10 Tips to Avoid Knee Pain While Running

10 Tips to Avoid Knee Pain While Running

You often see runners wearing a knee brace, as if it will protect their painful knee from further damage. But pain during any physical activity is not normal, and there is no such thing as “working through” your pain. If you have knee pain while running, it is a sign that your gait is off. Continuing to run with knee pain will cause more pain and dysfunction throughout your body, and it may eventually cause irreversible damage.

Here are 10 tips for improving your gait and avoiding knee pain while running:

1. Avoid over-striding. Many runners try to get a longer stride in hopes of increasing their speed and distance. But over-striding is not mechanically efficient; it causes your foot to strike in front of your knee, increasing ground reaction forces that can lead to injury. To avoid knee pain from over-striding, increase your cadence and shorten your stride, and run with soft and bent knees.

2. Avoid heel striking. When your heel is the first thing to touch down, it means your feet are landing in front of your knees, decelerating your forward momentum and sending impact forces into your knee joint with every foot strike. Your knees are not designed to absorb shock, especially of that volume and magnitude.

3. Lean forward with your entire body. When you lean forward from the ankles up, you position your feet to land below your knees, striking at midfoot. This reduces impact forces to your knees and up your kinetic chain.

4. Bend your knees, but don’t lift them. When your leg swings through with a bent knee, it reduces the amount of torque required from your hip flexors, conserving energy. It also keeps you from running with a stiff-legged gait that increases ground reaction forces. At the same time, avoid lifting your knees in front of you, which causes your foot to land ahead of your body.

5. Keep your feet aiming forward. If you sashay from side-to-side as you run, it is usually caused by an externally rotated hip. That means your hip, knees and ankles are misaligned, which can cause knee pain. Point your toes forward when you run to avoid lateral movement, and do some internal hip rotation exercises to offset excessive turnout.


6. Do resistance training. If running is your only exercise activity, you probably have multiple muscle imbalances and motor deficiencies throughout your body, which can lead to knee pain and injury from running. A balanced resistance training program can optimize your dynamic posture and reduce your risk of running injuries.

7. Eat like a champion. You may think you can eat anything you want as long as you run enough to burn it off, but the truth is, you can’t outrun your fork. Your knees need nutrients to support strong muscles, connective tissues and collagen. Eating like a champion means eating for peak performance, and junk food just won’t cut it.

8. Stop overtraining. Your body, and especially your knees, need ample recovery time between workouts to repair damaged tissues, adapt to overload, and restore cellular homeostasis. If your knees hurt, it’s time to let them rest and recover.

9. Wear supportive footwear. While shoes alone cannot prevent knee pain or fix your running gait, they do provide shock absorption and stability to reduce ground reaction forces. A neutral shoe that fits comfortably is ideal for most runners.

10. Get a 3D running gait analysis. Oftentimes, knee pain is caused by imbalances and compensation patterns originating elsewhere in your body that are invisible to the human eye. A 3D running analysis that uses instrumented technology to gather quantitative data can help you identify and correct motor deficits that cause knee pain while running.


Running Analysis and Knee Pain Rehab at NYDNRehab

NYDNRehab has a top-of-the-line 3D gait analysis system and a Zebris instrumented treadmill that measures ground reaction forces and pressure. These combined systems give us 27 pages of graphs and biomechanical performance data that helps us identify faulty running patterns.

We also perform a battery of clinical tests related to running injuries, and we use our C.A.R.E.N system to analyze kinematic joint angle data and dynamic stability. Surface EMG lets us analyze muscle firing patterns to identify compensation mechanisms and correct them. We also use diagnostic ultrasonography to confirm our findings and monitor treatment results.

In addition to pain and injury treatment and analysis, we offer physical therapy and chiropractic care, along with TeleHealth services for convenient remote patient care.

If you are a runner with knee pain in NYC, schedule your running gait analysis at NYDNRehab today, and see why our knee pain doctors are considered the best in NYC.

Range of Available Unique Physical Therapy Treatments at Nydnrehab

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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