Every runner’s worst nightmare.
Running has a way of making you feel like you’re on top of the world (runner’s high is legit, people!)—then tearing you down again. And that’s never more real than when you get knee pain while running.
What gives? Well, it might be a little condition known as runner’s knee.
What is runner’s knee?
Runner’s knee is an umbrella term used to describe a misalignment in the knee caused by a strain or a natural misalignment of a joint (a.k.a. if you have knock knees) or wide-set hips, says Cardelia Carter, M.D., an orthopedic surgeon and the director of the Women’s Sports Medicine Center at NYU Langone Health.
Generally, you’ll feel this pain at the side of the knee, or behind the knee cap as you bend and straighten. Carter says it’ll feel very different from the knee pain you might deal with after bumping into something, for example. Instead, “runner’s knee pain appears gradually and seems to be worse with physical activities.”
Since the condition is exacerbated by repetitive impact activities, runner’s knee is a super common overuse injury for those who like to pound the pavement. But you don’t actually need to be a runner to feel it, she says. People might feel runner’s knee pain while squatting or lunging too deeply, from taking the stairs, or from sitting for extended periods of time.
What causes knee pain while running?
To maintain pain-free knees, the muscles from your core down to your ankles need to work in sync to support your joints. But if these muscles are too weak to keep your hips and ankles in their proper place, the pain will centralize at your knees. So, unfortunately, whether or not you’re hit with runner’s knee is pretty much out of your hands, since it depends on how you’re built.
Naturally weak or under-active hips, for example, will cause your knees to collapse toward each other during any activity where weight is carried through the leg. (Think: jumping or climbing stairs or running on concrete.) And if your core isn’t strong enough to keep your hips steady, your knees will be forced to do the hard work of stabilizing your body. Cue pain.
And the sour cherry on top, says Carter, is that the lower limb misalignments that cause runner’s knee pain—wide-set pelvises, out-turned thighs—are more common in female bodies.
Now, before you go cursing your knees (that, may I remind you, have been working hard to carry you all your life), you should note runner’s knee is common and treatable.
So… how do I make knee pain go away?
Get VERY friendly with stretching and strengthening because they’re both going to become big parts of your life if you want to cut runner’s knee off at the…well, knees.
Recovering from runner’s knee is about “retraining the way that you move” and coming up with modifications that will allow you to go easy on your knees, says Meghan Cass, DPT, a physical therapist in Columbus, Ohio. And the best way to do that is with physical therapy.
Once a therapist has pinpointed the aggravating factor—like stiff ankles or the intensity of your exercise regimen—she can create a rehabilitative routine, says Cass. This might include modifying where you run (grass vs. road) or how deeply you lunge and squat.
You’ll also do moves that will strengthen your core and your inner thighs, or stretch your calves, in an effort to better position your knee for physical activity. A PT might also encourage you to mix different types of workouts into your regular routine, says Carter, such as yoga or swimming to replace a running or squatting session.
These methods won’t act like vaccines though, Carter warns. You’ll need continuous doses of knee-strengthening exercises to keep the pain from coming back.
And extra TLC, like icing the knee for 20 minutes, might also help, says Cass.
One important thing to note: If you experience knee pain while you sleep, or you notice swelling around your knee cap, you might be dealing with something more serious than runner’s knee. In this case, Cass suggests making an appointment with your doctor.