Knee Pain When Running
Knee pain when running usually builds with training: more miles, more hills, new shoes or a race block. Runners often feel it around or behind the kneecap, or along the outside of the knee. At ELATE in North Park, San Diego, Dr. Ashley Aguero, DC, looks at your training load and how your hips, knees and ankles share the work. Then she builds a plan to keep you running where possible.
Why it often happens
Mileage that rises faster than your body adapts, especially at the start of a race block
Downhill running and hills
Hip strength and control. How well the hip steadies the knee on each stride.
Ankle mobility and foot strike
Stride length. Overstriding puts more load through the knee.
Sleep, stress and recovery during a heavy block
Pain on the outside of the knee often gets blamed on the IT band. The IT band is fibrous tissue. We look at hip control, training load and running mechanics around it.
What we look at
Your running history and current plan
Single-leg squat and step-down control
Hip strength and ankle mobility
Running video, if you have it
How we help
Hands-on care, including adjustments and Sports Myofascial Therapy
Strength work for the hips and thighs
Training changes: volume, hills, pace and stride
Clear steps back to full mileage, as in our return-to-sport pathway
We reinforce care with movement and training so the change carries into your runs.
What you can try this week
Cut weekly volume or intensity for a week
Swap downhill routes for flatter ones
Keep easy runs easy
Add two short strength sessions for the hips and thighs
When to get checked sooner
Get assessed promptly, or see a physician, if you have:
Swelling in the knee
A knee that locks or gives way
Pain after a fall or a twist
Pain at rest or at night
Trouble putting weight on the leg
Questions we get
Should I stop running?
Not always. Many runners keep running with changes to volume, pace or terrain while we work on it.
Is it runner's knee?
We don't put a label on it from the outside. We'll tell you what we find and refer you if a medical exam or imaging makes sense.
Do I need new shoes?
Sometimes, but shoes are rarely the whole story. We look at training and movement first.
Can I still race?
Often yes. It depends on the timeline and how your knee responds. We'll plan toward race day together.