Knee pain is one of the most common complaints among runners. It can occur in people who are just starting out, returning after a break, or who have recently increased their training load. Experiencing pain does not automatically mean there is a serious injury, nor does it always mean that running needs to stop completely.
Why can the knee hurt?
One of the most common causes is patellofemoral pain, often felt at the front of the knee, around the kneecap. It may occur while running, going up or down stairs, or squatting.
However, knee pain can have different causes and does not depend on a single factor. Previous injury, physical capacity, training load, recovery, and individual characteristics can all influence the onset of symptoms.
Can increasing training too much have an effect?
Yes. Rapid increases in distance, intensity, or frequency can temporarily exceed the body’s ability to cope with the load. However, there is no universal rule that guarantees a “safe” progression for everyone. The response to training is individual.
For this reason, rather than relying only on a fixed weekly percentage, it is important to understand how the body is responding to training.
I have pain. Should I stop?
Not always. In some situations, it may be possible to temporarily adjust running by reducing distance, speed, or frequency while working on strength, functional capacity, and load tolerance.
In patellofemoral pain, therapeutic exercise is one of the interventions with the strongest scientific support, particularly when it is adapted to the individual and the demands of the sport.
When should I seek an assessment?
It is important to seek professional advice if the pain:
- persists or gets worse;
- starts earlier and earlier during a run;
- interferes with daily activities;
- is accompanied by significant swelling;
- causes instability, locking, or difficulty fully straightening the knee.
After trauma, being unable to bear weight, visible deformity, or significant swelling are reasons to seek a more urgent assessment.
What is the role of Physiotherapy?
The goal should not be only to reduce pain. In Sports Physiotherapy, the aim is to understand how the problem developed, how the athlete is responding to load, and what needs to be restored in order to return to running safely.
The approach may include load management, therapeutic exercise, education, and a gradual progression back to running.
In summary
Knee pain while running should not be ignored, but it also does not necessarily mean that exercise has to be stopped. Understanding the cause, adjusting the load, and restoring capacity are key steps towards continuing to run with confidence.
References
Neal BS, Lack SD, Bartholomew C, Morrissey D. Best practice guide for patellofemoral pain. Br J Sports Med. 2024;58(24):1486-1495.
Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral pain. J Orthop Sports Phys Ther. 2019;49(9).
Fredette A, Roy JS, Perreault K, et al. The association between running injuries and training parameters: a systematic review. J Athl Train. 2022;57(7):650-671.
National Health Service. Knee pain [Internet]. London: NHS; 2023.
