Patient question
Why does the front of my knee hurt when I run?
Dr. Pablo GelberOrthopaedic Knee Surgeon
Quick answer
Pain around or behind the kneecap during or after a run is most often patellofemoral pain, also called runner's knee, and it usually follows a change in distance, pace, surface or shoes. Most runners recover by adjusting load and strengthening the hips and thighs, says Doha knee surgeon Dr. Pablo Gelber at Aman Hospital.
What typically sets it off
Runner's knee is an overload problem. It tends to appear a few weeks after something changed: more kilometres, a faster group run, hill repeats, a new pair of shoes, or a switch between the treadmill and the road.
In Qatar the seasons drive this. Many people run little in summer, then restart outdoors on the Corniche, Aspire Park or Al Bidda Park when it cools, often building up too quickly for an autumn race. Others move all their running onto a treadmill for months, then find outdoor running feels different on the knees.
Other causes to keep in mind
- Patellar tendinopathy: pain pinpointed just below the kneecap, more with hills, sprints and jumping
- IT band syndrome: pain on the outside of the knee rather than the front, typically at a predictable distance into the run
- Fat pad irritation: pain just below and either side of the kneecap, worse when the knee locks straight
- A stress reaction in the shin or kneecap is uncommon but possible with a big jump in volume, especially if pain is present at rest
How to change your running
Reduce weekly distance by roughly a third to a half, and run on flat routes for a while. Taking slightly shorter, quicker steps reduces the load on the kneecap joint with each stride. Downhills are usually the hardest part and are worth avoiding early on.
Add two or three sessions a week of hip and thigh strengthening: side-lying leg raises, bridges, step-downs and controlled squats. Build back up by about ten percent a week once runs are comfortable. In summer, run early morning or late evening, or indoors, and keep well hydrated.
When to see a knee specialist
Book an assessment if pain lasts beyond six to eight weeks despite these changes, if it is present at rest or at night, if the knee swells, or if you felt a pop or the knee gave way. Running through pain that is getting worse each week is a reason to be seen sooner.
At Aman Hospital in Doha, Dr. Gelber examines the knee, hip control and alignment, and arranges imaging only when the examination suggests something more than overload.
Frequently asked questions
Do I need new running shoes?
Shoes are rarely the whole answer. A worn-out pair or a sudden switch to a very different shoe can contribute, so change gradually and focus first on training load and strength.
Is running bad for my knees in the long term?
For most people, regular running built up sensibly is not linked to more knee arthritis and may even be protective. Problems usually come from doing too much too soon.
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