Which is all to say that several factors can contribute to knee pain. For runners, an overuse injury from performing repetitive movements could be a culprit, but if you attribute the issue to that alone, you may be missing other literal pain points that are worth addressing. Below, two experts well-versed in all things running and knee pain off their pro tips on what may be causing your knee pain while running—and what to do about it to keep your body healthy for miles and miles.
Is running *really* bad for your knees?
Dr. Rodante Saballa, director of movement at wellness club Remedy Place and a board-certified chiropractic sports physician, says running isn’t “bad” for your knees, although it is not the best activity choice for every single person. You should always check with your doctor before starting any new fitness routine, and if you’re already dealing with knee or other joint pain, consider getting cleared by a physical therapist prior to pounding the pavement.
“For the majority of the population, [however], running is a great activity to enhance physical health, cardiovascular capacity, and [support] mental clarity,” Dr. Saballa says, who adds that the pain and injuries that people associate with running are usually caused by human error rather than the activity itself. Two common examples being failing to warm up properly or skipping the cool down stretches. “Both lead to excessive tightness in the muscles around the knee, which ultimately leads to poor biomechanics in the joints. And that’s where a lot of those aches and pains come from,” says Dr. Saballa.
Queue up this 10-move dynamic warm-up from Nike master trainer Traci Copeland before any type of running workout:
Other than skipping a proper warm up and cool down, you can look at a more holistic picture to fully understanding injuries and pain related to running. “Injuries are complicated,” says Nick Kafker, co-founder of Recover Athletics, who’s worked with some of the world’s leading sports medicine physicians and researchers to design evidence based workouts that help runners prevent injury. “People love to blame single things like shoes, or the hard surfaces we run on, but the science suggests that pain is complicated and usually the result of a combination of different factors like training, sleep, nutrition, and life stresses—jobs, family, finances. They all add up.”
3 ways to prevent knee pain from running
1. Strength training
Dr. Saballa and Kafka agree that taking a preventative, aka a “pre-hab” approach to knee pain should be your first line of defense. “One of the best things we can do as runners to fix and prevent knee pain is to maintain a consistent strengthening routine to keep our body strong and resilient,” says Kafker, who referenced two studies with promising findings for runners who pick up weights: One study shows that athletes who strength train have less overuse injuries, and another found that lifting and running (aka hybrid training) improves performance.
Another reason to prioritize the weights: Having more muscle may help take some of the impact from running out of your joints. “Doing some type of hybrid strength training where you’re able to develop muscle is going to help reduce the impact and stress on the joints because [muscle] is able to take more force,” says Dr. Saballa.
2. Warm up properly
As Dr. Saballa mentioned before, not priming your body to run beforehand is a big no-no when it comes to preventing knee pain. This is because both help prevents injury and pain for specific reasons. Let’s start with the warm-up.
“The biggest two points of a general warm-up are to increase core body temperature and improve blood flow to your working muscles. This is really important because the increased core temperature optimizes certain enzyme activity for energy and metabolism, and then the increase of blood flow brings fresh oxygen and fresh nutrients to those working muscles,” says Dr. Saballa. In addition to doing dynamic stretches, walking is a great way to warm-up the same muscle groups you use while running, according to Dr. Saballa.
3. Stretch afterwards
It’s tempting to hit the showers straight after a run, but the cool down is key to helping keep your knees and body pain-free. Dr. Saballa says the goal for a cool down is to lower your heart rate and body temperature, and prevent stiffness in your muscles that can happen when you have lactic acid accumulation. “If you engage in your active recovery, the goal is to use the same muscle groups you used in your activity. So if your main activity was running, walking is a great cool down,” he says.
Once you’re heart rate and body tempt start to return to normal, don’t skip the post-workout stretch. And when it comes to knee pain and running, the main muscles to target are the calves, hip flexors, quads, and glutes, according to Dr. Saballa. “The glutes are so important because they anchor the lower extremity into your pelvis and your spine,” he says. “So it’s an area where force transfer is either your worst enemy or your best friend. If we can capitalize on keeping those glutes loose, not only will it keep the lower half happy, but it’ll keep your spine and low back happy as well.”
These cool-down stretches for runners will do the trick: