Knee Pain

Photo diagram of woman's knees indicating two areas of knee pain

DO I HAVE KNEE PAIN?

To start determining the cause, take a closer look at where you feel pain.

A Behind or around your kneecap.

B On the outside of your knee.

What causes knee pain?

Photo of a man running outside who may experience future knee pain

Your knees take on a lot. They support the weight of everything above them with every step you take. And when you run, they bear a load of 2 to 3 times your body weight.

Their job entails high-impact, repetitive motion—and that can take its toll. Knee problems are common, especially among runners. Almost half of all running injuries are to the knee.

Knee pain usually strikes in one of two areas—either behind or around your kneecap, or on the outside of your knee. Where you feel pain provides clues to what's causing it.

Pain behind or around your kneecap (Patellofemoral Pain or Runner's Knee)
Drawn diagram of knee with kneecap highlighted to show area of pain

The most common cause of knee pain is your kneecap rubbing against the lower end of your thighbone instead of gliding smoothly over it. That friction damages the cartilage beneath your kneecap, in some cases wearing it all the way down to the bone.

  • Overuse, the most common factor among active people.
  • Muscle weakness in your thighs and hips, which prevents them from properly stabilizing your knee.
  • Your gait. Too much inward collapse of your knee as you run or walk—a common problem—results in extra stress to your knee joint and kneecap.
  • Overpronation, which also stresses your knee as your lower leg turns inward while your thigh rotates your knee outward.
  • Aging and/or osteoarthritis, which contributes to the softening or breaking down of cartilage.
  • Trauma, such as a blow to your knee that damages or breaks off part of the cartilage or bone.
Pain on the outside of your knee (Iliotibial Band Syndrome)
Drawn diagram of knee with iliotibial band highlighted to show area of pain

Pain on the outside of the knee is usually attributed to Iliotibial Band Syndrome, the second most common cause of knee pain. Your Iliotibial Band is a fibrous band that extends from your hip to the outside of your knee. When that band rubs against the bottom of your thigh bone, the band can become irritated and inflamed.

Overuse or an increase in exercise are the main causes of Iliotibial Band Syndrome, which can also cause pain and swelling at your hip joint. Other factors that can stress your Iliotibial band and knee include:

  • Running down hills.
  • Changing your running or exercise routine.
  • Running or exercising on a different type of surface (hard concrete, uneven ground, etc.).
  • Wearing worn-out shoes.
  • Weak gluteal and/or hip muscles.
  • Overpronation.
  • One leg that's longer than the other, causing imbalance as you run, walk or even stand.
Want to learn more about your knee pain?TAKE THIS SELF-ASSESSMENT

If you have dull, aching pain around or under your kneecap,
take the first quick quiz.

If you have sharp, burning pain on the outside of your knee,
take the second quick quiz.

Self- Assessment
Quiz
If I have a dull, aching pain around my kneecap, does it worsen when I:
  • Walk up and down stairs.
  • Walk on a hill.
  • Run or play sports.
  • Jump, squat or otherwise bear weight while straightening my leg.
  • Sit for long periods of time.

If one or more of these statements is true for you, you show key symptoms of Runner's Knee. Keep reading for recommendations on treatment and relief from the experts at FootSmart, the Podiatry Institute and the Running Injury Clinic.

Self- Assessment
Quiz
If I have a sharp, burning pain on the outside of my knee, does it:
  • Begin after I take up or increase my running or other exercise?
  • Begin after I change my running or exercise surface or routine?
  • Hurt when I run, but generally subside when I stop?
  • Now hurt throughout the day when previously it used to hurt only when I ran?
  • Worsen as I continue to run?
  • Feel like small knives are stabbing the outside of my knee?
  • Radiate up the side of my thigh?
  • Sometimes produce a snapping sensation when I straighten my leg?

If one or more of these statements is true for you, you show key symptoms of Iliotibial Band Syndrome. Keep reading for recommendations on treatment and relief from the experts at FootSmart, the Podiatry Institute, and the Running Injury Clinic.

Are there any serious concerns with Knee Pain?
Photo of a doctor assessing knee pain damage

Most knee pain stems from overuse and can be treated at home. If you suffer an injury or trauma to your knee, however, you'll want to see a doctor to assess the damage. Also talk to your doctor if your knee pain is sudden, severe, or unexplained by the causes and symptoms above.

How do I treat and prevent knee pain?

The good news is that most knee pain can be alleviated through rest, strengthening, and simple things you can do on your own. The steps you take will be determined by where you feel pain.

Photo of a woman icing knee to help reduce swelling from Runner's Knee
Runner's Knee (pain around or under your kneecap)

As with many injuries, you'll first want to rest and ice the area to reduce the swelling. You can also take over-the-counter pain relievers and anti-inflammatory medications. Then try the following recommendations:

  • Wear stable shoes with good arch support, especially while walking or exercising.
  • Strengthen your gluteal and hip muscles, which will promote knee stability while walking and running.

The Running Injury Clinic recommends two hip exercises for people with Runner's Knee:

Hip abduction
  • Strengthening the muscles used to move your leg outward from your body.
Gluteus medius strengthening

If the pain and swelling continues, consult your doctor, who may recommend orthotics or even surgery in extreme cases.

Photo of a person wearing a knee brace to treat iliotibial band syndrome
Iliotibial Band Syndrome (pain on the outside of your knee)

Rest and ice are the first order of business, along with taking over-the-counter anti-inflammatory medication and pain relievers. Then move on to the following recommendations:

  • Replace older, worn-out shoes that no longer provide adequate support or stability.
  • Wear supportive shoes with added arch support. Unless you overpronate, avoid shoes with stability or motion-control features. Some research indicates that wearing such shoes when you don't need them can actually increase knee pain symptoms.
  • Wear knee supports or braces.
  • Stretch before running or other exercise.
  • Avoid running or walking on hills.
  • Use a foam roller to massage the outside of your knee and thigh.
  • Strengthen your gluteal and hip muscles.
  • Consult your podiatrist about custom orthotics, if pain persists.

The Running Injury Clinic recommends Three hip exercises for people with Iliotibial Band Syndrome:

Hip abduction
  • Strengthening the muscles used to move your leg outward from your body.
Hip extension
  • Strengthening the muscles that attach to the iliotibial band to reduce strain.
Iliotibial band foam rolling
  • Rolling and stretching the iliotibial band to reduce adhesions and scar tissue.