Running is good for us. It builds muscle strength, improves circulation, controls bodyweight, and helps to boost our mood and mental resilience through the dark winter months.
So when a new knee pain shows up, it can be hugely disruptive – not to mention frustrating.
What tends to cause knee pain in runners? There are several potential culprits (scroll down!), but the trigger point is almost always an activity change. If you are suffering from recent pain during or after running, it’s worth asking some of the following questions:
Have I increased my distance recently?
Have I increased the intensity of my workouts?
Am I running on a different surface, or in different footwear?
Have I started a new sport alongside my regular running?
If you have an underlying issue with your knee, a new (or higher-impact) exercise programme may put more strain on the joint and bring that problem to the surface. So what are the most likely reasons for that pain? Here are four causes that we commonly see in our patients.
Early arthritis
Osteoarthritis can happen at any age, but it becomes more common as we get older. Arthritis Research UK estimates that 1 in 5 adults over 45 have knee arthritis. Symptoms vary but, for most people, arthritis pain starts as a dull, aching discomfort that comes on after activity. It may linger for an hour, or even a day or two, before settling down. Could distance running have caused it in the first place? Many studies have found no obvious link. But if early arthritis is present in your knee, intensive running could potentially trigger a flare-up.
More on this: What does knee osteoarthritis feel like?
Torn meniscus
This is perhaps the second most common factor. The meniscus is a thick pad of cartilage that cushions the gap between your femur (thighbone) and tibia (shinbone). It’s actually quite common to see meniscal damage in patients’ knees when we operate for other reasons. In fact, research suggests up to 40% of people over 65 may be carrying a tear of this kind. Unlike arthritis, meniscus pain tends to be sharper and more intense; a catching pain that’s usually localised in one area of the knee.
More on this: How do you repair a torn meniscus?
Tendinopathy
Tendinopathy is a catch-all term for tendon-related problems: inflammation, swelling, or damage to the tissues that connect our muscles to our bones. In runners, it’s usually prompted by overloading. A common form is patellar tendinopathy – that’s pain or inflammation just below the kneecap, where it connects to the shinbone. Hamstring tendinopathy is another common running injury. As is per anserinus, where a bursa (a fluid-filled sac) becomes irritated and inflamed.
More on this: The 60-second guide to… Tendonitis (and how to treat it)
IT band syndrome
The iliotibial band is a thick tendon that runs down the outside of your leg from the pelvis to the knee joint. It typically flares up, sometimes as if from nowhere, around 5-10 minutes into a run. The discomfort – usually a sharp pain on the outer side of the knee – is caused by the IT band rubbing against the femur and nearby bursa. Result: inflammation and pain, which usually goes away quickly after rest but has a habit of recurring on subsequent runs.
More on this: What is iliotibial band syndrome?
What to do about running knee pain
When a new knee pain strikes, your first response should be to rest it. It’s often tempting to soldier on and hope the issue disappears. But knee problems rarely respond well to the no-pain-no-gain / grin-and-bear-it approach to exercise. The RICE method – rest, ice, compression, elevation – is a proactive way to reduce swelling and encourage healing in the early stages. And when you do go back to running, it’s important to build up gradually and methodically. This could involve diversifying your exercise: consider activities with a low joint impact like swimming or cycling, and cross training to build strength in supportive muscles such as your glutes and hamstrings.
Is the pain still coming back? At this point it’s probably time to see a doctor or physiotherapist so you can get a full diagnosis. Knee pain isn’t always a sign of deep-set problems. But it’s important to understand what’s going on below the surface so you can consider the potential treatment options – and protect yourself from further damage.
Are you suffering from ongoing knee pain? We’re always happy to take a look at your knees and offer advice. You can make an appointment on our booking page – or call or email us direct. We’ll make sure you’re seen, examined and treated as soon as possible.
