February 16, 2021

Tips for Runner’s Knee While Training For A Marathon

In our blog, Meghan Taff, Netic PT, breaks down what causes runner’s knee, prevention tips, and more.

Susan Nowell

The marathon you’ve been training for is just 2-3 weeks away. You've long since paid the registration fee, invested in the right shoes, and tracked your training runs. But as you finish up your recent run, you notice something that wasn’t there yesterday: knee pain

The timing could not be worse. You’ve got a race in a few weeks! Now, what? 

In our blog, Meghan Taff, MPT, CSCS, Netic PT, was interviewed by PT Susan Nowell and breaks down what causes runner’s knee, prevention tips, other exercises and stretches to try so you can run healthier and happier.

Runner’s Knee

Patellofemoral pain syndrome (more commonly known as runner’s knee) is one of the most common types of running injuries out there. Basically, it’s generalized pain or irritation behind the kneecap. This is typically caused by training errors coupled with overuse. 

Training errors can include volume (increasing mileage before your body is ready, or adding aggressive hill training/speed workouts before your body is ready), imbalances in muscle strength and flexibility (weak hips/core, tight hamstrings or hip flexors), running gait factors (such as overstriding, low cadence), and extrinsic factors such has improper footwear and running surfaces (road, track, trail, banked surfaces). 

Since there are many different factors that can lead to runner’s knee, recovery can vary from person to person. It can also be used as a “catch all” for knee pain in general for runners and other athletes. 

“Because runner’s knee can mean different things for different people, it’s always important to talk to a medical professional to get a specific and thorough diagnosis and recovery plan,” says Meghan Taff, MPT, CSCS.

Recovery Starts With Prevention

The time to start foaming rolling is now, not after an injury. 

“If you’re not using a foam roller, start using it,” says Taff. 

She typically begins every call by asking her patients to double-down on their foam rolling exercises before getting started with anything else. 

“Most people have a foam roller and get excited when I bring it up. But when I ask how often they use it, people typically get quieter,” says Taff. “We’re kinda conditioned to be reactive rather than proactive when it comes to injuries like these.”

But soft tissue imbalances play a big role in injury prevention and recovery. In fact, working on your soft tissue first will help make your stretching more impactful.

“I have people complain that ‘my IT-band is tight and I stretch and stretch’. Once they start doing exercises with their foam rollers, they can release the soft tissue and stretch the muscles that feed into the ITB, which makes the relief that you get from stretching more long-lasting,” says Taff.

Dedicated Warm-Ups and Cool-Downs

How many hours a day are you sitting? 

8-10? Maybe more?

“You can’t undo 8-10 hours of sitting every day,” says Taff. “That’s why it’s so important to fully commit to warming up and cooling down when you exercise.”

Again like foam rolling, dynamic stretching helps alleviate some of the pressure and tension we put on our muscles and joints after sitting behind a desk all day. It pumps blood and oxygen into the muscles, increases your core body temperature and helps your joints run more smoothly – all while preventing injury during a run. 

“You’re not static when you run, so it’s important to get that blood flowing and muscles moving before you get your run started,” says Taff. “Especially since most of us are sitting for so much of the day.”

While every body reacts differently, after just a week of regular warm-ups and cool-downs, your body will feel the difference.

Here are 6 dynamic warm-ups that will help your knees
  • Knee hugs to calf raise
  • Figure-4 hip stretch
  • Lunge twist
  • High knees
  • Glute kicks
  • Grape vine

Taff notes that women can be more prone to runner’s knee, so it’s doubly important for women to take the extra time to warm-up to avoid injury. 

Experiment with Different Types of Exercise

You should already be tapering your runs if you’re 2 weeks out from a marathon. This alone plus your foam rolling and dynamic warm-ups can help you  alleviate your knee pain.

“If they’re paying attention, runners should drop their mileage in the weeks leading up to the race. They should be at about 40-60% their normal mileage in the week before the marathon.” says Taff. 

Still looking to stay active outside your easy runs leading up to the race?

While it’s imperative to speak with a professional, Taff has a few “knee-safe” activities she recommends to her own patients:
  • Running in water
  • Swimming
  • Cycling
  • Using an elliptical machine

Want more PT advice? Sign up for our 7-day free trial for a free conversation with a Netic PT.

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