top of page
Search

Knee Pain When Running — Why It Happens & How to Fix It (Without Quitting Your Miles)

ree


Knee Pain When Running Isn’t “Just Part of the Sport”

Few things are more frustrating than finally building consistency with your running… only to have knee pain derail your momentum.


Maybe it’s:

  • tightness around or behind the kneecap

  • sharp pain with hills

  • discomfort mid-run

  • soreness the next morning


Most runners assume they need:

  • better shoes

  • more stretching

  • total rest

  • or that they’re “just getting older”


In reality, knee pain when running is rarely a knee-only problem. It's usually a mechanics + loading problem that shows up at the knee.


At Thrive HQ, this is one of the most common running issues we see—and one of the most fixable.



Why Your Knee Hurts When Running

Here are the four big drivers we see over and over:

1️⃣ Too much load, too fast

(mileage jump, speed, or hills)

2️⃣ Inefficient mechanics

(overstriding, heel smashing, straight knee position)

3️⃣ Weak links at the hip or foot

(so the knee takes the force)

4️⃣ Under-recovery

(not “overtraining”)


Let’s break down the biggest needle movers.



1. Cadence & the 5–20 Rule

If your cadence is low (<170ish), you’re likely overstriding, which:

  • increases braking force

  • increases pressure behind the kneecap

  • forces the knee to absorb more load

Research + coaching experience both show:

Increase cadence ~5% → reduce ground reaction force ~20%

That’s the 5–20 rule.


You don’t need to jump to 180 right away—just up by 5% and stick there for 5-6 runs to acclimate before increasing further.


2. Foot Strike + Shin Angle

The bigger issue isn’t “heel vs forefoot.”It’s landing with a straight leg and a backward-angled shin (braking).


Try:

  • landing your foot under your body rather than way out in front

  • a slight forward torso lean from the ankles

  • softer, quicker steps


This spreads load across more joints instead of dumping it into your knee.



3. Hip + Glute Strength = Knee Bodyguards

If the hip can’t control movement, the knee becomes the “middle victim.”

Look for:

  • knee collapsing inward

  • pelvis wobbling

  • trouble with single-leg balance


Key strength work:

  • Goblet Spanish Squats (3×12–15)

  • Lateral Step-Downs (3×8–10 per side)

  • Single-Leg RDLs (3×8 per side)

  • Front-to-Back Scales (2×30 sec)


Slow tempo > heavy weight oftentimes in this situation.



4. Warm Up Your Nervous System (Presynaptic Potentiation)

Static stretching doesn’t prepare your body for 3x bodyweight forces each step. Activation does.


Simple pre-run sequence (5–8 min):

  • plank with leg lifts

  • side plank

  • bent-knee calf raises

  • arch raises

  • band clamshells


Get the brain and muscles online before load hits the knee.



What Won’t Fix This Long-Term

🚫 Just resting a few weeks

🚫 Only stretching

🚫 Only foam rolling

🚫 Buying new shoes

🚫 Hoping it goes away


Those don’t change how you run, how you load, or how strong your system is.



What Actually Works

Reduce irritation (not all running)

Swap downhill and speed work temporarily. Maybe reduce mileage 10–20%


Build strength in the right places

Hips, glutes, single-leg control


Improve mechanics

Know what is going on with your cadence, shin angle, torso position and foot landing placement. Make improvements/modifications to these based on what issues you are experiencing.



When Is It Time to Get Assessed?

If this has lasted:

  • 2–3 weeks

  • keeps coming back

  • or you’re training for something…


…it’s worth getting seen. Especially if you’re being told to “just stop running” (we won’t say that).



How Thrive HQ Helps

At your Pain Diagnostic Session we look at:

  • hips, knees, ankles together

  • running mechanics (cadence, stride, foot strike)

  • single-leg strength

  • tendon capacity

  • weekly mileage

  • terrain

  • footwear

…and then we build a customized 4–8 week plan.


📍 Serving Lake Elmo, St. Paul, and the East Metro.


Want to Fix Knee Pain Without Stopping Running?


👉 Book a Free Discovery Call with Our Teamhttps://www.thrive-hq.com/speak-with-our-team



🚀 Pain-Free Runner Challenge (FREE Beta – 10 Spots)

We’re building a Pain-Free Runner Challenge and the first round is totally FREE for beta testers.

  • limited to 10 runners

  • clinician led

  • focused on knee, hip, Achilles, and foot pain

  • targeted for distance runners


👉 Join Early Access List (Free beta group):


Once the 10 free spots are taken, we close enrollment.

 
 
 
bottom of page