"Runner and their knees, man." Quite a touchy subject in the running community to say the least. This joint has one plane of motion and only flexes and extends. So, why does it cause runners so many problems?
Unpopular belief, but majority of the time knee pain is due to the joint above or below it. This would mean either weak ankles or hips. To finally tackle why your knees get hit the hardest on your run, let's first figure out what kind of pain you're experiencing.
Knee pain causes and symptoms
Type of pain
Runner's knee (patellofemoral syndrome)
Pain under the knee cap; gets worse while running hills; can swell
Rest, cold therapy, strengthening the quads
IT band syndrome
Pain on the outside of the knee, caused by weak glute muscles and overuse
Rest, strengthening the hips and glutes, strengthening the abductors
Achiness at the bottom of the knee cap, will occur during runs, squatting or jumping
Seeking a physical therapist would be the first step, upon treatment gradually incorporating leg extension exercises
Achiness in the knee or hip, swelling, post-exercise tenderness
Mobility and strengthening exercises to help prevent and relieve symptoms. These exercises should utilize multiple planes of motion in the hip and working both adductors/abductors.
These knee injuries are the most common amongst runners. Once determining what you're experiencing, consult a physician for a rehabilitation plan. Once feeling ready to continue on your own, the following exercises can help tackle weak hips and glutes that are causing your knee pain.
Knee exercises for pain free running
Complete each exercise 2-3 rounds of 15-30 repetitions. These exercises utilize a step and a band. Consult your physician if you're in therapy for the pain or injury being addressed.
Side Step Ups: This exercise is awesome. First, step ups are incredible for strengthening the quads and glutes. By moving laterally (side step up), you're moving your leg and hip in a way that might be challenging for runners who typically move only forward and back. It is important to incoproate this type of variety to build strength in multiple planes. Additionally, your ankles work to stabilize your body weight and your balance is tested.
Band Kick-Backs: Wrap a tight band just around the bottom of the quads, top of the knee. Shift your weight to one side and kick the other leg back in a diagnal plane. You'll feel both hips work; your stabilizing hip will tighten as your other side works to kick against resistance (build strength). This helps people who have weak glutes and suffer from IT band syndrome.
Lateral Band Walks: Wrap a band around the bottom of the quads, top of the knees. Bend the knees and sit in a squat stance. Take big steps to the left until your hips fatigue, then repeat on the other side. Take equal amount of steps on both sides. As an added challenge, remain in your squat stance the entire duration of the exercise. These band walks strengthen the glute med; a muscle that is extremely weak for most runners. It will also strengthen your piriformis; a muscle that is inervated by the sciatic nerve and can also cause discomfort when neglected.
Cable Adductor Pulls: Wrap an ankle strap attached to a cable machine (or a band attached to an anchor point) around your ankle. Keeping your leg straight-ish, pull the leg in using your inner thighs. This is typically an extremely weak muscle that is neglected by runners. By strengthening your adductors, you can improve your stability while running and decrease poor running efficency.
Utilizing these exercises to target knee pain will result in stronger hips and quads, therefore less pressure and pain in the knee. However, you must perform these exercises religiously and remain consistent. As you begin to notice your knee pain decrease, you can use these exercises less often and engage in them as preventative measures.
Michaud, T. C. (2021). Injury-free running: Your illustrated guide to biomechanics, gait analysis, and injury prevention. Lotus Publishing.