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  • Q&A with Australian Health Practitioners

    I have knee pain when running - What can I do?

    Related Topics
    Back & Neck Pain Pain Sports Injuries & Prevention
    Hi there

    I'm just trying to figure out where I go from here.

    I have had knee, ankle & hip pain for years and always stayed away from any kind of exercise that would trigger it. In the past 3 years I have started exercising and I did well until I kept getting debilitating pain under my patelas and would have to pause for a month or so for it to settle. It's been all diagnosed as muscle imbalance.

    I saw a brilliant physio that retrained my muscles (inactive glutes) to fire up when I exercise (squats & lunges), then I also got some orthotics by a less caring podiatrist who sent me away after a fitting and told me to just do more stretching & foam rolling.

    Currently I am only suffering when I run, it seems to be mainly from my left knee which wasn't even the worse one and my left ankle and usually I limp away from a short 1k run.

    I'm not sure what to do at this point, I regularly stretch & foam roll but I'm wondering if I should see a specialist in running or who do I turn to?
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    Rodney Nieuwenhuizen

    Physiotherapist

    Graduated in 1997 from the Uni of Melbourne and have studied extensively the problem shoulder. Also have interests in knee, foot and ankle, and wrist … View Profile

    Hi there,
    When you last visited the physiotherapist did the pain fully resolve?  If so, my first suggestion would be to return to the physio for either some more specific deep tissue massage (places the foam roller just won't get), or progression/review of your existing glut strengthening exercises.
    When you run do you tape your knee?  Did you get a proper runner fitting?  You haven't mentioned these interventions and they could have significant effect on your knee pain.
    Over the years I have found that knee pain is a process of management whilst the muscles are strengthening.  What you have done and doing is part of the process and sometimes it requires some short term physiotherapy to get you back on track.

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  • Josephine Perry

    Bowen Therapist

    Josephine is a fully qualified Bowen Therapist, with full insurance cover and Association membership. Rebates provided by most health funds, according to levels of cover.Practice … View Profile

    Bowen Therapy is an extremely effective treatment for stimulating muscles to assume correct alignment.  The treatment is gentle, and the effects can last for days to years.  Running would place extra strain on misaligned muscles which would cause exacerbation of the pain symptoms - in other words, reinjury.     Once the muscles are properly aligned, a gentle, supported  progression in exercise would be advisable.

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    Sunil Mulay

    Massage Therapist

    Sunil is a professional remedial massage therapist with a deep interest in the functioning of the human body’s structural systems, and the conditions that are … View Profile

    Agree with Rodney, have you visited the physio who helped you?
    Have you been given any exercises to improve the functioning of your feet? From the fact that you visited a podiatrist, it sounds like you might have pronated feet or flat feet? If so, having someone show you specific exercises to activate your arches and imrove the biomechanical functioning of your feet may also help your knee pain quite significantly
    I find with knee pain, you very often have to work top down (addressing inactive gluts, etc), as well as bottom up (addressing foot pronation, etc)!
    All the best, and feel free to check in here with further questions.

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  • Jack Cowled

    Chiropractor

    After treating a range of professional and amateur athletes in Scotland, Jack Cowled has returned to become LiveActive’s dedicated sports chiropractor. Jack's long history of … View Profile

    There can be many causes of knee pain particularly during movement.
    Without more information it is difficult to determine what is causing your particular problem.
    However, you mentioned that working on glute inactivity has helped previously, which leads me to believe that the knee joints themselves are not the problem. 

    It might be time to visit a health professional again, particularly one who specialises in Funtional Movement. This is a screen which examines complex body movement patterns in order to identify limitations or asymmetries.
    This could be particularly useful for someone in your position who suffers from pain during exercise.

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  • Dr Aaron Albrecht

    Chiropractor

    Dr. Aaron Albrecht works at Body Wise Chiropractic in Bibra Lake, Western Australia. The clinic is located within a gym, and Dr. Albrecht is the … View Profile

    Hi poster! Pain which limits your activities of daily living is always a frustrating occurence. In the case of pain behind the patellae (known as retropatellar pain), there are a few conditions which spring to mind. The fact that the pain arises after running leads me to suspect that the most likely cause is a condition called 'patellofemoral pain syndrome' (PFPS). This is commonly caused, as you mentioned, by an imbalance in muscle contraction during straightening of the knee. The part of your quad muscle on the inside (your vastus medialis obliquus or VMO) is prone to firing too late, or being too weak to counter the early, strong contraction of the head of the quad on the outside (vastus lateralus or VL); this results in the patella being pulled through its track on the wrong angle.

    In order to check if this is the case, try doing body weight squats, but stand with your feet at shoulder width, and toes pointing about 20 degrees out, rather than straight ahead. This exercise is more about muscle coordination than strength, so don't add weight, just go for repetitions, morning and night (doing it while brushing your teeth is a good prompt). Really concentrate on contracting the muscle on the inside of the thigh. After doing this for 2 weeks, go for a light run, and see if there's any improvement. If so, seeing a chiropractor, osteopath, or physiotherapist to release the VMO, and tape for the knee pain, as well as assess the cartilage behind the knee cap to see just how much damage has been done is a great idea.

    If there has been no improvement, it is still a great idea to visit one of these specialists, as the amount of time you have been suffering (chronicity) means there may be some damage to the joint surfaces.

    If you are in the metro or Fremantle area of Western Australia, I'd be happy to examine the case, as I work in a gym, providing treatment to a number of professional athletes, and have a direct referral relationship w a knee specialist should there be any more concerning findings.

    Let me know how things progress over the next two weeks, I'd be interested in any changes.

    All the best,

    Dr. A

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