Running full speed, I leaped off the edge of a cliff. As I reached the highest point of elevation, I was INVINCIBLE…or, so I thought. Suddenly, the ground approached twice the speed as my running start. Here’s when I realized the landing was not going to be pleasant.
And then it happened, both feet planted deep into the freezing rocky dirt. As I felt a sharp pain shoot through my knee, I knew I was in trouble.
I hesitated to take the first step. I was sure there was a whole lot of pain coming with it.
Let’s just say my first step was a liar. As I moved forward, I felt fine, so I decided to pick up speed…
Each step was a warning shot for the next as the pain in my knee incrementally worsened. Runner’s knee pain then hung around for the rest of the race as well as my future training.
The safer route would have been to follow the line of runners across the log. But between race day adrenaline, endorphins, and reaching the pinnacle climax of an electric dance song pounding away at my eardrums, I sped up instead of slowing down.
I jumped with all my might to clear the creak that stood in my way between a cold and slow day of racing and some imaginary personal best I was chasing in the freezing cold arctic-like temperatures.
Let’s just say there was no personal best achieved that day.
After reaching the finish line at a slow pace, I dealt with runner’s knee pain for some time after. I’ve also dealt with a different kind of knee pain in the past. I’ve run as long as a 200-mile ultramarathon, so as you can imagine, I’ve dealt with my fair share of running injuries.
The point is runner’s knee pain is common, and it usually develops when you least expect it.
In fact, runner’s knee pain has been plaguing the runner’s world since the beginning of time. It’s such a commonality that some runners even believe it’s normal. They think it’s just something runner’s go through from the act of running. However, I’d like to offer a different perspective.
Put simply, we are human beings, so it’s in our nature to run. We stand, we walk, and yes…we run. Running merely is part of our existence. So, let’s eliminate the notion that knee pain is from running itself.
Sure, it can be caused by running too fast or too long too soon, but let’s not make the relationship between knee pain and running a generality as most non-runners do.
The truth is runner’s knee pain is the EFFECT of something we are doing “incorrectly” or “too much of” or even worse—a combination of the two.
As I discuss in Running Injuries: How To Avoid Injury And Run Pain-Free, the majority of our injuries come from a few critical issues. The issues I’m referring to are wearing the wrong shoe, improper form, and running too much too soon. I listed several steps you can take to eliminate pain from your running. If you haven’t read it yet, I suggest you do.
Here’s the good news: runners knee pain is manageable and treatable if you follow the right advice.
But as runner’s, we continuously run into the same problem. That is, once we start to push the limits in our running considerably, it becomes difficult to keep good form. And let’s face it, unless we have a time machine to go back in time to start running barefoot in the woods since birth, chances are we will experience runner’s knee pain. Plus, the further we run the more tired we become thus becoming more vulnerable to accidents and poor form.
I can tell you from experience, my form at mile 5 versus mile 85 during an ultramarathon is much different. Later in the race, it takes a substantiation amount of energy to move forward. So, running with proper form becomes of minimal importance rather quickly. Things can get sloppy in a hurry when your body experiences extreme fatigue, especially when running a new distance.
And remember—the mileage you run is only relative to your current abilities. Whether you run your first 5k, half-marathon, marathon, or ultramarathon, your body will eventually experience fatigue. So regardless of the distance, if you are pushing your limits, then good running form will become more and more difficult to maintain.
Plus, a shoe that works well for the beginning of a training program may cause knee problems later. That’s why it’s critical to get fitted for shoes at your local running shoe. They will determine your foot strike, provide a selection of shoes to choose from, and even let you take them for a test drive.
So, as you can see, even with the best shoes and form, you still have a chance of developing runner’s knee pain, especially when attempting to reach a new distance. And this becomes especially frustrating if you are in the middle of a training program.
Well, that was before you found this guide with a set of surprisingly effective ways that will help stop runner’s knee pain even while training. But remember, it’s always important to first consult a doctor beforehand…
I am not a medical professional, and this information is not intended to be a substitute for professional medical advice. I’m just sharing what worked for me from my own experience.
But first, let’s discuss the two most common types of runner’s knee pain. These two syndromes are what most runners will experience at some point in their training.
Two Types of Runners Knee Pain
Statistics show that 65-85% of runners will become injured each year [*]. Pretty scary numbers, I know.
And what’s the most common running injury?
Yes, you guessed it, knee injuries. Two injuries take up the majority of the percentage above. So although there are other causes, the runner’s knee pain you are experiencing will typically boil down to one of the following…
1. Patellofemoral Pain Syndrome (PFPS)
PFPS is the most common form of runner’s knee pain. It’s so common in fact that it holds the name “runner’s knee.” The Mayo Clinic explains it like this…
“Patellofemoral pain syndrome is pain at the front of your knee, around your kneecap (patella). Sometimes called “runner’s knee,” it’s more common in people who participate in sports that involve running and jumping.”
2. Iliotibial Band Syndrome (ITBS)
ITBS is less common but still causes a massive amount of knee pain for many runners each year. The Mayo Clinic explains it like this…
“Iliotibial Band Syndrome occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.”
After years of running and reaching distances as long as the 200-mile ultramarathon, I can confidently say I have experienced both. But there is a silver lining.
What’s so positive about my knee pain you may wonder?
Well, fortunately, I have developed some handy tricks in the process. Methods that I use not only to help get rid of the pain, but it allows me to continue training as well.
Today, I rarely feel any pain in my legs. That’s because I use certain tricks to tackle potential injuries even if there’s the slightest chance of injury. As you can imagine, I used several of them when preparing to run 200 miles.
But when I first started running, knee pain was just knee pain. I knew nothing about it besides the word “OUCH.” And even when I became knowledgeable on the subject, it was still difficult to distinguish the difference between PFPS and ITBS.
I did, however, notice that the two don’t usually develop together. So, the quicker you can determine the type you have, the faster you can begin to work towards a treatment.
But remember, as runners it’s essential to listen to your own body. You need to determine if the pain you’re experiencing is good or bad. This holds especially true for beginner runners.
What do I mean exactly?
Well, for a better understanding let’s discuss the difference between good and bad pain. Before diving into the 8 surprisingly effective ways to stop runner’s knee pain, let’s discuss the difference between “pain from gain” and “pain from strain.”
Pain from Gain vs. Pain from Strain
The endurance runner faces a paradox—we try to avoid pain to allow us to endure more even though pain is a signal for growth, which eventually provides us with more endurance.
That’s why it’s essential to understand the difference between GOOD pain (growth related) and BAD pain (injury related).
When you first begin to run, one of the first sayings you hear is “no pain no gain.” Sure, I get the point—when you push against resistance, you grow back stronger. But if you’re new to running, it’s difficult to distinguish the difference between GOOD pain and BAD pain. If you experience pain when you run, chances are something is wrong. I’ve learned many hard lessons figuring this out for myself.
You may also call GOOD pain “pain from gain” and BAD pain “pain from strain.”
Yes, your body gets tired, and you wear out mentally, and you sometimes need to push through it, but overall, running should be an enjoyable experience. If it’s not enjoyable, then it may be time to reevaluate your approach. That’s why you need to listen carefully to your body and adjust when necessary. The more you listen to your body, the easier it becomes to understand the different pains.
Take leg pain, for example. When you run, your legs might become tired, but when you push through it, they eventually grow back stronger. That’s GOOD pain (pain from gain), and we expand by demand, so if you push through the resistance, you will only benefit.
But what if a new pair of running shoes was causing the leg pain? What if you overpronate from flat feet but are wearing a neutral shoe? Now, the more you run, the more pain you experience. If you push through this BAD pain (pain from strain), it will lead to injury.
And leg pain is only one example…but a critical one. By listening to your body, you’ll understand the difference between GOOD pain and BAD pain and your endurance will progressively grow.
Remember this—we are symmetrical beings. We have two eyes, two hands, two legs, two arms, two nostrils, two feet, two ears, and so on. That’s why if you are experiencing pain on only one side, chances are you it’s a pain from strain…not gain.
Next, let’s jump into the 8 surprisingly effective ways to stop runner’s knee pain.
8 Ways To Stop Runner’s Knee Pain Even While Training
Before discussing the methods, let’s first list the basic treatment techniques for runner’s knee pain. The following are basic tips and are always worth considering.
- RICE (rest, ice, compression, elevate)
- Get fitted for shoes at a running store.
- Learn proper running form: lean forward and land midfoot.
- Physical therapy
- Patella and IT band straps
- Foam roller
Now that you know some basic tips, let’s dive into some more uncommon ones. Read below for 8 surprisingly effective ways to help get rid of runner’s knee pain. These are tricks I’ve used to not only heal from ITBS and PFPS, but to continue training in the process.
1. Sleep With Ice Packs
I offer this same tip in The 200 Mile Ultramarathon Survival Guide…
My guess is most runners do not sleep with ice packs on their knees, and some will not agree with this. The fact is neither did I until I began training for a 200-mile ultramarathon.
During training, I significantly increased my weekly mileage and ran back-to-back long runs. To say this disrupted my body would be an understatement. So, as my mileage increased, I took ice packs, put them on my knees, and wrapped them with ace bandages. I would then fall asleep with them on.
Not only did the ice prevent and cure runner’s knee pain caused by running back-to-back long runs; but it provided a compression to my knees that lasted throughout the night.
Ice and compression are known to promote increased blood flow, quicker recovery, and decreased muscle soreness. Overall, they experience less fatigue.
Being a husband and father of two young boys, the whole 20 minutes on 20 minutes off just didn’t fit into my schedule. At least not for the 200-mile distance. With the extra time spent running, when I came home, it was off to work. And in the evening and on the weekends I would try my best to shift from crazy ultra runner to engaged super daddy.
One night to save time I wrapped my knees with ice packs and passed out writing on my laptop while lying on the couch.
When I woke up to run there was a noticeable difference. So, I reapplied the ice every night until my next run. When it was time to run again, there was a substantial improvement in how my knees felt. Pain and soreness were significantly reduced.
Ever since, any time I experience knee pain while training, I wrap up my knees before bed and it sure makes a difference.
2. Take Micro Strides
Most runners know the frustration that knee pain can create. I know I do. You want to rest so you can heal, but at the same time, you don’t want to lose progress in your training.
And yes, sometimes it takes one step backward to move two steps forward. I’ve been there myself. But as runner’s, we sometimes reach an unfortunate point in our training where a critical decision must be made.
We ask ourselves “Do I stop training for my race and rest?” Or “Do I continue moving forward to race day while attempting to manage the pain?”
It’s a dilemma most runners will face at some point in their running career. And this dilemma can only be solved by the runner, no one else is qualified.
Personally, I’ve always continued on training. At times I’ve made matters worse. But other times, I’ve come up with effective solutions to runners knee pain while training. One solution being to take micro steps.
What’s a micro step?
A “micro step” is just a nickname I gave to taking extremely short and quick steps. It’s a mix between a walk and a run. Not only does it relieve some impact, but it also engages different leg muscles while giving others a rest. It also prevents you from braking too hard.
Simply put, micro steps provide a lower-impact run. I’ve eliminated knee pain entirely with micro steps alone. No, I was not setting personal records. But it allowed me to finish several training programs and make it to race day in one piece.
3. Run Pool Laps
I was naturally drawn to pool running during my own experience with runners knee pain. It’s a training method I implemented when I dealt with a knee injury that forced me to stop running.
When I was facing a troublesome time from injury, I decided to physically run laps in the pool.
I literally ran back and forth hundreds of times until the bottom of my toes ripped apart. I’d recommend wearing water shoes and just going after it.
You can play around with the exercises, do side steps, run backward, alternate a run lap with a swim lap…you name it. The pool is an incredibly effective place for recovery and allows you to continue running with runner’s knee pain even when it’s at it’s worse.
4. Run Backwards Downhill
Running backward downhill was useful when dealing with IT Band syndrome.
You see, when running forward downhill it puts pressure on the iliotibial band. This pressure causes increased levels of irritation and inflammation. So, one day I had a simple yet effective idea. Since I couldn’t run forward downhill I just turned around and ran backward.
Here’s what I did: I ran uphill, took it slow on flat surfaces, and ran backward on every downhill.
Seriously, I turned around and ran in reverse on every single descent. Although it was a unique way of training, it paid off. And most importantly, it allowed me to get back to what I love—running.
Eventually, I began running backward down every other hill until I was only running backward down the very steep descents. Soon enough, I was running down every decent but pacing extremely conservatively.
The idea reminds me of the fly attempting to exit a home through a closed window. No matter how hard the fly tries it can never break the glass. But if it would only look two feet over to left, to the open door, the outcome would be effortless.
Closed-minded hard work can sometimes leave us dead on a windowsill. We are surrounded by simple and effective solutions everywhere. Fortunately, running backward was a simple solution and worked brilliantly when dealing with IT Band Syndrome.
5. Walk Up Steps
One time when I was dealing with significant runner’s knee pain I trained walking upstairs. I literally walked up a Stairmaster for every training run in preparation for my next race. It allowed my running muscles time to heal while continuing to build my endurance.
Yes, it was a risk, and I had no idea if I was going to recover by race day. But what was the worse case scenario? If it hurt on race day, I planned to just walk really fast to the finish. You win some, and you lose some, it sure wouldn’t have been the last race I ever ran.
The key to the Stairmaster was never to touch the side handles. This way you gain the full benefit of the exercise and do not cheat yourself.
The thought process is that you’re still forcing your body to respond in a similar intensity that running provides. I increased my mileage incrementally, eventually reaching one workout of 6 hours.
There was certainly a lot of time spent staring at the gym wall building intense mental strength. I also brought movies along with an endless playlist of new music.
The point is this: it allowed me to continue training while healing simultaneously. Walking engaged other leg muscles and significantly reduced the impact on my knees.
Walking upstairs was a solution to my knee pain. It promoted an effective recovery without ever having to miss a day of training.
6. Try Shock Therapy
After cold compression, at night and while sleeping I used a handheld electric muscle stimulation unit. This causes the muscles to contract, naturally speeding the healing process.
Here’s how they explain Electrical Muscle Stimulation on Wiki…
“Electrical Muscle Stimulation (EMS) is the elicitation of muscle contraction using electric impulses. EMS has received an increasing amount of attention in the last few years for many reasons…it could be used as a rehabilitation and preventive tool for partially or totally immobilized patients…it could be used as a post-exercise recovery tool for athletes.”
It goes on saying…
“The impulses are generated by a device and are delivered through electrodes on the skin near to the muscles being stimulated. The electrodes are generally pads that adhere to the skin. The impulses mimic the action potential that comes from the central nervous system, causing the muscles to contract. The use of EMS has been cited by sports scientists as a complementary technique for sports training. In medicine, EMS is used for rehabilitation purposes, for instance in physical therapy in the prevention of disuse muscle atrophy which can occur for example after musculoskeletal injuries, such as damage to bones, joints, muscles, ligaments and tendons”
You can pick up a small device online. They range from $30 to $200 and even higher depending on how many features you want. Personally, I went on the low end, and it worked just fine.
But be careful! A few times the ground wire fell off, waking me up in the middle of the night with an electric shock! It sure works better than an alarm clock, yes…electrocution comes with no snooze button.
7. Practice Yoga Daily
As of late, my body has felt incredible even with the excessive stress from training. I credit this to my recent daily yoga practice. Well, more like a few times per week.
You don’t realize how stiff and prone to injury you are until you begin stretching and bending in new ways.
I’m telling you, the first time I sat on my knees and feet was PAINFUL. Now, I can climb up and down a wall from a back bend position. The core strength and flexibility you develop is unbelievable.
There is tons of research backing the benefits of yoga for running. And whether you wish to try it or not, here’s what I can tell you: it has made me a much stronger runner.
Not strong in the sense of how much weight I can lift off a dumbbell rack. I’m talking about real healthy and sustainable strength.
I’m confident it provided significant benefits towards completing my 200-mile ultramarathon. Just being able to squat and bend my knees at times was refreshing.
Want to start yoga yourself?
The key is to be patient and to know it’s a journey with no finish line. You must start with the basics and put in the work every day. The more humble you remain, the better the experience you will have.
Yoga has helped me recover quicker, but even better, it helps prevent runner’s knee pain.
If you are interested in starting Yoga check out my post, The Top 11 Benefits Of Yoga For Trail Runners. I say trail runners, but it’s beneficial for all kinds of runners at all skill levels.
The benefits I mention are as followed…
1. Running Uphill Becomes Easier
2. Avoid Painful Ankle Rolls From Technical Trails
3. Run Faster With Less Effort
4. Improves Stability To Run Further Distances
5. Prevents Pain and Injury From Tight and Weak Muscles
6. Gain More Energy From Opening Your Chest
7. Shifts Your Focus Away From The Finish Line
8. You Won’t Burn Out and Use Up All Your Energy
9. Eliminates Hesitations When Running On Trails
10. Prevents Injuries From Fatigue
11. You Experience A New Sense Of Freedom
As you will read, much of it has to do with preventing injuries by developing a strong core and increasing flexibility. So, check it out to promote an injury-free running experience.
8. Run Once Per Week
Did you know that the number one reason someone quits running is due to injury? As mentioned, 65%-85% of runners become injured each year. And do you know what the most common injury is?
The answer: overuse.
Remember when I stated one of the top reasons for runner’s knee pain is running too much or fast too soon?
Runners actually become injured the most by running too much!
Running causes injury that causes you to stop running. Talk about a self-sabotaging cycle!
So how do runners become injured by running too much? Before answering, you first must understand what an overuse injury is.
Simply put, it’s the trauma to your muscles, tendons, ligaments, or joints due to the impact of running on the ground. But you see, trauma is a good thing if you give your body time to heal and grow—injuries develop when the trauma you’re inflicting on your legs exceeds the rate you can recover from it.
That’s why recovery is so important. When you run on unrested legs, you increase the odds of injuring yourself. That’s why if you train four or five days per week as a beginner, you have a good chance of developing an overuse injury.
But here’s the good news: by running once per week, the probability of injury nearly vanishes. A full week is plenty of time for your legs to rest and rebound for your next run. It also gives you time to fix body misalignment issues due to the wrong shoes or bad form.
Through all the distances I’ve run, whether it be 10 or 100 or 200 miles in length, guess what? Once I started running once per week, I did it with zero overuse injury—that is, I did it with no injuries caused by overtraining. By spending more time recovering, it caused less wear and tear. My body transformed into an injury-free machine!
Injured already? I’ve been in that dark place and found the light by running once per week. I injured myself when I changed from a road shoe that supported overpronation to a neutral trail shoe.
When I took my new trail shoes for a spin the first time, I ran way too long and hard. I did not allow my body enough time to adapt to the new shoes and ended up hurting my IT band. But by running once per week, not only did I bounce back from the injury, but I trained for another ultramarathon in the process. I had sufficient recovery time each week, put stress on the injury, pushed it 10% further each time, and allowed sufficient time to heal for the next run.
As my knee healed during the week I increased the mileage just 10% longer. It was the sweet spot before the pain prevented me from running or causing further injury. Sure the doctor didn’t agree with me, but I was dealing with a traditional doctor who only knew traditional running, not one who ran ultramarathons by running once per week.
Overuse injuries like plantar fasciitis, runner’s knee, and IT band syndrome have been plaguing the running world as far back as we can remember. But guess what? Running once a week is the vaccination and cure for this overuse epidemic.
Want to learn more about running once per week?
I share everything you need to know in my new book called, A Runner’s Secret: One Run Will Get It Done. It will not only change your running for the better, but it will change your life. It will also provide you with more TIME for training and allow you to cross the finish line of ANY distance if you follow the program.
Now your only problem becomes finding a place to put all your finisher medals.
Here’s my promise to you: by reading my new book, A Runners Secret, and following the training programs, you will have the tools to run ANY distance by running ONE DAY PER WEEK!
Picture yourself approaching the finish line of your first marathon with the crowd roaring, cheering you on. Or imagine hopping off the couch and taking your life back by setting the goal of running a 5k. Or see yourself becoming leaner and developing more energy from training and finishing your first half-marathon.
Or….if you dare…imagine reaching an unfathomable level of consciousness by defying the laws of human endurance and ripping through your first ultramarathon.
If any of this sounds like something worth doing or a new way worth living, then give A Runner’s Secret a read.
Inside the pages, you will learn…
–The secret formula for designing A Runner’s Secret training program: That’s right, you get the secret sauce. YOU become the master.
–Training programs for 5k, 10k, half-marathon, marathon, 50k, 50-mile, 100k, and 100-mile distances: This means no time wasted planning your runs. Just simply pick a plan, start with week 1, and begin training the instant you open your book.
–Racing & training tips for every distance: These expert tips will help the entire process go a whole lot smoother. No wasted time and energy from trial and error. You gain the know-how before you even begin.
–The secret Dos and Don’ts to make running once per week even easier: These secret tricks are the icing on the cake. They will make this simple process even simpler and help ensure you get through training.
–And much….much more: the mental aspect is my favorite. There are enough fresh perspectives in this thing to destroy every limited belief you may be holding that prevents you from running long distances.
Put simply: run once per week and run any distance imaginable!
Let’s Bring It Home
Runner’s knee pain can be frustrating for any runner at any level. I know, I’ve been there, it’s not easy to sit on the sidelines unable to do the things you love most. For many, running isn’t just something we do, it’s apart of who we are.
When we say “I am a runner” we mean it.
But unfortunately and fortunately, just as in life, we get the bad along with good when we run.
I say both unfortunately and fortunately because if done right, the bad can be used for growth as well.
Remember—without the night sky, we can’t see the stars. Meaning, without the dark there is no light. Adversity, struggle, pain, when we learn from them, they are no so-called “problems” but GIFTS in our lives to help us grow.
That’s precisely why I was able to create this guide you are reading now. Suffering in my running enabled me to develop solutions for getting rid of runner’s knee pain. I not only learned how to overcome the leading cause of running injuries, but I was able to share my knowledge and help other runners like you. And for me, the pain I experienced as one runner was worth it to help many.
Plus, I found the blessing hidden in the pain.
What do I mean exactly?
Well, during my bout with IT Band Syndrome I took some time off racing and ran slow while recovering. During my slow pacing, I practiced becoming fat adapted. And that not only changed my running for the better…it changed my life. It provided me with extraordinary energy and a solution to severe nausea I experienced during ultramarathons.
In that sense, fighting a case of runner’s knee pain was one of the greatest gifts I could have asked for. But it’s easier to connect the dots looking backward. In the midst of runner’s knee pain, it can pull you down emotionally.
But remember, with every peak, there is a valley, and with every high, there is a low. So, keep resting, keep moving forward, and eventually, you will get out of the slump. And guess what? You just might find yourself coming back stronger and more powerful than ever before.
So use this time of adversity as an opportunity, build your foundation, and find your own stars in the night sky.
Who cares if you run less mileage and at a slower pace. Trust me, one day those shirts and medals just sit in some old box under your bed. That race you ran with a 30 second faster pace will shrivel to a memory of zero significance.
But you know what can’t be boxed up?
The person you became by finishing those races. And the growth you develop from coming back from an injury is yours, and it’s yours forever. Making sacrifices is just apart of the process.
Know that sacrifices must be made when dealing with an injury if you don’t want to sacrifice running itself.
We must all make sacrifices when running long distances…start with self-doubt.
You can absolutely manage runner’s knee pain, but you first have to believe that it’s possible.
If thoughts create beliefs and beliefs create limitations, then think like a runner and believe in yourself. You will then run through any obstacle that stands in your way.
With the different methods listed you now have a few more tools at your disposal for building your come back. And who knows…you may come back stronger than ever.
Remember…Endurance will come over time, but if you rush, injuries will come in no time at all.
And if you haven’t already, prevent runner’s knee pain by following the proven method in A Runner’s Secret: One Run Will Get It Done. Simply click an option below. Inside the pages you will receive training programs for the 5k, 10k, half-marathon, marathon, 50k, 50 mile, 100k, and 100 mile distances. Run ANY distance by running ONE day per week!
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