Knee Pain When Running? Stop Blaming the Pavement (or Your Trainers)

Stephen Lunt
Jun 16
4 min read

IT bands, patella tendons, quad tendons – you're knees are screaming for a reason.

If your knees start giving you grief every time you lace up and hit the pavement, join the club. It's one of the most common complaints I hear – and it usually comes bundled with a long list of self-diagnoses:

“I just need to stretch more”“I think it might be arthritis…”“Probably just need new trainers.”

Sound familiar?

Here’s the deal: knee pain is rarely a mystery – it’s a message. And if that message keeps coming back, it’s time to look past the usual suspects.

Not Just 'Runner’s Knee' – What Could It Be?

We tend to lump all knee pain into the same box, but here are the usual culprits:

IT Band Syndrome – tight, overworked lateral tissues causing pain at the outer knee
Patellofemoral Pain Syndrome – dull ache under or around the kneecap
Patella Tendinopathy – sharp-ish pain at the base of the kneecap (aka "jumper’s knee")
Quadriceps Tendinopathy – pain at the top of the kneecap, where the quad joins in
General overload/irritation – sometimes it’s not one structure, but the whole system saying, “Slow down, mate”

And while they each have their nuances, they often share one big thing in common: Your body isn’t coping with the way you’re running or loading it.

Trainers Help... But They Won’t Fix This

Here’s the truth: you can’t outrun poor mechanics, weak glutes, or stiff hips – no matter how expensive your trainers are.

Yes, your running shoes matter — especially if they’ve done more miles than your family car. But they’re just one piece of the puzzle. If your hip control is poor, your glutes are 'asleep' and your quads are tighter than that post run hamstring, no trainer in the world is going to fix your knee pain long term.

Changing your footwear might buy you some time. But it won’t change the fact you skipped leg day… for about five years.

The Real Fix? Build a Better Runner

Let’s break it down. Here’s what your knees are crying out for:

1. Strength Training That Supports Your Stride

Knees love strong support systems. That means:

Glutes – control the femur and prevent excessive inward knee collapse
Hamstrings – help absorb load and decelerate
Calves & Soleus – often overlooked but essential for shock absorption
Quads – especially important for eccentric control during landing

Throw in some:

Step downs
Split squats
Heel-elevated goblet squats
Glute bridges
Calf raises (yes, again)

2–3 times a week. Doesn’t need to be fancy – it just needs to be done.

2. Targeted Mobility – Not Random Stretching

Still foam rolling your IT band into oblivion? That’s not the answer.

Instead, focus on:

Hip mobility – especially rotation and extension
Ankle dorsiflexion – big player in how your whole leg loads
TFL/quads release – if they’re overactive, your IT band will cop it

You’re not trying to become a yogi – just restore normal range and movement options.

3. Smarter Load Progression

Your knee might not be sore from today’s run – it’s probably the last 3 weeks catching up with you. Things to watch:

Sudden spikes in distance or intensity
Poor sleep, high stress (yes, they affect tissue recovery)
Cutting back on strength during race prep

Stick to gradual increases, build in recovery weeks and train like you want to be running in 10 years – not just smashing a PB next Sunday.

4. Better Mechanics = Happier Knees

Overstriding. Poor cadence. Slouching like you're carrying the weight of the world on your shoulders. It all adds up.

Small technique tweaks can reduce joint stress:

Slight forward lean from the ankles
Midfoot strike under your body
Cadence around 170–180 bpm (use a metronome app and thank me later)

When It’s Time to Get It Checked

Still hurting after a few weeks? Tried all the tricks and nothing’s changing?

Here’s your sign to stop guessing.

Knee pain that hangs around might need:

A tailored strength plan
Movement screening
Load management tweaks
A proper diagnosis (not just Dr. Google and wishful thinking)

Final Thoughts – It’s Not Just ‘Your Knees’

So whether it’s your IT band, your patella tendon, your quad tendon – or a bit of all three – the problem is rarely local. It’s a full-system issue and your knees are just the unlucky ones stuck in the middle.

New trainers are great. Rest days are helpful. But if you’re not putting in the work to build a stronger, more resilient runner — you’ll keep having the same conversation with your knees.