Knee Pain Series: Getting Rid of Knee Pain with Running

Oh boy, this is a hard one! Knee pain with running can be very specific to how you run, your technique. Sometimes there are general guidelines that can be given to strengthen your glutes or core, stretch your hips, etc, but overall there is usually something you are overdoing or undergoing while you stride that can overtime lead to knee pain. Typically when someone comes to me with knee pain I suggest a running analysis, in short, me watching you run to determine what might be the cause. However, for the sake of this blog and getting you started in the direction of healing, we’ll discuss the more common reasons for knee pain while running and what you can do about it. 

Assessing the Situation

After a quick assessment of your strength and mobility, it’s easy to see why you hurt when you run. Hip weakness and stiffness can limit your stride length, increased side to side movement, or difficulty running on uneven or inclined surfaces. 

The first place you can notice hip involvement is in your stride length. If you tend to stride behind you vs under you or your steps are small then you may be demonstrating tightness of your hip flexor muscles. You may have hip tightness due to decreased core awareness or control, the way you stand or walk, or due to having a sitting job. When our hips tend to tilt forward vs in a neutral position, over time our hip flexor muscles shorten leading to difficulty or the inability to actively move your pelvis which increases the strain to your knees and eventually pain with running. 

If you have increased side to side, or lateral, movement when you run then hip weakness is more likely the problem. When we place our foot down on the ground to take a step forward, we need to activate our glute/buttock muscles to stabilize our hip and leg; however, if these muscles are weak or you are unsure how to turn them on then you may lean to the side to accommodate. Lateral movement increases the stress placed through the knee and can lead to ligament or tendon inflammation or damage and joint degeneration. 

Hip weakness or tightness can lead to difficulty running on uneven or inclined surfaces like hills and sidewalks. Not only do we need a long stride for inclines and uneven surfaces, but we also need a lot of hip and core strength to get us up and down the hill. If you are lacking the mobility in your hip that you need for this then the knee is strained to pull you along. If you are lacking strength in your hip and core for hills and sidewalks then the strain is placed at the knee because it is down the chain and taking up much more force. 

So How Do You Fix It?

Stretch and strengthen your hips! Easy enough, right?! If it were easy, everyone would be able to get rid of their knee pain no problem and I wouldn’t have a job! 

Stretching your hip takes time and consistency to see a change and then it is something that you need to maintain ongoing in life. Stretching is also one of the things everyone struggles to make time for, especially the amount of time we really need to take to stretch. I recommend 5-10 minutes of focused stretching each day which can be done throughout your day or at the beginning and ending of your workout/training. 

Some of my favorite hip stretches include: 

• Kneeling hip flexor stretch

• Hip 90/90 IR/ER stretch

• Figure 4 stretch

• Piriformis stretch

Strengthening your hip is easy enough, do these exercises I’ll mention below and wa-la! Wrong! Strengthening the muscles is only part of the work. The most important part is learning how to activate these muscles when standing, walking, and running so that they can help you take the strain away from your knees….much more difficult. 

Start with completing exercises like this to strengthen the muscles of your hip: 

• Clamshells

• Bridges

• Glute blasters 

• Squats or Sit to stand

• Side steps

Work your way up to completing at least 3 sets of 10 of each one with moderate resistance or difficulty. Once they start to become easier and you have good form and control then you need to start training your brain to use these muscles. When you’re standing at the sink to brush your teeth, focus on squeezing your glutes/buttock muscles and holding them. When you’re walking, work on squeezing the glute on the side you are weight bearing on. You can progress to doing the same thing when you are running. You may have to slow down your running pace to focus on the technique of squeezing your right glute when your right foot is on the ground, for example. As you become better at this idea, you will be able to incorporate the technique when on uneven or incline surfaces to help you take strain off of your knees. 

This All Sounds SO Confusing! 

Yes, yes…it can be very overwhelming knowing where to start and how to make your body do these things correctly. Don’t get frustrated! I’m here to help you! When you work with a physical therapist, we can tell you what muscles to contract and how to make that happen and make sure you are doing them correctly to effectively get rid of your knee pain. A physical therapist can also do manual techniques on your hip and knee to assist in the healing process. Now, all you have to do is schedule a phone consultation. They’re free! And when you go to my website, www.onthemovempt.com/schedule-a-consult you will be able to easily pick a time that works for you! Let’s get started!