There are two major causes of knee pain from running. Here’s how to treat your pain, and prevent it from occurring again in the future.

The two major causes of knee pain from running

If you’ve spent any time on the trail, you’ve likely already suffered knee pain from running. This common condition affects a large number of runners, with women affected disproportionately. However, most knee pain from running is due to two treatable causes:

  • Patellofemoral pain syndrome, also called “runner’s knee” or PFPS, that is felt inside the knee around the kneecap
  • Iliotibial band syndrome, or IT band syndrome, that is felt on the outer knee along the side

In this post, we’ll discuss the common causes of patellofemoral pain syndrome and IT band syndrome, along with methods for treating and relieving your pain. Another major concern, especially for older adults, is whether you should run with osteoarthritis. We’ll also discuss that later in this post. The following video gives a brief overview of the many causes and treatments for knee pain conditions.

What causes inside knee pain from running?

Patellofemoral pain syndrome, or runner’s knee, is an unfortunately common condition. It accounts for up to 20% of all running injuries, and it affects women disproportionately.

As the NHS explains, runner’s knee often feels like:

“During your run, you may develop pain at the front of the knee, around the knee or behind the kneecap. The pain may be dull or it could be sharp and severe.”

This pain will likely increase when you run uphill, downhill, or walk downstairs. It also probably hurts more whenever you bend your knee–whether that’s while sitting or doing deep knee bends. Finally, inside knee pain from running typically develops gradually since runner’s knee is often caused by strength imbalances. explains:

“Strength and mobility imbalances will have a greater effect on the body over increased mileage, resulting in issues like runner’s knee. The dilemma is you often won’t know you have these imbalances until your knee starts to nag you. At this point, it becomes important to back off and identify where the injury originated.”

Common causes of runner’s knee

The most common causes of runner’s knee include:

  • Overuse
  • Increased mileage
  • A knee injury
  • No or little cross-training
  • Training issues, such as running on hard surfaces or with an running form
  • Malalignment in any of the leg bones
  • Weak or unbalanced hamstrings muscles
  • Weak hip or inner quadriceps muscles
  • Foot issues, such as hypermobility, overpronation, or flat feet

How to relieve inside knee pain from running

It’s likely that your runner’s knee was caused by either a mechanical problem or a training issue. For both causes of knee pain from running, take some time off first. Continuing to run on the knee could cause more pain down the line. Instead, take some time to rest and figure out what was causing your pain in the first place.

If you’ve recently hit the trail hard and increased your mileage, your knee pain from running is probably due to training issues. Rest comes first.