What causes knee pain when running?

As a part time runner, ex-footballer with a history on recurring knee pain, I know all too well the feeling of knee pain during runs. I'm not sure if it's me or if it always seems to crop up when I'm feeling fit again?!

In this post I'll talk you through some of the most common causes of knee pain in runners and how to manage each of the common causes.



Footwear plays a critical role in the prevention or exacerbation of knee pain during running. Ill-fitting or worn-out shoes can lead to improper foot alignment and inadequate support, causing stress on the knees. Choosing the right pair of running shoes that suit your foot type, gait, and running style is crucial. Pronation, supination, or over pronation issues should be addressed with appropriate footwear features, such as stability, motion control, or cushioning.

Regularly replacing worn-out shoes can also prevent knee pain by ensuring adequate shock absorption and support. Additionally, orthotic inserts or custom-made insoles can further enhance foot and knee alignment, reducing the risk of injury and discomfort.

Have you seen my blog post about the best running shoes for tempo runs? I discuss my personal favourites for each of the big brands.

Load Management

Load management refers to the balance between the intensity, duration, and frequency of running sessions, as well as the recovery time between runs. Overloading the knees with excessive mileage, sudden increases in training volume or intensity, or inadequate rest can lead to overuse injuries, including knee pain.

Gradually increasing mileage and intensity, incorporating rest days into your training schedule, and allowing for adequate recovery between hard workouts are essential for preventing knee pain caused by overuse.

Cross-training activities that reduce impact on the knees, such as swimming or cycling, can also help maintain cardiovascular fitness while giving the knees a break from repetitive pounding. Monitoring training load through tools like training logs or wearable fitness trackers can help runners avoid overtraining and reduce the risk of knee pain.


Maintaining adequate mobility in the muscles and joints surrounding the knee is essential for preventing pain and injury during running. Tightness or weakness in the muscles of the hips, thighs, and calves can contribute to poor biomechanics and increased stress on the knees. Incorporating regular stretching and mobility exercises into your routine can help improve flexibility and range of motion in these areas, reducing strain on the knees. Targeted exercises such as hip flexor stretches, quadriceps and hamstring stretches, and calf stretches can help alleviate tightness and improve overall lower body mobility.

Additionally, exercises that focus on strengthening the muscles around the knee, such as squats, lunges, and clamshells, can help improve stability and support for the knee joint. A comprehensive mobility and strength training program can not only reduce the risk of knee pain but also improve running performance and overall athletic longevity.

Muscular Weaknesses

Muscular weaknesses, particularly in the muscles surrounding the knee, can contribute to poor biomechanics and increased stress on the joint during running. Weakness in the quadriceps, hamstrings, glutes, and hip abductor muscles can lead to imbalances in muscle strength and stability, resulting in abnormal knee movement patterns and greater susceptibility to injury.

Incorporating strength training exercises that target these muscle groups into your routine can help address muscular weaknesses and improve overall knee function. Exercises such as squats, lunges, leg presses, deadlifts, and hip abduction exercises can help strengthen the muscles around the knee, providing better support and reducing the risk of pain and injury during running.

Additionally, exercises that focus on improving core strength and stability can help enhance overall body mechanics and reduce the impact of running on the knees. A balanced strength training program that addresses muscular weaknesses can complement your running routine and promote long-term joint health and injury prevention.


Overuse is a common cause of knee pain among runners, often resulting from repetitive stress on the joint without adequate rest or recovery. Running too frequently, increasing mileage too rapidly, or performing high-intensity workouts without proper recovery can lead to overuse injuries such as patellofemoral pain syndrome, iliotibial band syndrome, or patellar tendonitis. To prevent knee pain caused by overuse, it's essential to incorporate rest days into your training schedule and gradually increase mileage and intensity to allow your body to adapt.

Cross-training with low-impact activities such as swimming, cycling, or yoga can provide a break from running while maintaining cardiovascular fitness and promoting recovery. Listening to your body and recognizing early signs of overuse, such as persistent discomfort or swelling in the knee, is crucial for preventing more serious injury. Adjusting your training volume or intensity as needed and prioritising rest and recovery can help reduce the risk of overuse injuries and keep your knees healthy for the long run (pardon the pun).


In conclusion, knee pain can be a frustrating and recurring issue for many runners, including myself, who have experienced the discomfort firsthand. However, understanding the common causes of knee pain and implementing effective management strategies can significantly reduce the likelihood of experiencing such discomfort during runs.

From ensuring proper footwear and managing training loads to improving mobility, addressing muscular weaknesses, and preventing overuse, there are various approaches to safeguarding the health of your knees while enjoying the sport you love.

By incorporating these practices into your running routine and listening to your body's signals, you can minimize the risk of knee pain and continue to pursue your running goals with confidence and comfort.

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Arun Gray sports therapist strength and conditioning coach skegness

The author

Arun Gray is a sports therapist and strength & conditioning coach with over 15 years experience in the industry. He also has a personal history with chronic shoulder and back pain along with a range of other sporting injuries.

Arun writes about common injuries and aims to help people understand and manage their pain to prevent having to rely on national healthcare.

Read more about Arun