Leila asks: I’ve got this problem—after I run, either the outside or inside of my knee hurts, sometimes both. I figure those bands are mad? But the thing is [there’s] no pain before or during [the run]. It’s once I sit down or stop moving for a while that it starts settling in. I’ll ice and use ibuprofen for a couple days after, then I’m good again. I go running: Bam, it hurts again. What’s going on?
Knee pain is clearly a problem for you and you may have to be seen by a medical provider who can take a full history and perform a physical examination.
The knee is in a difficult spot, as it transmits and distributes the forces of running along what is known as the kinetic chain. The knee is held together by four ligaments that can be stressed when running if your core and glute strength are not adequate to keep your pelvis level and your femur in optimum alignment.
Related: To Relieve Runner’s Knee, Strengthen Your Hips
There are a number of factors that can add up to knee pain when running that do not cause problems when walking or doing general daily activities. If your femur is not aligned, the stress on your kneecap can cause pain that presents in the front or sides of the knee. If your pelvis is not adequately supported during leg loading, or if you are not lined up correctly, the knee can “wobble” when you run (like a four-legged chair on an uneven floor) and it can cause pain in the ligaments on the inside and outside of your knee. A rotated pelvis will give you a functional leg length difference that can also cause pain in the knee. In addition, a hard heel strike while running can put extra forces through the knee and cause pain.
You can try strengthening with squats, starting with partial squats and progressing to full squats. You should keep your lower leg in a vertical position during the squat. If, strength-wise, you are not ready for that, hang on to the kitchen sink while you do the squats until you improve.
However, there may be other areas that need strength work. An evaluation by a physician or physical therapist who works with runners may get you through this quicker as a diagnosis for the pain will direct your care toward a better and more efficient outcome. Also consider investing in a personal trainer to help with strength issues.
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Get answers to questions on health, injuries and sports medicine from runner-friendly physician William Roberts, M.D. If you have a question for the Sports Doc, please ask it on our Health & Injuries forum.
