What Every Runner Needs to Know About Knees

Ashley Lauretta
by Ashley Lauretta
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What Every Runner Needs to Know About Knees

You may not realize it, but the knee is the largest joint in the body. Whether you’re walking or running, it carries quite the load every day. Because of this, it is one of the most common areas for runners to experience pain — especially if you are pushing yourself too far, too fast.

“Injury creeps in when your training load exceeds your body’s ability to adapt,” mentions Nick Rinard, a certified physical therapist and, founder of Nick Rinard Physical Therapy. “Progress your training in small increments and don’t underestimate the power of a rest day to give your tissues a chance to heal and catch up.”

If you are following your training plan to a ‘T’ and are still feel knee pain creep up, here’s what you need to know to understand how it could be negatively affecting your stride and how to prevent it from happening again.


There is a reason you’ve heard of runner’s knee: The knee is the predominant site of leg injuries in runners (according to multiple studies). The thing to know about runner’s knee, however, is it is a sort of catchall term for any type of knee pain a runner may be experiencing.

“Runner’s knee could be any one of many diagnoses, so, as a term, it is not really a diagnosis — it is a symptom,” explains Rinard. “It can be a real problem, and it can be a big one if not well understood by the patient or treating healthcare provider, like a physical therapist.”

It should be noted that athletes, from any discipline, can have what is referred to as ‘runner’s knee’ even if they aren’t a runner. David A. Watson, DPT, at Professional Physical Therapy notes that if you are diagnosed with patellofemoral pain syndrome (PFPS), this is actually what the medical community refers to as runner’s knee.

“Specifically, PFPS is when the knee cap does not move perfectly within its groove during closed chain movements like stepping down a stair or moving into a squat position,” he elaborates. “This movement happens in running during the initial contact and loading phase, as the runner absorbs the impact of their bodyweight falling toward the ground on each step.”


One of the reasons it is so crucial to get knee pain checked out is because of the impact it can have on your stride. Though, Rinard says the joint itself doesn’t have much to do with your stride, “‘because it is a ‘mid-range’ motion.” So, while the knee doesn’t really play a crucial role in that respect, when it hurts it can do some major rewiring.

“Runners will [often] develop compensations to allow for reduced knee pain during activity,” Watson adds. “These compensations may reduce the knee pain, but may lead to additional injuries in the ankle or hip, such as Achilles tendonitis, plantar fasciitis, gluteal tendinopathies and hip labral injuries.”

Watson does note that the knee itself can be directly impacted by stride when a runner is ‘overstriding’ or lands with their knee fully extended. If that is happening, shorter strides can reduce the force placed on the knee during landing.


The good news is, that as with most injuries, those to the knee are completely preventable. A combination of proper warmup, strengthening and, if necessary, treatment, can help ensure you are using proper mechanics. Watson breaks down these three important steps:

  • Always warm up.
    “Runners should make sure they start each run with a dynamic warmup, which may also include foam rolling of any restricted tissues,” he shares. “Getting out of bed or work and going right to the pavement without getting your muscles warm and your heart rate up is a great way to cause injury.”
  • Target the right muscles.
    Strength training for runners should include specific exercises to target the gluteus maximus, gluteus medius, hamstrings, calves and intrinsic muscles of the foot and ankle,” Watson notes.
  • Seek treatment before it’s too late.
    “If runners are experiencing knee pain, they should seek a physical therapy evaluation as soon as possible,” he urges. “Do not wait until two weeks before the big race to seek help, as there won’t be much we can do besides pain management at that time.”

About the Author

Ashley Lauretta
Ashley Lauretta

Ashley is a journalist based in Austin, Texas. She is the assistant editor at LAVA and her work appears in The Atlantic, ELLE, GOOD Sports, espnW, VICE Sports, Health, Men’s Journal, Women’s Running and more. Find her on Twitter at @ashley_lauretta.


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