6 Causes of Knee Pain From Running—And How to Prevent and Treat It

Medically reviewed by Dr. Sabrina Strickland, MD · Orthopedic Surgeon, Hospital for Special Surgery · Last reviewed: December 13, 2023

Quick Summary

Knee pain in runners most often traces to patellofemoral pain syndrome, iliotibial band syndrome, patellar tendinopathy, meniscus injury, mild osteoarthritis, or training-load errors. The location of the pain — kneecap, lateral knee, joint line, or behind the knee — narrows the diagnosis quickly. Most running-related knee pain responds to load management, strength work for the hips and quadriceps, gait or shoe adjustments, and time, without requiring surgery.

August 20, 2021

Whether you’re lacing up for your first 5k, training for your next half-marathon, or enjoying an accessible way to get active, running can be a rewarding way to stay fit, get competitive, and just escape the stresses of daily life for a little while.

And while pounding the pavement (or the tread!) offers plenty of incredible benefits for both your mind and your body, it can also often come with some less-than-desirable aches and pains. One particularly common complaint: knee pain.

I contributed to this article on Health.com, which has a lot of useful information on preventing and treating knee pain related to running.

knee pain, running

Frequently Asked Questions

Should I run through knee pain or stop entirely?

Mild discomfort that doesn't worsen during a run, isn't present the next morning, and stays below 3/10 in intensity is usually safe to run through with reduced volume. Sharp pain, swelling, mechanical symptoms, or pain that limps your gait are reasons to stop and evaluate. Smart load management — not complete rest — is usually the right answer for overuse pain.

Are minimalist shoes or maximalist shoes better for runners with knee pain?

Neither is universally better. Maximalist (high-cushion) shoes can reduce impact loading and help some runners with patellofemoral or osteoarthritic pain. Minimalist shoes shift load toward the calf and Achilles, sometimes helping with patellofemoral pain but stressing the foot and ankle. The best shoe is the one that matches the runner's anatomy, gait, and history — not a category.

Does running cause knee arthritis?

Recreational running has not been shown to cause knee arthritis in most studies — and may even be protective compared to sedentary controls. Very high-volume running and prior knee injury increase risk. The bigger drivers of knee arthritis are genetics, prior injury, body weight, and meniscal status. For most people, running is safe for the knees when training volume is sensible.

6 Causes of Knee Pain From Running—And How to Prevent and Treat It

Frequently Asked Questions

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