People run for various reasons: to get fit, lose weight, beat their personal best, or simply clear their minds. Plus, the runner’s high, thanks to feel-good chemicals, makes it even more rewarding.
Unfortunately, the knee is the most injured joint among runners. Here, we’ll explore the different knee injuries that runners may experience, how they occur and treatment options.
Knee areas prone to injury
Damage to the structures inside and outside your knee joint can result in fractures, dislocations, sprains, and tears.
Knee components susceptible to running injuries include:
Articular cartilage - covers the ends of your shin bone, thigh bone and the back of your kneecap (patella).
Ligaments – there are four ligaments including your anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in your knee that connect your bones together.
Menisci - two cartilage discs that act as shock absorbers and help to stabilise your knee.
Tendons - connect your muscles to your bone.
10 common knee injuries from running
-
Runner's Knee
Runners knee, also known as patellofemoral pain syndrome (PFPS), is knee pain associated with your patella or kneecap. It is one of the most common knee injuries for runners.
It’s thought to be caused by an imbalance in the muscles that support your knee.
The main symptom is pain around your knee when you run. The pain can be dull or sharp and severe and usually worsens as the intensity of exercise increases.
Runners knee treatments include:
- Rest
- Over-the-counter medication
- Stretching and strengthening exercises to increase flexibility through physiotherapy
-
Chondromalacia Patella (CMP)
Chondromalacia patella is damage to your articular cartilage. It is a chronic condition that causes your kneecap cartilage to soften and break down resulting in pain and inflammation. It is typically caused by overuse of the knee, alignment problems, injury or ageing.
Knee pain around the patella typically feels worse when going up or down stairs. It may be brought on by sitting (with the knees bent) for long periods.
Rest is usually recommended to treat CMP, and you may also consider taking non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen. A physiotherapist may also be able to recommend stretching, postural and strengthening exercises.
-
Patella Tendonitis (Tendinopathy)
Patella tendonitis is generally an overuse and ageing injury. It is the result of your patella tendon being overstressed. A common name for it is jumper's knee.
Patella tendinopathy usually causes pain, stiffness, and loss of strength in your knee.
The first treatment for patella tendonitis is to reduce pain and inflammation with ice and rest. If you see a physiotherapist, they will recommend a personalised program of knee stretching and strengthening exercises.
-
IT Band Syndrome (ITBS)
Your iliotibial (IT) band is a tendon that connects your knee to your hip. It helps to stabilise your knee.
IT band syndrome (ITBS) can occur due to overuse, overstrain and biomechanical factors. Your IT band tightens and becomes irritated and inflamed. The main symptom is pain on the side of your knee.
The best way to treat ITBS is with rest and over-the-counter medication. Hamstring and iliotibial band stretches can also be beneficial.
-
ACL and PCL Injuries
An ACL or PCL tear is caused by overstretching the knee's ligament. It can occur when a runner stops suddenly, changes direction abruptly, lands incorrectly or has a direct collision.
You will feel pain and swelling around your knee. You might hear a popping noise, and you may feel your knee give way from under you.
Treatments for ACL and PCL injuries include rest, ice, compression, elevation and physical therapy. If your injury is serious, your doctor may recommend surgery.
-
Kneecap Bursitis
Prepatellar bursitis is an inflammation of your bursa (cushioning sacs between bones and soft tissues to reduce friction) in the front of your kneecap. Your bursa can become irritated and swell and then put pressure on your adjacent knee parts. This can cause knee discomfort during and after running.
It can be caused by either repetitive friction on the area, muscle tightness, or from a sudden injury to the knee.
To treat your kneecap bursitis and reduce the pain in your knee, you’ll need to rest and take a break from running for a while. You should elevate your leg whenever you can and apply an ice pack. When you feel pain in your knee, treat it with over-the-counter painkillers and NSAIDs to reduce inflammation.
-
Kneecap Subluxation
Your kneecap can be pulled to the side of (subluxation), or fully dislocate from the groove it normally glides over in your knee joint. The supporting tissues can be stretched or torn when this happens. It can be caused by a blow or a sudden change in direction when you put your foot on the ground.
Your kneecap will look out of place and will be accompanied by knee pain, swelling and a popping sensation.
To treat your kneecap subluxation, you’ll need plenty of rest and to apply ice to your knee. Compress and elevate it too. Your physio will recommend strengthening exercises and you may need to use crutches to take the weight off your knee.
-
Medial Meniscus Tear
A meniscus tear is a tear to the cartilage in your knee joint causing pain on the inside of your knee.
The most common cause of a meniscus tear is twisting of your knee when your foot is on the ground. It can also occur through direct impact in contact sports and in older athletes through gradual degeneration.
Whilst this type of knee injury from running can heal on its own, it may take a while. Rest your knee, use ice, compact it and keep it elevated, and you can also take over-the-counter pain medication like paracetamol to ease the pain. Physiotherapy will often help, but in serious cases you may need arthroscopy surgery to repair or remove any damaged cartilage.
-
Cartilage Degeneration
The cartilage in your knees may have become thin and worn out if you’ve been a regular runner for many years. If this happens, friction increases in your knee joint when you move it. This may cause knee pain generally, but you’ll likely feel knee discomfort during as well as after your run.
Physiotherapy is one of the most common treatments for cartilage degeneration – especially strengthening exercises. You may also find lower impact exercises, such as swimming, helpful.
-
Knee Stress Fracture
A stress fracture in the knee can be the result of increasing the amount or intensity of running, too quickly. Unfamiliar surfaces (path rather than grass), improper equipment (worn or less flexible running shoes) and increased physical stress (a runner increasing their running time) can also cause a knee stress fracture.
To treat a stress fracture, you’ll need to rest and stop doing the activity that caused it in the first place – in this case running. Your health care provider may recommend crutches to take the weight off your knee or a cast or special shoe to support the injury and reduce the pressure on it.
What are the risk factors for running knee injuries?
Overuse is one of the top risk factors for running knee injuries. Consider reducing the number of runs you do each week, running a shorter distance, or running on softer terrains.
Other risk factors include imbalances in the muscles around your knees – excessively contracting and extending these muscles can lead to injuries.
If you have an existing knee injury, this may become worse from running which can lead to long-term damage or weakness in your knee.
How to avoid knee injuries when running
If you have sore knees during or after running, you may need to look at how and where you run to avoid further injury. A simple thing like switching from road running to running on a treadmill means less force on your knees and ankles. You may also need to invest in running shoes that offer the right amount of support for your knees.
When you’re recovering from a knee injury or struggling with an existing one, build up the distance and regularity of your runs.
Strengthening exercises for your legs and back can help, as well as mixing up your routine with lower impact exercises.
Take a look at our helpful guide for more advice on how to run without damaging your knees.
When to seek treatment for your knee pain caused by running?
Most running knee injuries can be resolved by conservative methods such as rest, ice and stretching.
If your pain is not severe but lasts for a week or more, you should seek medical advice to have your knee checked over. Your GP or a physiotherapist will offer advice about exercises and stretches to help your recovery.
However, if your pain is severe or your knee is swollen you should see a doctor straight away. They will ask about your symptoms and perform a physical examination of your knee. You may be referred to an orthopaedic surgeon for further investigations or treatment.
How to diagnose your knee pain
Your GP or orthopaedic surgeon may request the following tests:
An X-ray or CT scan – to check for a fracture or arthritis.
An MRI scan – to determine cartilage or soft tissue damage.
Knee aspiration – to drain off fluid and help in the diagnosis of knee joint disease.
Knee arthroscopy – your doctor looks inside your knee using a telescope and a tiny camera to see if there is meniscus, cartilage or ligament damage. Knee arthroscopy is a minimally invasive surgery and can be used to treat your knee problem at the same time.
Treatment options for knee injuries caused by running
Treatment will depend on your specific running knee injury and your doctor will be able to advise you on the best course of treatment. Options include:
Rest – one of the simplest and most effective treatments for running knee injuries. You may also consider switching to lower impact exercises like swimming.
Apply ice – ice can reduce pain and inflammation in your knee immediately after running. Use an ice pack or ice compress and keep your knee elevated.
Take non-steroidal anti-inflammatory medication – over-the-counter NSAIDs like Ibuprofen not only help you with your knee pain, but they can reduce inflammation in your knee too.
Do exercises to strengthen and stretch your muscles – a physiotherapist will recommend a tailored program of stretching and strengthening exercises depending on the type of knee injury and its severity. Some potential exercises include bodyweight squats, hamstring stretches, single-leg squats, sitting knee extensions, and stabilisation lunges. Discover more with our helpful guide.
Wear a knee tape or brace – this supports your knee and takes the pressure and weight off it while you’re running. Discover more about choosing the best knee support for you.
Assess your footwear – if you’re a regular runner, it’s incredibly important to have the right footwear. Invest in a pair of running trainers suited to the type of running you do, whether trail, road or long-distance. Running trainers should offer the right amount of flexibility and support.
Surgery – some knee injuries will need surgery. This may include fractures, ligament tears such as ACL tear, removal of the plica, malalignment of the patella or, damage to the cartilage under your kneecap.
Discover more about therapeutic treatments for knee injuries and knee surgery with Ramsay Health Care.
FAQs about common running knee injuries
Is it ok to run with a hurt knee?
No, you shouldn’t run with a hurt knee. If you feel pain in your knee when running or after running, rest is the first thing you should do. If the pain doesn’t ease, consider seeing your doctor.
How long does a running knee injury take to heal?
This depends on the type of injury and its severity. Usually, a running knee injury may take around four to 12 weeks to heal. This can take much longer if you need extensive physiotherapy or surgery.