Knee pain while running isn’t normal and it’s not something you have to deal with day in, day out. A running physio can help you fix the cause, not just the symptom.
Quick Takeaways
It’s Not “Just a Sore Knee”
If you’re a runner in Rozelle or Panania who’s been brushing off knee pain as “just part of running,” we’re here to tell you.. it’s not. Your knee isn’t meant to hurt during your runs, after them, or while climbing stairs.
Pain is your body’s way of saying something isn’t quite right. It doesn’t necessarily mean something is damaged, think of it more as a warning light (like a check engine light in a car). And if you listen to it early, you’ll save yourself weeks (or months) of frustration down the track.
This blog is here to help you understand why that pain is happening, how a running physio can help, and what to expect when you come in for assessment and treatment.
Why Your Knee Hurts When You Run: The 3 Most Common Culprits
Knee pain in runners is rarely random. It’s usually the result of a mismatch between what your body is doing and what it’s ready for, whether that’s a lack of strength, poor running mechanics, or a sharp increase in training load. Below are the three most frequent types of knee pain we see in our clinics in Rozelle and Panania:
1. Patellofemoral Pain Syndrome (PFPS)
Also known as “runner’s knee,” PFPS is one of the most common injuries we see in runners of all levels. The pain typically shows up around or behind the kneecap and tends to flare with things like running downhill, squatting, lunging, or even just sitting for long periods (like during a car ride or at a desk).
What causes it?
The kneecap (patella) needs to glide smoothly within a groove in your thigh bone (femur). If there’s poor alignment or uneven pull from the muscles surrounding the knee (especially the quadriceps and glutes) it can cause irritation under the kneecap. Weak hips, tight quads, and poor running technique (like overstriding or knee collapse) are often involved, as these are all factors that can lead to excessive stress going through the knee whilst running.
What it feels like:
- A dull ache around or behind the kneecap
- Pain during stairs, squats, or after prolonged sitting
- Worsens with increased running volume, especially hills or speedwork
Why physio helps:
A running physio can assess your strength, mobility, and running technique to identify movement patterns contributing to the issue. With targeted hip and quad strengthening, cadence adjustments, volume adjustments and taping (in some cases), PFPS can usually be managed without long breaks from running.
2. Iliotibial Band (ITB) Syndrome
This one tends to sneak up on you mid-run, often in the outer part of the knee. You may feel great at the start of your session, only for a sharp or burning pain to kick in around the 5–10km mark, especially on long runs or descents.
What causes it?
The ITB is a thick band of connective tissue that runs from your hip to the outside of your knee. It helps stabilise the leg during running. If the glutes are weak or your stride mechanics are off (like a crossover gait or excessive hip drop), the ITB can rub repeatedly against the femur, irritating the structures underneath.
What it feels like:
- Sharp or burning pain on the outside of the knee
- Starts during a run and may worsen over time
- Often aggravated by downhill running or longer distances
Why physio helps:
Your physio will assess the stability of your hips and pelvis, check for movement compensations, and guide you through a progressive strengthening program. Contrary to popular belief, ITBs don’t need to be endlessly foam rolled, they need load tolerance and proper biomechanics.
3. Patellar or Quadriceps Tendinopathy
These tendon issues tend to affect runners who do a lot of hill work, sprinting, or strength training. Especially if you’ve recently ramped up your intensity. Pain is usually located just below (patellar) or above (quadriceps) the kneecap and may be worse at the start of activity or after a period of rest.
What causes it?
Tendons become irritated when they’re overloaded without enough recovery or foundational strength. A sudden jump in training intensity (such as adding stairs, hills, or intervals) is a common trigger. You might also notice symptoms when switching from base mileage to more explosive workouts.
What it feels like:
- Localised pain just above or below the kneecap
- Stiffness in the morning or after sitting, easing with movement
- Pain during jumping, running, or strength training
Why physio helps:
Tendinopathy responds best to a very specific kind of rehab. Not rest, not stretching, and not random exercises. Your physio will guide you through a slow, progressive loading program, adjust your training load, and ensure the tendon adapts properly over time.
When Should You See a Physio About Knee Pain?
If your knee pain:
…it’s time to book in with a running physio in Rozelle or Panania.
Even if the pain feels “minor,” early intervention makes a massive difference. It often means the difference between one week off or six.
How a Running Physio Finds the Root Cause
When you come to one of our clinics, we won’t just ice it and tell you to rest. We want to know why your knee is hurting, what we can do to fix it and how we can still keep you running during the rehab period (if possible).
That’s why we take a full-body approach. Your pain may be in your knee, but the cause could be further up or down the chain.
Here’s what to expect in your session:
1. Strength Testing with Dynamometry
We use specialised equipment to accurately measure the strength of key muscle groups — especially your glutes, hamstrings, and quadriceps. These muscles play a huge role in keeping your knees happy under load. Guesswork doesn’t cut it here, we need numbers!
2. Running Gait Analysis
We’ll film you running on a treadmill and break it down frame by frame. Are you overstriding? Is your knee crossing midline? Is your cadence too low? We’ll look for movement patterns that are increasing load on your knee.
3. Movement & Mobility Tests
Your knee might be working overtime because your hip or ankle isn’t moving well. We’ll check for mobility restrictions and compensations, things you might not even realise are happening.
4. Load History & Training Plan Review
Have you recently increased your mileage, added hill sprints, or changed footwear? Many injuries stem from too much, too soon, or too fast. We’ll help identify if your current plan is putting your knees at risk.
Your Rehab Plan: More Than Just Rest
Once we’ve figured out what’s going on, we’ll build a plan that helps you get back to running — not just pain-free, but stronger than before.
Your running injury treatment in Panania or Rozelle may include:
We won’t ask you to stop running unless we really have to. In most cases, we find ways to keep you moving so you can stay involved.
Real Results: What the Research Says
You want more than just our opinion, and we agree. Here’s what some of the latest evidence says:
- Barton et al. (2015) found that targeted strength and education programs significantly improve outcomes for runners with patellofemoral pain, especially when started early.
- A 2022 study by Rathleff et al. confirmed that progressive strength work for the glutes and quadriceps improves long-term knee function in recreational runners.
- Ferber et al. (2014) showed that gait retraining in combination with load management led to reduced pain and better outcomes for runners with ITB syndrome.
The takeaway? Good rehab isn’t about stopping. It’s about retraining your body to handle the loads that running throws at it — and do it well.
It’s Not Just Injury Care — It’s Performance Care
Even if you’re not injured, a running physio in Rozelle or Panania can help you optimise how you move, train, and recover. Knee pain might be the thing that brings you in, but the benefits often go far beyond that.
Many runners report:
- Better endurance and pacing
- Less soreness post-run
- Improved speed and efficiency
- Reduced risk of other injuries (like calf, hip, or shin issues)
Running is repetitive. Small problems turn into big ones if we don’t catch them early. That’s why we treat the cause, not just the site of pain.
Final Word: You Don’t Have to Push Through It
Running through knee pain doesn’t make you tough.. it makes your rehab longer.
If your knee is talking to you, listen. The earlier you get it checked, the faster you can get back to doing what you love.
Our team at iMove Physio and The Running Room are here to help runners in Rozelle and Panania move better, feel stronger, and run pain-free for the long haul.
Quick Recap
Ready to Ditch the Knee Pain?
Book your running physio assessment in Rozelle or Panania today. Whether you’re mid-training block, prepping for your first fun run, or chasing that next PB — don’t let knee pain slow you down.
