Running with bad knees

After about three years of laying off of running and focusing on swimming, I recently started the sport again. I stopped because of pain in my knees (mostly my right knee). But I’ve gradually felt an improvement in knee health, such as when I walk down stairs and stand from a low seated position.

With the pools closed, I thought I would give running another shot. For now, I’m running mostly just once a week and on grass for the majority of my run. I did a 5k run on the riverside paths and also about 3k at the track. So far so good.

I plan to get some Hokas for my non-grass runs. I took glucosamine sulfate about a year ago but did not feel any change. But it’s hard to say.

What else should I do? I want to continue running and do some sprint distance triathlons next year (5k run).

It’s more important that I maintain knee health than get faster. I can work on my swim and cycling speed. I’ll be in an even older group next year so I should do decently even with a bad run time.


What sort of pain do you have? Any medical diagnosis?

The general advice with knee pain and running is higher cadence, shorter stride, slow increases in mileage.


The pain is more after the run. I stopped because it scared me more than any type of unbearable pain. The pain is almost gone now but I want to be careful.

I’ll keep these things in mind. I do this now but I’ll be extra careful to not revert back to old habits. For distance, I’m doing a 5k run mostly now. I feel no need to increase the distance. Ideally I would do 6-10k to prepare for the triathlons, but I don’t want to push the running. I just want to make sure I can do the distance and not be sidelined because of knee pain.

What kind of pain, where in the knee?

It’s an overall pain. I suspect cartilage deterioration. My dad had that. And it’s why I took the glucosamine sulfate. I’ve never had a doctor look at it.

Above/below/behind kneecap, or inside, outside? Sharp, full, throbbing… That can help you a lot with figuring out what’s going on and off there’s anything else you should try…


In the front and kind of within the knee joint. A dull pain. Not throbbing. And after my runs in the past, some pain that made me careful about walking down stairs and doing other things because I would be stiff and in pain.

Not a medical diagnosis, of course, but generalized knee pain around the front of the knee after running that also results in pain going down stairs sounds like the common ‘runners’ knee’ diagnosis. Strengthening quads, buttocks is often recommended, along with stretching hamstrings and archilles. Cartilage deterioration often comes with some knee noises (but happens with runners knees sometimes too). A doctor’s looksie would, of course, be prudent if you’re going to do regular exercise on it.


Have you considered technique?

Also the shoes and weakness on any of the glute muscles can trigger knee pain.

Does the pain decrease with running in softer surfaces like grass or by stretching/foam rolling?


As others are saying, stretching before and foam rolling after will be very beneficial. Add in some glute strengthening exercises. The glutes are the main muscles to work on. Also, some leg days at the gym to strengthen the muscles around the knee. If no gym… Light (1 or 2 km) park or trail running to strengthen the leg and ankle muscles. The knee is giving you the feedback, but it’s in a relationship with your entire leg, and by extension, your body.
Also get a doctor opinion.
But mostly, protect the knee by strengthening everything it most directly connects with.
I’m suspicious of running shoes in general. I tend to go for flat runners, rather than all these fancy pants shoes. Look at what the athletes wear.


Yes, higher stride rate, lower stride length, and midfoor strike are my goals always. But I’ve been told my right foot landing is off.

I’m running on grass now and it’s working well. My stretching is bad. I will do more. Maybe daily.

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try to find a gym with an elliptical machine, I think that might help you out, get a compression knee brace. this machine does cardio but it also reduces joint impact on the knees.


Great! That worked for me too (IT band syndrome). Also doing glute strengthening excercises and one-foot balance ones.
In case you have already built scar tissue: manual massage and foam rolling with a lacrosse ball helped me a lot.

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I like the elliptical machine. I swing my arms as if I’m running, and I don’t hold onto the bars. It’s a good workout, but once the pools (fully) open, together with cycling, I’ll have plenty of opportunity to cross train and so will probably pass on these machines for the most part.


I do four things to keep my knees happy - the first when I run outside I’ve switched from road running years ago to trail running. I’m running much more on dirt, not on asphalt, on changing terrain that makes the run interesting and uses more varied technique. The second is to do more than half of my runs on a good quality treadmill with a fairly soft running platform, and only run uphill, all at 10 degrees (that took a while to work up to). The third is to run only on Hokas. And the fourth is to do lots of squats, including single leg squats, and lateral lunges. But if you already have a knee injury then I’m not sure if any running is OK.

If you want a great aerobic workout and are interested in a machine that has the flexibility to let your legs work a lot or not at all and rest and recover, then look for a gym with a SkiErg (ski ergometer) SkiErg Indoor Nordic Indoor Skiing Machine | Concept2 Ski. A number of private gyms in Taipei have one. I use one once a week and combine HIIT intervals with lateral lunges.


I wouldn’t immediately assume you have bad knees without professional advice.

Inactivity can result in knee pain especially if it feels like it’s under the kneecaps.

And especially possible during covid lockups.

Contrary maybe to common sense, exercising other leg muscles will have an overall benefit of resolving knee pain.

Even something as simple as doing three sets of squats with body weight everyday will help.

I went through this recently and thought my knees were getting bad. I did some research and started doing exercises to help the other muscles and within a few weeks my knee pain cleared up.

This after sitting and doing very little for a few months.


I’ve dealt with this for years. Kneecap is not tracking properly due to muscle imbalance in the quads. Normal quad exercises don’t always hit the crucial VMO muscle. That’s what you need to strengthen. What helps me is single leg drops standing on the edge of a step, plus stretching. Rear lunges are good too. Stay away from front lunges, leg extensions, or any other “traditional” quad exercises. Also, don’t try any exercises until the pain resolves. Cycling is great cross training.

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In my 30’s I started jogging when I was super over weight. After about 5 years my knees started to hurt so bad that I was wrapping them in ice and heat and using capsaicin cream after my jogs. It really seemed like my jogging days were over at this point, though I had just finished a marathon.

Then, for other medical reasons, I had to quit coffee for a while. The knee pain went away. Gone. None. I thought it was a fluke. I drank decaf and the pain came back. Stopped. The pain went away. I have tested this for 10+ years now and though you’ll not read it anywhere on the Internet, my own experience and love of jogging forces me to always recommend it when I hear of a runner with knee pain:

If you drink coffee, quit for a week or two. Just drink tea. See if it helps. I’m 53 and my knee pain is gone completely ever since I quit coffee. When I go back to coffee (because I miss it sometimes), the knee pain comes back.