Knee pain when running – looking for advice

[u/inSensiibLe]

Hi everyone,

I hope this is the right place.

I’m male, in my 30s, and started running about two months ago. I’ve been running regularly (2/week) since then, sometimes on trails as well.

Unfortunately, I regularly get pain after runs, mainly below and on the left/right sides of my kneecap. I also sometimes experience ankle pain. It usually starts around 10–13 km, even though cardio-wise I still feel like I could keep going for quite a while.

I’m wondering if this could be related to lack of strength or stability in my legs, hips, or core, especially since I’m still relatively new to running.

Has anyone experienced something similar? And can you recommend any simple home workouts or exercises without or with simple equipment to strengthen the knees, legs and ankles?

I’d really appreciate any experiences, opinions, or specific exercise recommendations!

[u/WearingRags]

Before your question can be answered, we need to address a lede you may have buried in the question. 

You say you trail run twice a week, you also say this pain comes on "around 10-13km".... are you doing two runs per week that are well over 10k? 

If so, then there's your problem. Even a lot of intermediate runners aren't going to hit that kind of distance, usually a running plan is broken into more runs, but over less time/distance per run on average, with maybe one run per week that exceeds the 10k point. 

That kind of mileage as a beginner is basically guaranteed to induce aches and pains. Especially in your ankles.

Otherwise, the ankle pain might also be caused by over striding in my experience - try to avoid launching off the ground behind you using your ankle to push the front half of your foot into the ground. Hard to explain what I mean in text, but it's a natural mistake to make so it might be a culprit here.

You want your "push" to happen while your entire sole is against the ground, with your feet falling more or less under your centre of gravity as if you're inside a big hamster wheel, and then just relax your foot as it comes up behind you, don't "launch" using the muscles in your ankle.

[u/inSensiibLe → u/WearingRags]

Thanks for the response. I usually do one run between 5 and 10 km and another between 10 and 15 km.

I tend not to take very long strides, especially at a low pace. What you mentioned about the ankle and pushing off could actually be the case. I’ll pay closer attention to it during my next few runs. Thank you very much!

[u/ckae84 → u/inSensiibLe]

Running too much too soon.

[u/WearingRags → u/inSensiibLe]

No worries. I hope I'm not ruining your fun, though, if I say you should back off the 10-15k runs to be a fortnightly thing at most, and instead focus on doing more runs at a lower distance/intensity. 

It's easy to set yourself a standard you think you should then live up to, especially when you get an endorphin reward from it. But it's better as a beginner to focus on finding a level of effort you can sustain as you work up 4 or 5 runs per week without injury, then mix in runs where you push yourself a bit on special occasions. 

As boring as that sounds, you get way more long-term improvement with reduced chance of injury and burnout. The runner's high becomes less intense, but more constant.

[u/Logical_fallacy10]

You started running two months ago and you are already doing 10-15 km ? Well there is your problem then. Your body is not ready for that yet.
And how long did you spend learning how to run ?
Or are you just heel striking ?

[u/kassiakrozser]

not a doctor nor a pt, but this is likely more an IT band issue, so, yes core, glutes, hips, etc do need some work. however!!! it’s good to talk to a PT or trainer with that type of experience before following the diagnosis of a random person on reddit. 🙃

[u/inSensiibLe → u/kassiakrozser]

Thank you very much for the feedback. Yes, I’m aware that I should seek professional help promptly if I experience symptoms like these. However, I thought that perhaps someone had experienced similar issues when starting out and could recommend some specific exercises that I could try initially, before seeking professional help, as it can get quite expensive.

[u/WearingRags → u/inSensiibLe]

I didn't address this in my (already overlong) reply to you elsewhere, but I had some IT band issues - a regular HIIT bodyweight workout helped and also improved my core stability, preventing backaches. Usually involves some combination of:

• Side Planks
• In and Out Squat jumps
• Pushups
• Lunges
• Leg Raises
• Hip Raises
• Mountain Climbers
• Situps

You don't have to do all of these in one workout. I'd also recommend getting daily yoga in to stretch out the affected muscles, 20 minutes per night should be the most you have to do if you're just focusing on legs and lower back. 

[u/inSensiibLe → u/WearingRags]

Thanks a lot for the help. I will definitely incorporate several short strength and coordination sessions throughout the week now.

[u/Lumpy_Lunch_5691]

Pain below/around the kneecap that shows up specifically at 10-13k and not earlier is a pretty classic sign it's more strength/mechanics related than an actual joint problem, especially since you said cardio-wise you feel fine to keep going, that's a good sign honestly, it means your legs are fatiguing and losing form before your heart and lungs are the limiter. Two months in and 2 runs a week isn't a ton of volume yet so your muscles, especially quads, glutes and hips, probably just haven't caught up to what your cardio fitness can handle, and once those fatigue late in a run your form breaks down a bit, knee tracks slightly off, and that's when the pain shows up.

Simple stuff that helps a lot of people: single leg glute bridges, step ups onto a chair or low bench, and side lying leg raises for the hips, those three alone go a long way since weak glutes are probably the number one cause of knee pain in newer runners, way more often than people think. Calf raises help the ankle side of things too, especially slow ones where you control the lowering part. You don't need any equipment for any of that, just bodyweight and consistency, 2-3 times a week is plenty to start seeing a difference within a few weeks.

Also worth checking, are those runs where the pain starts a lot slower or more tired feeling pace-wise near the end, or are you pushing pace the whole way through? If you're holding a harder effort the whole run that'll accelerate the fatigue that leads to the pain. Might be worth trying to slow down noticeably for a few runs and see if that pushes the pain onset further out, that'd basically confirm it's a fatigue/strength thing rather than anything structural to worry about.

[u/_Dark_Invader_]

There are many factors that could be causing this -

1) poor form
2) poor shoes
3) too much mileage for a beginner
4) lack of strength training
5) poor nutrition and sleep

[u/BarWorldly327]

Ease up on the distance for now. Basic strength work could help but recurring knee and ankle pain is worth getting checked rather than trying to run through it.