Niggly Knees

Niggly Knees

Knee pain would have to be the most common complaint I hear from runners. It has almost become an expected part of a running journey, but it really doesn’t have to be. We now know so much more about ‘runner’s knee’ and the wonderful news is, there is plenty we can do to help prevent it. 

Runner’s knee is an umbrella term for several different causes of knee pain. The most common cause of knee pain in runners is Patello-Femoral Pain Syndrome (PFPS): pain arising from the joint between the kneecap (patella) and thigh bone (femur). The pain is usually felt at the front or sides of the knee and will be aggravated by running, squatting and kneeling activities. 

Usually, the patella glides smoothly over the top of the femur, but the biomechanics of this joint can become impaired, leading to irritation of the surrounding fluid and soft tissue, which can then cause pain. The main cause of irritation in this joint is too much load or a change in load. 

There are many different factors that can contribute to overloading the patello-femoral joint, some relate to the runner (intrinsic factors) and others relate to the surrounding environment (extrinsic factors). If we can be aware of these factors and manage our running load appropriately, we can really help to reduce our risk of developing ‘runner’s knee’. 

Common examples:


  • Quadriceps weakness or imbalance
  • Gluteal weakness
  • Hip flexor tightness
  • Calf weakness
  • Ankle stiffness
  • Foot posture
  • Patello-femoral joint hypermobility or instability


  • Foot wear
  • Running surface
  • Inclines/Declines
  • Speed
  • Distance
  • Daily activity when not running (stairs, kneeling, squatting)

As you can see from the above, many of these factors, once identified, can be treated or modified quite easily.

If knee pain is affecting your ability to run (or do anything else for that matter) it doesn’t have to. It could be as simple as changing some of the factors listed above and starting a specific exercise program to get you back up and running (pun intended) once again. 

If you’re struggling with knee pain, please reach out to me via a DM or email I am always happy to be contacted and would love to help out if I can!

Han x

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