When you start clocking up the miles, you may find that you start feeling niggles around your knee.
While pain in your calf is often a sign that you may need more cushioning in your running trainers, you have strained or you need to stretch, the dreaded ache at your knee may be caused by overtraining. If rest is not an option - say you’re preparing for a big event like a marathon or a competitive activity of any sort - it’s time to call in reinforcements to ensure that the niggle doesn’t turn into an all-out injury.
Always consult your physiotherapist or doctor before taking matters into your own hands. Medicinal inteference may be necessary but if preventative measures are what you’re looking for, you have come to the right place.
Compression sleeves are some of the most common forms of support and you will have likely seen professional athletes donning this sort of brace as they are a well-used tool at the highest level to shield against further injury. There are various levels, from the lowest compression slip-ons to limit swelling via the patellar brace to guide the knee into a straighter line, to the medial/lateral support brace that provides more intensive support to prevent the knee from caving in.
To find out more, we consulted Jonny Mellor, eight-time marathon runner (his personal best is 2:10:03), the 2020 British Marathon Champion, coach and a Team New Balance ambassador to find out his tips and tricks.
Mellor is not a physiotherapist, but instead shares his own experiences of what has worked for him as an athlete and coach.
How to prevent knee pain when running
- Warming up is key
Start by performing a warm up routine prior to running. I’d recommend dynamic stretching and activation exercises before, then ease into the run either with a brisk walk or slow jog. This will help prepare your muscles and joints for the demands of running by activating key muscles around your hips and glutes to provide control and stability for your knees as you run.
- Build up intensity gradually
Don’t increase training levels too quickly. Whilst running is a simple sport in that often the more you do, the better you’ll get, any increases to volume and intensity should be done gradually and progressively. A common symptom of doing too much too soon is knee pain.
- Pay attention to your running footwear
It’s also important to make sure you’re running in a suitable pair of running trainers. I would recommend a visit to your local specialist running retailer to look at your running gait (how you run) who will then fit you in a pair of trainers accordingly. It’s also beneficial to change your trainers on a regular basis, I know when I need to change my trainers as I start to feel the road more and start to notice niggles and aches. General guidelines suggest around 500-miles but always check with the retailer based on their brand guidelines.
- Switch up your running surfaces
Running off road can also help reduce the impact on your body and pounding your knees take when running. Vary your running so you’re running on different surfaces throughout the week to avoid doing all your running on hard pavements. I love getting out on the trail or running some easy grass miles to give my body a break.
- Proactive not reactive
Finally it’s always important to take a proactive approach to injury prevention rather than reactive, so visiting your physiotherapist for a general check up and MOT is a good idea to help spot things before they develop into more serious issues. A physiotherapist will also be able to suggest exercises to perform away from running to help strengthen the muscles around your knees, such as your quads, hamstrings, adductors and calf muscles. This will help provide control and stability whilst helping with knee alignment.
Should I run with knee pain?
This will depend on how much pain you’re in and where the pain is. If it’s below the knee cap I would recommend stopping your run and returning home to apple the RICE treatment (Rest, Ice, Compression, Elevation).
If it’s around the outside of the knee it’s often a result of tight IT bands, so try stretching the area and see if this makes any improvement to your symptoms. Consider changing the surface you run on and if you might be due a new pair of running trainers.
With all knee pain, if symptoms don’t improve through rest then I would always recommend seeking out a physiotherapist. Learning to manage what you can and cannot run through comes with experience so if in doubt, don’t be afraid to rest or cross train until the soreness improves. Often an enforced rest can be a blessing in disguise!
What to do when you get knee pain after running
I would follow the same protocol as above, in the first instance follow the RICE treatment protocol and if it doesn’t improve with rest and icing, seek advice of a physiotherapist. I would also look back at your training diary and look out for any signs of increasing your training load too quickly or a significant new stimulus, for example if you normally run on the flat and you’ve suddenly started to add hill work into your plan this could be a warning sign to look out for. Consider running your next few runs off road or back off your training a touch by reducing the volume to see if this reduces the soreness post run.
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HYDRAGUN HeatPulse knee massager
Never before has there been a more targeted massage treatment for your knee. HYDRAGUN is changing the recovery game forever with the creation of this new post-workout tool sure to be beloved by athletes the world over.
Place over your leg and the device delivers heat and vibrative pulses to counteract niggles that occur. While not a replacement for a good stretch after you exercise, it will help relieve stiffness and soreness when it occurs by boosting circulation. The sleek HeatPulse helpfully is cordless and is designed to create immediate pain relief without the need for a costly professional treatment or elbow grease.
There are five temperature settings (40-60oC), three massage speeds and the battery life should last up to 180 minutes. It is crafted from a lightweight and trademarked fabric that is soft on the skin and comfortable, while adapting to your body to create a customised fit thanks to the velcro fastening.
The brand suggests that it will also help with arthritic knee problems as well as recovery post-surgery.
Buy now £139.00, HYDRAGUN
Therabody Theragun Elite (RED)
Theragun is arguably the best known massage gun brand on the market and the Elite is its quietest device with extra built-in sound insulation for discrete pummelling either from home or the gym - though as this is a relatively large device you may want to look for something more compact if portability is a priority (the brand’s Mini may work if this is the case but more on that below).
With an amplitude of 16mm, this offers the deepest tissue massage of all its competitors, it also comes with five head attachments and five speeds, which are customisable either in the Bluetooth-enabled app or on the device’s screen, and a triangular ergonomic multi-grip handle that offers less strain when targeting hard-to-reach areas this is no doubt a powerful tool, yet feels gentle on the skin.
It is ideal for IT band stiffness as well as aches and pain at the lower back and all over the leg - including the knee.
The Therabody app hooks up to Apple Health and Google Fit to suggest recovery routines post-workout, which is a nice extra touch.
Buy now £375.00, John Lewis
Therabody RecoveryAir Prime
If it’s good enough for the professional athletes, it’s finding a way into our recovery arsenal. The Therabody RecoveryAir Prime is a game-changing device that uses the power of pneumatic compression technology to prevent DOMS after high intensity activities like running.
Unlike stretching or foam rolling, this is a passive technique that you can use while watching TV or unwinding before bed and so it is much more likely to be used if you’re someone who is time pressed or never gets round to actually doing the stretches.
It works by boosting your body’s natural ability to pump blood around the body and increases circulation through sequential inflations/ deflations and squeezing/releasing - a process that has often been used by physios and hospitals but is now available from the comfort of your own home. This encourages healing, flexibility and counteracts stiffness and swelling.
While not specifically targeted for the knee, it tackles the entire leg.
Buy now £599.00, Therabody
Patella Tendon Knee Strap 2 Pack
Small in size so as not to intefere too dramatically with your strides, these knee straps - when affixed into the correct position - offer stability and support for the kneecap to control the movement and prevent repetitive strain from occuring as you pound the pavement.
Place below the patella and they’ll also control the vibrations. The straps are made up of a breathable and sweat-wicking fabric and are personalisable in size with the velcro fastening.
You can use them for running, walking and hiking as well as the likes of weightlifting, football, tennis and more.
Buy now £12.99, Amazon
POWERLIX Knee Support
With almost 28,000 five star reviews on Amazon, this is one of the most lauded compression sleeves on the market. First and foremost, it has great customability with different sizes, ranging from S to XXL, to ensure a snug and supportive fit.
By incorporating this product into your training, it provides a stable pressure on the knee joint and boosts circulation to reduce inflammation and swelling. It has an elastic construction and a breathable fabric to prevent the build up of sweat as you run faster and for longer.
Buy now £11.04, Amazon
Neo G Knee Support Open Patella - Knee Brace
This open design offers more security for the front of the knee joint that will be welcomed by runners who are experiencing pain or have had a meniscus tear. Through the velcro fastening, you can tailor the level of compression to provide stabililty and reduce stress on the area. The brace itself is made from neoprene that helps to keep the muscles warm.
Buy now £15.99, Amazon
FORTHiQ Cordless Knee Massager
This device may look like its fallen off a Stormtrooper but it is, in fact, a massager for the knee area that you can pop on at the first sign of trouble and make the most of the three vibration modes to reduce swelling.
It is also heated, providing infrared or laser lighting, to relieve stiffness. The massager goes around the patella and doesn’t include the front but works great for pain relief that can be caused by a torn ACL. The device is easily programmed through the touchscreen.
Buy now £89.99, Amazon
HypaGel Hot/Cold Therapy Pack with Compression Cuff
As soon as you start to feel pain in your knee, call in the healing reinforcements of this ice pack. As Mellor explains, RICE (Rest, Ice, Compression, Elevation) is essential so for the second step, this pack will work wonders. It comes with a handy compression cuff and can be used hot or cold.
Buy now £9.57, Amazon
