Is It Runner’s Knee or Something Else? How to Tell What’s Causing Your Pain

Knee Pain While Running? Let’s Figure Out What’s Really Going On

That dull ache at the front of your knee. The nagging discomfort every time you go up the stairs. Or maybe it’s a sharp pain that flares up after a long run. If you’ve felt any of these, you might be wondering: Is it runner’s knee, or is something else going on?

Knee pain is incredibly common—especially among active people—but not all knee pain is the same. While runner’s knee (officially called patellofemoral pain syndrome) is one of the most talked-about conditions, it’s not the only one that could be causing discomfort.

Let’s take a closer look at a few of the most common culprits and how you can start narrowing it down.

1. Runner’s Knee (Patellofemoral Pain Syndrome)

Where it hurts: The front of the knee, around or behind the kneecap
When it hurts: When walking upstairs, squatting, sitting for long periods, or after running

Runner’s knee is a broad term for pain that comes from irritation of the cartilage under the kneecap. It often shows up gradually and can worsen with repeated activity, especially movements that load the knee while bent—like going downstairs or sitting in a car for too long.

Common signs you might be dealing with runner’s knee:

• Dull, aching pain at the front of the knee

• Clicking or grinding feeling under the kneecap

• Pain that flares up after prolonged sitting or running

• Mild swelling around the kneecap

What causes it?
Poor alignment of the kneecap during movement is usually to blame, often due to muscle imbalances, poor hip control, or foot mechanics.

2. IT Band Syndrome (Iliotibial Band Friction Syndrome)

Where it hurts: Outer side of the knee
When it hurts: During or after running, especially downhill

The iliotibial band is a thick band of tissue that runs down the outside of the thigh and attaches near the knee. When it gets tight or irritated, it can rub against the outer part of the knee, causing inflammation and pain.

How it feels:

• Sharp or burning pain on the outside of the knee

• Pain that starts partway through a run and worsens over time

• Tenderness when pressing on the outer knee

What causes it?
IT band syndrome is often linked to overtraining, poor running mechanics, weak glutes, or lack of flexibility in the hips and thighs.

3. Meniscus Injury

Where it hurts: Deep inside the knee joint
When it hurts: During twisting movements, squatting, or pivoting

Your meniscus is the cartilage that cushions the bones of your knee. It can tear from sudden twists or repetitive stress over time.

Typical symptoms include:

• A catching or locking sensation in the knee

• Pain when squatting or twisting

• Swelling and stiffness

• A feeling that the knee might “give way”

Meniscus issues can range from minor to more severe, and while they’re often associated with athletes, they can happen to anyone.

4. Tendonitis (e.g., Patellar or Quadriceps Tendonitis)

Where it hurts: Just below or above the kneecap
When it hurts: During activity, especially jumping or running

Tendonitis refers to inflammation of the tendons around the knee—usually the patellar tendon (just below the kneecap) or the quadriceps tendon (just above it).

What you might notice:

• Localised tenderness

• Swelling

• Pain during or after high-impact activities

• Stiffness, especially first thing in the morning

This condition is common in sports that involve jumping, sprinting, or sudden changes in direction.

So, How Do You Know What’s Causing Your Knee Pain?

It’s not always easy to self-diagnose knee pain, especially since many of these conditions share overlapping symptoms. However, thinking about where the pain is, when it happens, and what movements make it worse can help point you in the right direction.

Still not sure? That’s okay. You don’t need to figure it out alone.

A physiotherapist can assess your movement, identify muscle imbalances, and guide you toward the most effective treatment plan. That might include:

• Targeted strengthening

• Manual therapy

• Mobility work

• Taping or bracing

• Activity modification to help you stay active while healing

Final Thoughts: Don’t Ignore the Niggle

Whether you’re an avid runner, a weekend walker, or just someone trying to stay active, knee pain is not something you have to put up with. The earlier you identify what’s going on, the sooner you can start addressing it—and get back to doing what you love without discomfort slowing you down.

If your knee has been bothering you lately, or if the pain keeps coming back no matter how much you rest, it might be time to dig a little deeper.

📅 Book an appointment at Proactive Physiotherapy and let’s figure it out together.

You take the steps—we’ll help make sure they’re pain-free.