Knee Pain When Running: 5 exercises to fix it
Written by Gustavo Ramos
June 28, 2019
I can guess that as a runner, you’re having an ache or pain in your knees or some other joint while running.
And I know that it can improve with strength training.
There are a few common causes of knee pain that occur among runners. To understand them we have to first review how the knee joint functions.
Because the knee is a hinge joint, it's function is to flex and extend in only one direction—front to back. This makes it an easy target for an improper stride and weak musculature. The ankle joint and hip joint don't have this problem.
With regards to the lower body, the knee joint takes the most toll when running with weak muscles. If your calves, hamstrings, and quads aren't prepared to absorb the force of the initial contact with the ground and your hips aren't strong enough to keep your knees stable the joint will suffer.
2 common Stride Compensations
If you were to video your stride from the side view and front view there are two compensations you can look for to see what exercises you need to focus on in your strength training. Keep reading to see my full workout prescription for any runner with knee pain.
1. Caving IN
Focus on: banded hip thrusts and crabwalks
You can have a stride where the knees or arches cave in during each strike or the leg swings out which can cause knee pain in the inside or outside parts of the knee. For this, you need to prioritize strengthening the abductors of the hip to stabilize the leg side-to-side when running.
Perform more sets on banded hip thrusts and crabwalks. This will strengthen your hip abductors and correct the caving.
Make sure that your form is correct when performing these exercises.
If your knees are caving in during a crabwalk or your arches are collapsing during a squat then these exercises will just reinforce your bad movement. Focus on driving the knees out during these movements and creating an arch in the foot. The video below explains what that means.
2. Heel Striking
Focus on: Romanian Deadlifts and Bulgarian split squats
If your stride shows a lot of heel striking this can transfer a lot of stress to the knee joint since your planting leg is mostly straight.
With heel striking you may have more knee pain in the front where the knee cap is or deep in the joint itself. More than likely you have shin pain as well.
You need to prioritize strengthening the gluteus maximus (main glute muscle) and hamstrings. This will help distribute the forces of running to the “pulling” muscles of the lower body.
Over time you will be able to comfortably strike with more of your mid-foot and absorb the impact with a slight knee bend. Then "pull" your planted leg back with your hamstrings and glutes to propel you forward.
This video shows the difference between heel striking and forefoot striking.
A perfect low-bar squat is a great way to bring up the hamstrings and glutes. But doing only great squats won’t be the solution to your knee pain. Add in more sets of Romanian deadlifts and Bulgarian split squats to strengthen these muscles for running.
The 5 exercises
No matter which stride compensation you have, you should perform all the exercises below. I recommend performing 3 sets of every exercise, at least once a week. With an additional 2-3 sets on the exercises that match your stride compensation and pain areas.
Again, I can’t stress the importance of perfect form. Watch the videos below, then take videos of yourself to monitor your form.
If you can’t seem to get it right, shoot us a DM on instagram with your videos for some form tips.
If you’re close to one of our gyms, come in for a free consultation.
1. The squat
What it helps: knee stability, hip strength, leg strength
Rx: 5-8 reps with moderate weight (after perfecting form)
A low-bar squat is a great way to get a ton of lower body muscles firing. A perfect low-bar squat should be felt in the hamstrings, glutes, and quads.
I set the reps here at 5-8 to build some baseline strength but as you master the squat I recommend incorporating higher rep sets (10-15 reps) to challenge your muscles in the endurance range.
2. RDL’s (Romanian Deadlifts)
What it helps: hip strength, hamstring strength, back strength
Rx: 8-12 reps with light weight
Romanian Deadlifts are great for learning how to move well at the hips. It’s similar to conventional deadlifts but the knees don’t bend and you don’t lower the weight to the ground.
This keeps constant tension on the hamstrings and will teach your body to bend at the hips. Romanian deadlifts will hit the hamstrings hard. Keep the weight light when first starting and focus on strict form. Your back should not round or bend at all during the movement. Be sure to watch the video below.
3. Bulgarian Split Squats
What it helps: hip stability, knee stability, Left-Right imbalances
RX: 10-20+ reps with bodyweight
This is by far one of my favorite exercises for correcting lower body imbalances. When done right this exercise should be felt in the quads, hamstrings, and glutes. When performed incorrectly you will feel only a quad burn, and your back leg will cramp up because you’re too upright. I’m saying this because it’s happened to every client I’ve ever shown it to.
Watch the video a few times before trying this one out, and start out with just your body weight (trust me). If you think you can do more, just increase the reps. I’ve had clients do these with up to 30 repetitions per leg with no weight. Perfect form comes first.
4. Hip thrust
What it helps: glute & hip strength, knee stability
RX: 10-25 reps with light weight
The hip thrust is by far the most effective exercise for making you faster when running. Because of how it loads the hips, it strengthens hip extension in the same way that you would use it when extending your hip when running.
If you add a hip circle above your knees when thrusting then you will challenge the abductors and increase knee stability. Having strong glutes will allow you to properly stride without putting all the load on your hamstrings, helping that knee pain.
Outside of running, strong glutes will improve the orientation of your hips in a resting posture. With most of us sitting for long hours the glutes atrophy and other muscles take over. This can lead to other pains when running like hip pain and low-back pain.
Also, who doesn't want their butt to look good?
What it helps: knee stability
RX: 10-15 reps on both sides with a light to medium band
Crabwalks or “lateral band walks” are difficult to do right. Even our coaches at SST have to check their form while they’re doing them. It’s not an exercise you can shut your brain off for.
To properly execute a crabwalk there needs to be constant abduction and external rotation of the femurs (upper leg). When you go to take a step, neither knee should cave in! Watch the video and notice how my shins stay vertical when looking from a front view.
Practice this one, and do it in front of a mirror if you need to. You need to practice the correct movement pattern to have it carry over into your running. If your knees are collapsing inwards in this movement then they'll cave in when you’re running.
Get Strong, Be Pain Free!
Once you begin strength training you’ll notice that your runs will start to feel better. Although you’ll notice improvement give your knee pain some time to get better. You may still need to monitor your stride and continue to tweak how you’re actually running to put those muscles to work.
Please give yourself at least one day of rest in between your lifting day and a hard run. You need to give your muscles (and joints) time to recover to get better and stronger.
Note that these are only recommendations. If you need a tailored exercise program based on your needs please contact us.
If you want a solid training program in addition to the exercises above download our FREE beginner strength training program below
*Always get cleared by a medical professional before beginning any training program after a serious injury.