Inner Knee Pain from Running May Be Runner’s Knee. Here’s How to Keep Running Smart

Dedicated and driven to improve performance through consistent training, runners are particularly susceptible to repetitive stress injuries; in fact, running is one of the major causes of ankle pain, foot pain, or knee pain.

This is because running involves repetitive movements. When you run, three times your weight hits the ground, with the stress of the impact reverberating through your foot, ankle, knee, and hip. Any weak point in the kinetic chain or change in your training routine can easily lead to injuries.

One common knee pain condition that affect runners is Runner's Knee, also called Patellofemoral Pain Syndrome.

The good news is that with active treatment (not stopping activities completely!), you can take control of Runner’s Knee pain and continue to enjoy running, the endorphin kick, community and friendship, mental health benefits, and more. Runner's Knee is a tricky condition to manage, but it's not impossible.

Let's dive into how to differentiate Runner's Knee from other kinds of knee pain that might come from running, how to know if your knee and thigh muscles are ready for a run, and what to do to keep running without pain.

One telltale sign of Runner’s Knee is the movie goer’s sign. When sitting for 30 minutes and standing up causes pain, but the pain resolves after taking 10-20 steps, it's quite likely your inner knee pain is due to Runner's Knee.

One of the worst things you can do to make your Runner's Knee recovery time longer (and more painful) is to try to run or strength-train through pain. Because the root cause of Runner's Knee is the VMO muscle switching off in response to pain signals, we need to reduce the pain first before you run or do your Runner's Knee exercises.

Training or running through pain will only make the pain worse, and your VMO will learn not to switch on, in order to avoid pain. More load ends up going through the knee, because the muscle isn't taking it, leading to more pain. Even some physical therapists don't do this right, but breaking this cycle is the key to Runner's Knee recovery.

Here's what you should do instead:

Before you run, make sure to activate your VMO so it can take the load, using the Alleviate Massage Blade. It only takes a minute or two of light, gentle strokes.

After you've done your VMO activation moves, do the small knee bend test. If you can do the test without knee pain, you are ready for a run or your strengthening exercises. If you can't do the small knee bend at all without pain kicking in, your knee isn't ready. Don't push through pain.

Runners should know a few other types of knee pain conditions, since running also makes you higher-risks for other types of knee injuries, including:

Iliotibial Band Syndrome is caused by the IT band, a thick band of tissue running from the hip to the shin, rubbing against the outer part of the knee. This friction can cause inflammation and pain on the outside of the knee, a clear distinction from Runner’s Knee, which is felt more inside the knee or behind the kneecap.

Jumper’s Knee, or Patellar Tendonitis, involves inflammation of the patellar tendon connecting the kneecap to the shinbone. The pain is typically felt below the kneecap and can be sharp or aching, especially during activities that involve jumping or rapid direction changes, such as playing basketball.

Several factors can make runners more susceptible to Runner’s Knee than others, including:

• Gender: Women, especially adolescent women, are at a higher risk of Runner's Knee pain due to wider pelvises that can affect knee alignment.
• Weight: The heavier you are, the more stress goes through your knees with every step.
• Weakness in the kinetic chain: If you mostly run and don't do strength training, you may have weaknesses in the kinetic chain from the foot and ankle to the calf, knee, and thigh, all the way up to the hip. This can increase your risk of Runner's Knee.
• History of Knee Injuries: Previous knee injuries, such as ACL or PCL tears, can predispose you to Runner’s Knee.
• Foot-Related Problems: Conditions like Posterior Tibial Tendonitis (PTTD), overpronation, flatfoot, fallen arches or high arches can contribute to improper knee alignment and knee pain.

To Determine if your inner knee pain after running is Runner’s Knee, the symptoms we examined above can help. Aside from symptoms, physical therapists use three tests to diagnose Runner's Knee, which you can also do yourself:

The key to managing Runner’s Knee is active treatment.

Runner’s Knee develops when the kneecap is misaligned, due to an imbalance in the power output of the thigh muscles that need to work together to keep the kneecap in the correct location. This malalignment causes pain, which switches off the key muscles that keep the kneecap in the correct position, further contributing to inner knee pain.

Our Alleviate Method first focuses on breaking that vicious cycle of pain and malalignment, and applies the three pillars of physical therapy treatment for long-term recovery:

By massaging the VMO (Vastus Medialis Obliquus) muscle before running, you can “wake up” this key muscle that pulls the kneecap inward and upward, reducing pain and improving range of motion. After your run, give it another round of soft tissue massage to release tension and transform the tissue so it can take on more load, without pain.

Taping or a purpose-built knee brace can help correct the kneecap alignment. This reduces the stress that goes through the kneecap and thigh muscles with each step, reducing pain. Additionally, choosing the right running shoes that fit well, give you stability, and feel comfortable is crucial in managing load and preventing further injury.

Rebuilding strength throughout the kinetic chain not only reduces pain and resolves the root cause of your running knee pain, but also prevents recurrence.

Bonus point: strength in your lower body means you’ll be able to run faster, longer, and more frequently – and you’ll be protected against other kinds of running-associated injuries like Plantar Fasciitis.

Alleviate was founded by a patient-and-clinician duo to bring the effective chronic pain treatment from physical therapy offices to everyone's home.

Runner's Knee treatment that you can do yourself is at the center of our history: Rick, one of the co-founders, met Luke, the other co-founder, when he went to Luke's physical therapy clinic after years of dealing with Runner's Knee pain without much success. Luke fixed his knee in 6 weeks.

With Runner's Knee Essentials, you can use the Alleviate Method to recover from Runner's Knee at home, using the methodology Luke used on Rick's knee. No physical therapy training required!