If you’ve ever finished a run only to notice a nagging ache in your knee, you’re far from alone. Knee pain after running is one of the most common complaints among recreational and competitive runners alike. While some knee discomfort after a hard session is normal, persistent or worsening pain is a signal that something needs attention.
At Burwood Physio, our sports physiotherapists see a high volume of running-related knee injuries. In this article, we break down the most common causes, what you can do at home, and when it’s time to book in with a physiotherapist.
Common Causes of Knee Pain After Running
1. Patellofemoral Pain Syndrome (Runner’s Knee)
Patellofemoral pain syndrome (PFPS) — commonly called “runner’s knee” — is characterised by a dull ache around or behind the kneecap. It typically worsens with prolonged running, going up or down stairs, or sitting with knees bent for extended periods. PFPS is usually caused by poor kneecap tracking, weak hip muscles, or training load errors.
2. IT Band Syndrome
IT band syndrome causes sharp pain on the outer side of the knee, typically appearing after a set distance into a run. The iliotibial band is a thick band of connective tissue running from the hip to the shin. When it becomes tight or irritated, it rubs against the outer knee, causing inflammation and pain.
3. Patellar Tendinopathy
Patellar tendinopathy (sometimes called “jumper’s knee”) affects the tendon connecting your kneecap to your shin bone. Runners who do a lot of speed work, hill running, or who have rapidly increased their training load are most at risk. The pain is typically felt just below the kneecap and is often worse first thing in the morning.
4. Meniscus Irritation
The menisci are two C-shaped pieces of cartilage that act as shock absorbers in the knee. Running on hard surfaces, downhill running, or biomechanical issues can place excessive load on the menisci, leading to pain, swelling, and stiffness. A meniscus injury requires professional assessment to determine the severity.
5. Pes Anserine Bursitis
This is inflammation of a small fluid-filled sac (bursa) on the inner side of the knee, just below the joint. It often causes pain that is worse after exercise and at night. It’s more common in runners who overpronate or have tight hamstrings.
Immediate Self-Management Tips
If you develop knee pain during or after a run, these strategies can help in the short term:
- Reduce your training load. Cut your weekly mileage by 20–30% and avoid hills and speed sessions until the pain settles.
- Apply ice. Apply an ice pack wrapped in a cloth to the knee for 15–20 minutes after running, up to 3 times per day.
- Stretch your hip flexors, quads, and IT band. Tightness in these areas is a common contributing factor to runner’s knee and IT band syndrome.
- Strengthen your hip abductors. Weak gluteus medius muscles are one of the most common causes of running-related knee pain. Side-lying hip abduction and clamshells are simple exercises to start with.
- Check your footwear. Worn-out or inappropriate running shoes can significantly affect lower limb biomechanics. If your shoes are more than 700–800 km old, consider replacing them.
When to See a Physiotherapist for Knee Pain
You should book in with a physiotherapist if your knee pain:
- Has not improved after 1–2 weeks of reduced training
- Is accompanied by significant swelling or locking of the joint
- Came on suddenly during a run (especially after a twist or fall)
- Is affecting your gait or causing you to limp
- Keeps coming back each time you increase your training
How Physiotherapy Helps Runners with Knee Pain
A physiotherapy assessment for running-related knee pain typically includes a thorough movement analysis, strength testing, and biomechanical assessment. From there, your physio will develop a tailored treatment plan that may include:
- Hands-on soft tissue treatment and joint mobilisation
- A structured strengthening and flexibility program
- Running technique coaching and load management advice
- Taping or orthotics to offload painful structures
- A graded return-to-running program
Our Sarah Nguyen specialises in running injury rehabilitation and return-to-sport planning. If you’re based in Burwood, Strathfield, Homebush, or the surrounding Inner West, we can help you get back to running pain-free.
Don’t let knee pain stop your training. Book an appointment with Burwood Physio today.
About the Author: This article was prepared by the clinical team at Burwood Physio. Our AHPRA-registered physiotherapists have extensive experience treating running injuries across all levels of sport.
