» Blog
» Knee Pain After Running

Knee Pain After Running

Running is such great exercise! Great for both mind and body, running lets you feel the wind in your hair, interact with your neighborhood, and energize yourself. But running is a repetitive, weight-bearing exercise, so there is a high risk for injury. Knees bear the brunt of the impact when you run. Knee pain after running is incredibly common. In fact, knee injuries account for about half of all running injuries.

The Major Causes of Knee Pain After Running

Knee pain after running may be common, but it isn’t inevitable. These are the factors that contribute to a higher risk of knee pain for runners. 

Overuse By Increasing Speed or Distance    

It may seem like increasing speed or distance is a matter of willpower and determination. Yet, increasing your speed or distance by more than 10% per week puts you at risk for knee pain after running. Your connective tissues and joints are simply not ready. 

Cardiovascular and muscular fitness often improves more quickly than tendons, bones, cartilage, and ligaments. So, runners, especially beginners, suffer from overuse injuries. This accounts for 8 in 10 running injuries. 

Lack of Strength and Flexibility

Runners who lack strength and flexibility risk injury on every run. Your physical therapist at Ironhorse Physical Therapy & Pilates in San Ramon, CA, will assess which areas need strengthening and where you lack flexibility. Everyone’s body is different, so you’ll need a customized program to assure optimal results. 

Poor Running Form

Your feet should land softly under your center of gravity, but it doesn’t always work out that way. Poor pelvis and leg alignment when you run make injuries more likely. Your running form requires a full assessment if you have recurrent knee pain after running or have suffered several running injuries. Once assessed, your physical therapist will tailor a program to get your running form on track. 


Your shoes can have a powerful impact on how you walk and even more impact on how your body moves as you run. Your running shoes or more accurately, how your feet fit or interact with your shoes, affect the force on every part of your body. How your feet land sends shock waves up through your entire body. 

Wearing the wrong shoes or old ones puts stress on different areas, like your knees, so you end up with inflammation, irritation, and pain.

Common Explanations for Knee Pain After Running

The 5 most common explanations for knee pain after running are:

  1. Runner’s Knee
  2. Iliotibial (IT) Band Syndrome
  3. Patellar Tendinitis
  4. Meniscus Tears
  5. Bursitis

Don’t worry if you have one of these reasons for knee pain after running. You can treat your current pain and prevent it in the future to get you back on the road again. 

1. Runner’s Knee 

Runner’s knee is the most common cause of knee pain after running. “Patellofemoral pain syndrome” is pain around your kneecap. It hurts either when you are active or after you sit with your knees bent for an extended period. 

While you run, your kneecap and leg bones all move. This puts pressure on your kneecap. Too much pressure causes irritation and inflammation. Tight muscles, poor form, and structural issues like a kneecap out of alignment, can all make runner’s knee worse.  

Knee pain is often causes an issue at either the hip or the foot/ankle. Talk to your physical therapist at Ironhorse Physical Therapy & Pilates in San Ramon, CA, for a treatment plan to strengthen your knees, feet, ankles, and hips. Physical therapy can help reduce the pain, recovery time, and help prevent runner’s knee in the future. 

2. Iliotibial (IT) Band Syndrome – Pain Outside the Knee

Long distance runners find Iliotibial (IT) band syndrome common, too. The iliotibial band is a layer of connective tissue running down from your hip to just beyond your knee. Iliotibial (IT) band syndrome causes the outside of your leg to be lower than the inside of your leg. Just a few millimeters of difference can cause your pelvis to tilt, adding more stress to the iliotibial (IT) band. If you have pain after running on the outside of your knee, it could be Iliotibial (IT) Band Syndrome.

Runners move forward and backward, and not side to side. This movement pattern can tighten up the iliotibial band. Combine that with the overuse from long distance running, and you end up with friction where your IT band meets your knee. The friction produces inflammation and pain.

If your pain is more than a 3/10 on pain scale before during or after running  , we recommend Stop Running and Talk to Your Physical Therapist at Ironhorse Physical Therapy & Pilates in San Ramon, CA to find a way you can continue to run without exacerbating the issue. 

Foam rolling the IT band doesn’t usually help and can actually make things worse! An over-the-counter anti-inflammatory pain medication may help ease the pain until you get to the root of the issue but is is just a bandaid! The problem will Likely return once you go back to running if you haven’t addressed the root cause. 

Working with your physical therapist who also runs and is a certified run coach, to figure out root cause is extremely important. You may need to strengthen your core and hips. IT band syndrome can become chronic, requiring a month or two of rehab, so as soon as you have pain on the outside of your knee, call us. 

3. Patellar Tendinitis – Jumper’s Knee Also Causes Knee Pain After Running

Patellar tendinitis, or Jumper’s Knee, commonly causes knee pain after running. The pain centers below your knee, where your patellar tendon connects your kneecap to your shin. This is the tendon that allows you to straighten your leg and extend your knee. 

If you have recently increased your running distance or are running more often, you are more likely to suffer from Jumper’s Knee. Tight quads or hamstrings also add strain on your patellar tendon. The extra stress causes tiny tears in your tendon, resulting in pain and inflammation. You may think that stretching would be the solution to a tendon problem but it can actually make tendon issues worse. You may need to initially unload the tendon by decreasing your run volume and intensity and it really severe cases, you may have to stop running to calm things down. But you don’t want to have prolonged rest because the muscle gets weak overtime so that the next time you go running, the symptoms may come back even sooner. For example, the knee pain would come on at mile two or three and then after a period of rest you notice that the pain is starting earlier maybe half a mile or a mile into your run. 

Talk to your physical therapist about the best flexibility and strengthening exercises and other physical therapy treatments to stimulate tissue healing and reduce the risk of recurring injury. 

4. Meniscus Tears

A meniscus tear injures the piece of cartilage between your shin and thigh bones. Your knees each have 2 menisci — one on the inside and one on the outside of your knee. With a meniscus tear, the pain and inflammation extend around your knee, and it can be hard to extend your leg fully. 

Meniscus tears are more likely with repetitive use and twisting motions. You are more likely to tear your meniscus when you stop suddenly or change directions quickly.

Rest, Ice, and Physical Therapy for Meniscus Tears

In a mild case, you’ll find some rest, ice, and over-the-counter anti-inflammatory medication will help you feel better as you stop running for a short time. These remedies don’t repair the tear itself, so you will likely  need more treatment. 

Your physical therapist at Ironhorse Physical Therapy & Pilates, can help you with a recovery plan, making surgery less likely. 

5. Bursitis 

A small, fluid-filled sac, called the bursae, near your knee can get inflamed or irritated. For runners, the two most common types of knee bursitis are: 

  • Pes Anserine Bursitis – The pain is just below the joint on the inside of your knee near your hamstring
  • Prepatellar Bursitis – The pain is right on your kneecap  

Bursitis in your knee or anywhere else in the body occurs when repeated strain inflames the bursae. You may have knee bursitis if you have recently increased your mileage or speed. 

Keep Running if Your Knee Isn’t Swollen

Talk to your physical therapist, but it may be possible to run through the pain once the swelling goes down. 

Some people feel relief when they Ice their knee but compression and early mobilization and gentle exercise usually yield the best results. follow your physical therapy treatment plan to reduce the chances of needing corticosteroid injections or surgery to remove your bursa. If you get a fever, contact your doctor because sometimes the bursa becomes infected, which requires antibiotics.

Is Running Bad for Your Knees?

No. Running is NOT inherently bad for your knees. And running regularly strengthens your knees and protects you from getting arthritis as you age. Running strengthens your joints because the connective tissues between your upper and lower leg adapt to the activity. 

But there is a limit. Your knees don’t just keep getting stronger the more you run. And running through knee pain is seldom the right thing for your knee health. Always check with your physical therapist if you have any knee pain after running. 

In Conclusion

Knee pain after running is common, especially if you increase your speed or distance by more than 10% a week or you are returning to running after a break such as getting Covid or having a baby or another injury. But the place to start with most knee injuries is initially to rest for a short amount of time (from a few days to 1 week, depending on severity)  and physical therapy to figure out the root cause so that the problem doesn’t keep coming back after you rest a bit. 

Contact Ironhorse Physical Therapy & Pilates in San Ramon, CA, if you are experiencing any knee pain after running. We will conduct a thorough assessment to get to the root of the issue.