Running and Knee Injuries; The Despair of Knee Injuries

Men and Women Running on beach
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Running and knee injuries are one and cannot be separated but only to be possibly prevented. Running is a very common form of exercise and that you can just wear a pair of shoes and run.

It basically means that when you run, both feet will be in the air during the air-phase.

Unlike walking and jogging, 1 leg will always be in contact with the ground before the other foot touchdown. In terms of speed (from slowest to fastest), walking -> jogging -> running.

Running is fun and enjoyable only if you are injury-free and pain-free. However, running is filled with overuse and chronic injuries if there is a lack of proper care and injury prevention was followed beforehand.

Anyone can run but if you are not careful, you will start getting injuries. Even the most experienced of runners, can suffer many injuries.

Pain vs. Injury

Pain is your body’s natural response or indicator to some kind of damage to your body tissues.

Furthermore, don’t ignore the pain, listen to your body and consult your physical therapist as soon as pain develops.

If you tackle the pain early, it will recover quickly. On the other hand, there are good and bad pain.

There are many types of bad pain such as sharp pain, nagging pain, sore, throbbing, shooting and so on.

Next, the good pain is known as Delayed Onset Muscle Soreness (DOMS) is the soreness and pain felt after 24-48 hours of your workout.

Person sitting and holding injured ankle

The burn you feel during an intense running workout is known as acute sore due to a buildup of lactic acid.

Injury is a body tissue damage due to internal or external factors, or a combination of both factors.

When you run or exercise through bad pain, you are at a higher risk of some kind of injuries and not only running knee injuries.

To prevent an injury to happen in the first place is to take a break when you felt bad pain after your workout. Prevention is better than cure!

A few days off to allow your body to recover but instead you ran through the pain and now you are injured.

Once you are injured, depending on the severity of injury, it may take weeks, months and/or even years to recover fully!

What Kind of Running Knee Injuries?

Runner’s Knee a.k.a Patellofemoral Pain Syndrome (PFPS)

Runner’s knee is one of the most common knee injuries for runners, as the namesake. The inflammation and pain is usually at the front of knee and more specifically at the patella (kneecap).

patellofemoral pain syndrome

It will begin as a mild pain and gradually worsen if there isn’t sufficient rest from running. It is an overuse injury caused by excessive overloading with insufficient rest.

How it happened?

Risk Factors:

  • Gender – Female has a higher risk of injury than male due to anatomical differences such as wider hips with a larger Q-angle which places a greater stress on the knees.
  • Age – Runner’s knee is common for youth, knee pain for older populations are generally caused by arthritis.
  • Overweight – Places unwanted and excessive stress and pressure on the knees.


  • Overtraining! – Too much too soon. Always start your workout with the easiest intensity and progress not more than 10% per week.
  • Weak lower extremities muscles.
  • Muscle imbalances of the lower extremities.
  • Many other possible causes.

Iliotibial Band Syndrome (ITBs)

Iliotibial Band Syndrome (ITBs) is one of the most common knee injuries which causes pain to the lateral (outer) side of the knee.

IT band is basically a tough fibrous tissue that originate from your hip joint and is inserted at the lateral condyle of the tibia.

Iliotibial Band Syndrome (ITBs)

There will be a sharp pain at the outer knees whenever the knee is flexed up to 30 degrees (the amount of flexion of typical walking and/or jogging).

How it happened?

Risk Factors:

  • Leg length discrepancy – The length differences between both legs are greater than 3 cm.
  • Improper surface – A surface that’s too hard (tarred road), uneven and even hilly surfaces.


  • Overtraining! – Too much too soon. Always start your workout with the easiest intensity and progress not more than 10% per week. Excessive friction and rubbing of the IT band leads to inflammation and pain of the outer knee.
  • Lack of strength of the hip adductors and gluteal muscles. This causes an excessive hip movement with every stride and the IT band gets stretched and eventually irritating it.
  • Excessive foot pronation may lead to ITB syndrome.

Shin Splints

Shin splints refers to the inflammation and pain felt at the shin bone, usually at the middle part until the ankle. This is an overuse injury due to excessive jumping and landing movements.

Shin Splints

Shin splints technically isn’t a knee injury but this is a bonus information as this injury is quite common among runners.

How it happened?

Risk Factors:

  • Inappropriate footwear – This leads to a higher stress on the shin.
  • Improper surface – A hard surface which places a high stress on the shin with each stride.
  • Improper running technique – landing on heels.


  • Overtraining! – Too much too soon. As a runner, you run too much volume or too high intensity in such a short period and you risk yourself getting shin splints.
  • Overpronation of the foot which places more stress on the shin.
  • Calf muscles imbalance.

What can you do about it?

Skeleton Thinking

Injury Prevention!!

  • Always remember prevention is better than cure!
  • Follow the FITT (Frequency, Intensity, Time, Type) principle.
  • A proper warm-up and cool-down protocol after your runs.
  • A proper stretching and strengthening program to address any flexibility and strength issues respectively.
  • Get a good quality footwear, the ones with good arch support and adequate amount of heel cushion.
  • Learn and implement a proper running technique. I recommend you to try ChiRunning technique.
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  1. Pain management.
  2. Improve muscle strength.
  3. Improve muscle flexibility.
  4. Improve balance.

Bottom Line..

Running injuries and pain is a barrier to any runners, recreational or competitive alike. It is important to run and train within your body limits, you know your body more than anyone else.

Progressively overloading will lead to a stronger, fitter and healthier body; too much too soon and you will risk injury. Once you are injured, everything will be back to square one!

Besides, you can even run to lose weight, but if you run too much, you will only suffer pain and injuries.

Why do you think competitive runners are also facing these kind of knee injuries even with so much experience in running? Leave your comment below!

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