Knee Pain When Running: Causes, Treatment and When to See a Physio

Are you experiencing knee pain when running in East, South, West or Central Auckland? Whether you are training for a race, running around your local park, or simply trying to stay active, knee pain can make running uncomfortable and may stop you from doing the activities you enjoy.

Knee pain is common among runners, but it is not always caused by the same problem. The location of your pain, when it starts, what makes it worse and how your knee responds after running can all provide useful information.

At AZ Physiotherapy in East Auckland, we assess running-related knee pain and help people understand what may be contributing to their symptoms and how they can safely return to running.

Common causes of knee pain when running

Knee pain can develop gradually or appear after a change in your running routine. Some common contributing factors include:

1. Patellofemoral pain (runner's knee)

Pain around or behind the kneecap is common in runners. It may become worse with:

• Running
• Going up or down stairs
• Squatting
• Lunging
• Sitting for long periods
• Increasing running distance or speed

This type of pain can be associated with changes in training load, lower-limb strength, movement control and how the knee is being loaded.

2. Patellar tendon pain

Pain at the front of the knee, particularly just below the kneecap, can sometimes involve the patellar tendon. Running, jumping, sprinting and other activities that repeatedly load the tendon may increase symptoms.

3. Iliotibial band (ITB) related pain

Some runners experience pain around the outside of the knee, particularly after running for a certain distance. Symptoms may become noticeable during longer runs and can sometimes settle when activity is reduced.

4. Meniscal or joint-related problems

Pain associated with twisting, squatting or certain movements may sometimes involve structures within the knee joint. If you experience significant swelling, locking, catching, giving way or difficulty fully moving the knee, a physiotherapy assessment can help determine whether further medical assessment or imaging may be appropriate.

5. Training load changes

Sometimes the problem is not simply the knee itself. A sudden increase in any of the following can increase the load placed on the knee:

• Running distance
• Running frequency
• Speed
• Hill running
• Sprinting
• Interval training
• Strength training

For example, suddenly increasing your weekend run from 5 km to 12 km may be more demanding than your body has adapted to.

Why does my knee hurt only when I run?

You may feel completely comfortable walking but develop pain after running for 10, 20 or 30 minutes.

Running places considerably higher and repeated loads through the lower limb compared with normal walking. If your current capacity has not adapted to your training load, symptoms may develop during or after a run.

A physiotherapist can assess factors such as:

• Knee movement
• Hip and ankle mobility
• Lower-limb strength
• Single-leg control
• Running technique
• Training volume and intensity
• Previous injuries
• Recovery between sessions

The goal is not simply to treat the painful area but to understand what may be contributing to the problem.

Should you stop running completely?

Not necessarily. The appropriate approach depends on the cause and severity of your symptoms.

For some runners, temporarily reducing running distance, speed or frequency may allow symptoms to settle while maintaining fitness through suitable activities. Your physiotherapist can help develop a gradual return-to-running plan based on your symptoms and current capacity.

A return-to-running programme often follows this pattern:

Reduce → Recover → Strengthen → Gradually load → Return to running

Rather than stopping all activity for a long period, the focus is often on finding an appropriate level of loading and progressively increasing it. Our sports rehabilitation programmes are built around exactly this, and sports taping can offer extra support while you build back up.

When should you see a physiotherapist?

Consider getting your knee assessed if:

• Your knee pain keeps returning when you run
• Pain is affecting your running distance
• You have stopped running because of pain
• Your knee is swelling after exercise
• You experience clicking, catching or locking
• Your knee feels unstable or gives way
• You have pain going up or down stairs
• Your symptoms have not improved despite reducing activity
• You are unsure how to return to running safely

If you have had a significant injury, substantial swelling, inability to bear weight, or a locked knee, medical assessment may be appropriate. If your knee pain started with a specific incident — a twist, fall or collision — it may be covered by ACC, and you don't need a GP referral to see us.

Knee pain physio in East, South, West and Central Auckland

If you live in East Auckland, South Auckland, West Auckland or Central Auckland, you do not necessarily need to travel far to get your running-related knee pain assessed. Our clinic is in Pakuranga, East Auckland.

Our physiotherapy assessment looks at your symptoms, movement, strength, functional activities and training demands. We can help with:

• Running-related knee pain
• Sports injuries
• Patellofemoral pain
• Tendon rehabilitation
• Strength and conditioning
• Return-to-running programmes
• Return-to-sport rehabilitation
• Exercise prescription
• Manual therapy and soft tissue techniques
• Taping where appropriate

Running again without constant knee pain

Knee pain does not always mean you have to give up running. The important step is understanding why your knee is becoming painful and finding the right balance between recovery and loading.

Whether you are a recreational runner, training for an event, playing sport or simply trying to stay active, a structured rehabilitation programme can help you progressively build strength and confidence.

Book an appointment with AZ Physiotherapy to have your knee assessed and develop a rehabilitation plan suited to your needs.

Sources

• ACC: What we cover