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Running and Knee Pain: Myths and Facts

Apr 9

True or false: Running increases your risk of knee osteoarthritis (OA).

Actually, recreational runners have lower rates (3.5 percent) of OA than sedentary individuals (10 percent). Only elite runners and professional athletes (13 percent) demonstrated increased rates of OA.

If you are a runner, however, you probably have experienced knee pain. Knee pain or injury is the most commonly reported ailment among runners and accounts for up to half of lower extremity running injuries.1

Let’s investigate other common myths associated with knee pain and running and compare them with the facts.

Myth: Knee pain is always a direct result of a problem in your knee.

Fact: Not always. Knee pain has been linked to deficits above and below the knee, including weak muscles in the hips, trunk, thighs, lower leg and foot; tight muscles in the thighs and lower leg; and the amount of joint mobility in these same areas.3,4,5

A complete assessment by a physical therapist will be able to determine whether any of these factors are contributing to your pain. If so, the PT will develop a program to address these deficits and return you to action.

Myth: You need to push through your knee pain to get rid of it.

Fact: No, and you potentially could make things worse. It is important to address the underlying causes in order to alleviate your pain. Having a full assessment of your knee and leg is key to finding out what is driving your pain.

Myth: Running technique has no effect on knee pain.

Fact: There are many ways to decrease impact force on your knees when you run, and these may help decrease knee pain. In general, taking shorter, faster steps and thus increasing your step rate by 5 to 10 percent can reduce the load on your joints and possibly alleviate knee pain.5

Switching from a rearfoot strike pattern to a forefoot strike pattern can greatly decrease load to your knee.6  Improving muscular control of your lower extremity through strengthening also can dampen forces when you run.5

Please don’t hesitate to contact your local clinic today and consult a physical therapist to determine whether any of these strategies is right for you.


  1. van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SMA, Koes BW.  Determinants of lower extremity running injuries in long distance runners: a systematic review.  Br J Sports Med. 2007;41(8):469-480.
  2. Alentorn-Geli, E, Samuelsson K, Musahi V, Green CL, Bhandari M, Karlsson J.  The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis. J Orthop Sports Phys Ther.  2017;47(6):373-390.
  3. Powers, C.  The influence of abnormal hip mechanis on knee pain: a biomechanical perspective.  J Orthop Sports Phys Ther.  2010;40(2):42-51.
  4. Patel DR, Villalobos A.  Evalauation and management of knee pain in young athletes: oversue injuries of the knee.  Transl Pediatr.  2017;6(3):190-198.
  5. Lenhart RL, Smith CR, Vignos MF, Kaiser J, Heiderscheit BC, Thelen DG.  Influence of step rate and quadriceps load distribution on patellofemoral cartilage contract pressures during running.  J Biomech.  2015;48(11):2871-2878.
  6. Vannatta CN and Kernozek TW.  Patellofemoral joint stress during running with alterations in foot strike pattern.  Med Science Sports and Ex.  2015;47(5);1001-1008

Written by Chris Myers, PT, DPT, OCS, FAAOMPT, Upstream Rehab Institute