Is it okay to walk with runner’s knee?

High impact activities should be avoided for people with runner’s knee. The good news is that moderate walking is a low impact activity and is often recommended during recovery, along with applying pressure to release key muscles like the psoas and iliacus. Usually, a 15-20 minute walk at a slow or moderate pace is enough to get your joints moving and loosened up. Avoid hills and pay attention to your pain levels when doing so

By Christine Koth . Tue Nov 09

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