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What Your Doctor Isn’t Telling You About Runners Knee And Chronic Knee Pain (And The 5 Keys to Fixing It)

Runners Knee And Chronic Knee Pain

Dangit, My Knee Is Hurting Again

For years and years I had chronic knee pain and runners knee – even though I wasn’t a runner.

I didn’t run long distances. I wasn’t overweight. And I didn’t even eat an unhealthy diet – which is why I was a little puzzled as to why I was suffering from chronic knee pain.

I had pain for about 3-4 years, and around the 4th year is when I started weight lifting and doing leg exercises.

But the pain started getting even worse and led to overuse injuries like tendinitis and chondromalacia.

So I did what everyone does – I went to the doctor.

… And he was pretty much as useless as can be.  He wasn’t exactly well-versed in sports medicine and just told me to “stop doing what hurts” and “ice it.” Stuff I could’ve Googled without a $50 co-pay.

So like most people do, I ignored it. A few months later I joined the college crew team and we started to train 5-6 days a week, which included running, and later, a lot of pain for me.

I asked some other people on the team what was going on, and another guy said, “Got that hollow feeling under your knee? Yeah man me too, knees are weak, ya know? It’s just that damn runners knee.”

“Knees are just weak? BS.” I thought to myself.

Interestingly enough, I hear this “shoulders are unstable,” “knees are weak,” garbage all the time.

How could a body part so essential to daily life (like a knee) be inherently weak? How could be it so prone to injury? Obviously, people before us weren’t training like pro NFL guys, but come on.

Through later research and many years of testing, what I found was pretty interesting and also permanently fixed my knee pain.

For many of you – this guide may fix your chronic knee pain and runners knee, or dramatically alleviate the symptoms and pain.

I know that’s a bold claim seeing as many of you ice your knees on a weekly basis, tape them, massage them, or have been told you need a knee replacement, but I’m hoping that this will open up your mind to a deeper understanding of your joint health.

The Bee’s Knees – Knee Anatomy 101

Knee Anatomy - Knee Pain - Runners Knee

To help you understand exactly how the knee was designed to work, let me give you a brief intro on knee anatomy.

The bones - Above the knee is the femur; below the knee are the Fibula and Tibia.  In-between everything there are four ligaments that hold it all together and keep it loaded properly.

The tendons - Above the knee (attached to your quad muscle) is the quadriceps tendon; below the knee (linked to your kneecap) is the patellar tendon.  This is usually the area you feel “hollowness” in (chondromalacia) if you do too much mileage running or have bad form/loading patterns.

The ligaments - There are four ligaments – think back, front, left, right. That’s pretty much a dumbed down explanation of the ligaments. They basically restrict movement and make sure everything stays lined up properly. If it doesn’t, you are putting weight on the knee in a way it was not designed to load weight (and thus having pain, and injury)

Meniscus - Some padding in the center of the knee to function as a shock absorber.

The knee is a stability joint. It is not meant to be very flexible.

It is meant to just bend straight up, and straight down, with very little rotation.

That is all fine and dandy, but there are a couple problems that lead to the knee not bending straight up and down, but rotating.

What I’ve found is that tendonitis, like in many other parts of the body, is usually do to improper biomechanics (movement and form), rather than just overuse.

With knees it could be the case that you are a long-distance runner, but in my experience (after having this for years) I’ve found that tendonitis usually only happens in one knee (or in one elbow, or shoulder, or bicep), and it will happen repeatedly. In other words, it’s a pattern.

And after much research I found that these patterns are usually linked to poor biomechanics. Once you fix those, you stop getting it as much (or it improves/goes away completely).

You Might Have Knee Pain And Runners Knee If…

Runners Knee And Chronic Knee Pain

There are a couple criteria I’ve noticed in people with knee pain.

I’m not going to state the obvious like being overweight, getting too much exercise, etc.  We all know that excess weight is excess weight. And we all know that running 100 miles is a lot for anyone.

A. You have everted feet (feet that point outwards)

Why: Foot eversion is one of the many ways that your body compensates for having terrible alignment, usually caused by muscle imbalances, activation issues, tightness, etc. It’s your body’s attempt at still somewhat maintaining proper biomechanics. It’s like if you injure your knee, when you step down the stairs you try to use your hip more to compensate.

If your feet are everted more than 10-15 degrees, it’s very unlikely that you knee is loading weight properly.

B. You have previously injured an ankle or a hip.

Why: Studies have shown that if have an injury (e.g. ankle), it tends to decrease your proprioceptive abilities after that. In other words, if you injure your ankle, you can’t balance on that ankle as well afterwards. You need some re-training and conditioning.

Remember that the knee is just at the mercy of what happens around it: if the ankle or hip has lost flexibility, that has to go somewhere, and the knee suffers.

C. You sit all day and started exercising again, or started exercising more frequently (tight hips and groin muscles anyone?)

Let’s face it, sitting sucks, and it is part of this chronic pain epidemic. Sitting by itself isn’t the culprit, but sitting (and lack of movement) is one of the origins of tight muscles and tissues around the hips.

What I’ve found is that, due to a combination of things, the shortening of certain muscles prevents the lower back from maintaining it’s natural arch, leading to chronic lower back pain (just when sitting, or even when running, squatting), as well as knee pain.

[ Side note: I've written a three part guide for how-to fix chronic lower back pain. Oh, and these are things THAT ACTUALLY WORK. Unlike 999999% of the crap on the internet.  Use this post for immediate relief, and then this one and this one to understand and prevent it in the future. ]

The Master Plan (The 4 Part System to Fix It)

Alright, I’ve found that 4 things are the most critical in fixing knee pain / runners knee and again I have used this exact process to step by step fix my chronic knee pain:

  1. Work on your ghetto booty (Strengthen that butt)
  2. Improve hip flexibility
  3. Improve ankle flexibility (history of everted feet, achilles injuries, shin splints?)
  4. Trigger point therapy & self myofascial release (self massage)

Let’s start talking about each one and why they are absolutely critical to preventing knee pain in the future.

A. Work That Booty! The Biggest Thing You Can Do To Fix Knee Pain is Strengthen Your Butt – Here’s Why

I was terminally skinny. My entire life.  I’m talking, 145 pounds at 6 foot 2, skinny.

When I started doing butt exercises (to fix my knee pain) I put over three inches on my butt in about 9 months.

Talk about a ghetto booty. And yes, women loved it.

But seriously, I’m going to show you right now why your butt is so important in regard to knee pain, and why so many of us need to work on that.

Gluteus Maximus - Knee Pain - Runners Knee

Gluteus maximus. Notice the attachment points going down the side of the leg towards the knee (IT Band area). Wikipedia

Gluteus maximus. What does that make you think of? (As a kid I always thought that was a cool name like Leonidas. Leonidas Maximus.)

Your glutes are the powerhouse of your lower body. Many people seem to think that the quads are, because we live in a quad-dominant world where everyone has tiny butts from sitting all day and lack of activity.

But believe it or not, the gluteus maximus is really the central strength point of your lower body.  That’s where real power and strength originate from.

In your case, the gluteus maximus also helps control rotation of the femur (your upper leg) which influences your knee alignment.

Remember what we talked about earlier?  Your knee is designed to just bend up and down, with verrrrry litttle rotation. 

A weak butt permits more rotation in the femur than usual. It causes the your upper leg (the femur) to rotate inwards, and the fibula and tibia will try to compensate by rotating outwards and rotating the feet outward.  Ideally your knee would point straight forward, and the foot would load the weight evenly, so when you look at your leg as you walk, it would just bent straight down.

Try this! Just take 30 seconds and walk around your house naturally – my own knee (the one with a history of trouble) slightly rotates inward with each step. Bad!

In fact, a study done supported this whole glute-knee pain relationship, which found that female runners with the lowest glute activation had the highest rates of knee pain and chondromalacia.

It’s also a win-win that no matter if you’re a man or a woman, getting a bigger, firmer bootay will only be a win-win situation.

I made a nice little video for you below, showing the exercises to do. I would suggest doing 4-5 sets of each exercise for 8-12 repetitions, 2x a week if you find the time.  They don’t take too long.

Butt Exercises (see video)

  • Glute bridge
  • Bird dogs
  • Lunges
  • Single leg deadlift

B. Work On Your Splits & Stretch the Hips

Hip Muscles - Knee Pain - Runners Knee

The muscles surrounding the hips have lots of shared attachment points with the femur, and the knee.

Alright – so the first thing you absolutely need to do is work on getting that ghetto booty. Your girlfriend/boyfriend/husband/life will love it, AND you’ll also fix that knee pain. It’s really really important, and it will also help if you have chronic lower back pain.

But that’s not all.

You also need to improve hip and ankle flexibility – here’s why.

The knee is a stability joint, meant to just bend up and down (and not rotate much).  When there is not enough flexibility in the hips or ankles, that rotation has to go somewhere when you engage in some movements, and the knee starts getting rotation which = pain, dysfunction, and injury.

The hip muscles are closely linked to the gluteal muscles, in regard to how they influence your walking gait, leg rotation, etc.

The hips (and the ankles) are also designed to be flexible.

We can compare the hips and shoulders for a second, because they are both ball and socket joints, and thus are designed to be flexible.

Say you’re running on a track, or jumping, or lunging, or running left and right through an obstacle course – there is obviously some left and right motion (and rotation) going on there. Ordinarily the ankles and hips will bend and rotate to accommodate that change in motion.

But if your hips are too tight, and your ankles too inflexible, the knee is being forced to be flexible which = baaaaaad.

We already established how important your butt is, and having proper gluteal activation right?

As it turns out, having tight hip flexors prevents maximal glute activation too.  Some people find out that they have weak abs, and tight hip flexors, when they go into a deep squat and feel it more in their hip flexors and quads rather than their butt.

So we’re going to include a bit of hip flexor stretching in this part as well.

The video below will show the hip and groin stretches that I recommend.

Hip & Groin Exercises (see video)

  • Hip flexor stretch
  • Front lean split stretch
  • Side kung fu stretch

C. Improve Ankle Flexibility

Your feet and ankles are the bottom of your kinetic chain. If your ankle is not loading weight properly, that messes up everything above it.

Unfortunately we live in an era where foot and ankle dysfunctions are rampant.

One massively common dysfunction today is called pronation distortion syndrome — characterized by foot pronation ( flat feet ) and internally rotated knees.

People who have this (and believe me, it’s a large percentage of us) typically suffer from the same, repeated lower body injuries, like: Plantar fasciitis, shin splints, patellar tendonitis and lower back pain.

This is due to a lot of things, but the reasons for improving the flexibility of the ankles are the same: remember that the knee is meant to be stable, not flexible, and that ensuring ankle flexibility will make sure that it transfers any load rather than passing it to the knee.

Here are 3 ankle exercises I recommend.

Ankle and Calf Exercises:

  • Calf Stair stretch (2 sets of 30 seconds on each side)

Calf stair stretch

  • Strap Calf Stretch (2 sets of 30 seconds on each side)

Calf strap stretch

  • “Lean in” calf stretch  (2 sets of 30 seconds on each side)

OLYMPUS DIGITAL CAMERA

Part D. Stretch Those Quads

Quad Muscles - Knee Pain - Runners Knee

Alright, remember back up in part 1, how the knee has a couple tendons and ligaments attached to it?

On top of the knee is the quadriceps tendon — basically the top, center part of the leg going down to your knee cap.

By stretching that area out it will relax some tension throughout the knee, and will also reduce some symptoms for those of you with IT band issues or pain around the outside of the knee (more so if it hurts or is tight right around the knee).

Quad Exercises (see video)

  • Standing quad stretch (2 sets 30 seconds each side) 
  • Enhanced quad stretch (2 sets 30 seconds each side)

Part F. Fix Tension: Trigger Points & Myofascial Release

Unfortunately the internet is filled with a whole bunch of garbage.  For knee pain, most of the websites list the same crappy exercises and stuff – which usually just is the same stretches over and over (hip flexor, hamstrings, IT band stretches, blah blah).

I’ve tried them all, and most of the stretches that people recommend (by themselves) didn’t provide more than a few minutes of relief to me.  Take it for whatever it’s worth.

It’s gotta be a multi-faceted program to try and re-establish proper biomechanics – remember, that’s what this is all about.

Stretching is great for short term relief, and I’ve found it to work sometimes, but without strengthening weak and inactive muscles (like your butt), I hasn’t provided much long-term relief for me. But that’s just my 2 cents.

In any case, I have previously talked about my success with using trigger point therapy and the Egoscue method to beat chronic back pain (in combination with stretching, myofascial release, strengthening muscles, etc.).

The same is true for fixing your knee pain. There are a number of trigger points that develop around the knee and quad which you can self massage into oblivion, providing fantastic relief from pain. Stretching doesn’t fix trigger points necessarily. Here are the exercises I recommend (Myofascial release – obvious short term relief; trigger points – maybe not so obvious).

Myofascial Release (see video)

  • For quads (2 sets of 30 seconds on each side)
  • For IT band (2 sets of 30 seconds on each side)
  • For calves (2 sets of 30 seconds on each side)

Trigger Point Therapy for Knee Pain (see video)

  • Vastus Medialis (massage throughout the day, 10-15 deep, slow strokes each time)
  • Vastus Lateralis (massage throughout the day, 10-15 deep, slow strokes each time)
  • Rectus Femoris (massage throughout the day, 10-15 deep, slow strokes each time)

Part G. Tendinitis, Chondromalacia, etc?

Usually a pretty good indicator that you are doing some kind of activity with improper form or bad biomechanics is tendonitis.

If you go to a doctor, he/she will tell you it’s an overuse injury and to just rest. But if you go to a sports person, they’ll tell you to fix your form and lay off it when it hurts.

I’m inclined to believe “overuse” injuries are more form related than anything (unless you really are training 7 days per week, or multiple hours a day).

For example, I’ve gotten tendonitis in my left knee, as well as in my left elbow (as well as bicep).  These areas seem to repeatedly get it, despite the fact that I do equal volume on both sides of my body.  And I know that my left side has some bio-mechanical issues. Whatever the case, many of us get injuries in patterns.

Maybe for you the story is similar.

The origin doesn’t matter honestly, because the advice is the same: even though I know you probably won’t, you need to rest tendons for them to heal. They have very little vascularization, which is why healing takes forever.

But for those of you that are active, athletes, or love what you do… I know you aren’t going to take time off. So here’s what you do.

A. Reduce your volume a bit. Whatever it is – weightlifting, tennis, construction – just do less of it. Stop doing the things that hurt.  If you play tennis 3 hours a day, play it for 1.5 hours. If you usually curl 30 lb dumbells and you have biceps tendonitis going down into your forearm, suck it up and curl 15′s.  If you usually do 100 lunges, do 50.  If you usually run 30 miles a week, cut that in half.

B. With that extra time, fix your form and biomechanics. 

Fixing biomechanics usually has a couple key things (that we covered here, but also cover in the back pain course, the weight loss course, and in the monk’s courtyard).

  1. Stretch the shortened muscles (improve flexibility around joints – e.g. stretch the hips)
  2. Strengthen weakened muscles (e.g.strengthen your butt)
  3. Use massage methods like trigger point therapy and myofascial release to fix aches and pain (e.g. massage the trigger points along the IT band and quads)
  4. Fix biomechanics using methods like the Egoscue method, and the Gokhale method

I’ve found that specific types of exercises and weightlifting repeatedly gave me tendonitis, and as soon as I closely evaluated my form (like on squats, dumbell curls, etc.), I stopped getting tendonitis. But if I became sloppy again or increased the weight too much, it would start burning and coming back in the exact same spots.

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I systematically tested many many many things I found and researched, and came up with a step-by-step method for fixing my knee pain.

The only time it comes back is if I haven’t been stretching regularly (since I’m always working on my booty ! ), and it’s never even remotely close to what it was before.

Try this out and let me know if it helps!  Shoot me an email too if you have any questions.

My 2 cents!

–Alex

Images: Quadriceps Tendon, Calf Stair Stretch, Strap Calf Stretch, Lean in Calf Stretch, Flowers, Female Runner, Person Walking

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179 comments… add one

  1. Dude, Good job on the article. I’m going to try this out. Can I make a suggestion? Please redo your videos. You are way too close to the camera. I can’t even see what you’re doing in many of the exercises. I mean I get the basic idea of what you’re doing, but sometimes I can’t see your lower half and see how you’re positioned. Other than that, there’s some great info, I’m going to try it all out.

    Thanks!

    Reply
    1. Hey Nate -

      Haha no problem! Thanks for the honest criticism – I thought about it the first time around, but will re-do them with more space. Cheers.

      - Alexander

      Reply
      1. I have been a track runner for 2 years now and i keep getting knee pain all the time i don;t know what to do about it our person trainer said to workout but I just had more pain and today well i was running both of my knee started to hurt really bad but My left knee felt like I was going to clasp on the road so do you think i should go to doctor about it. thank you so much.

        Reply
  2. Very well done mate, for beginners (like myself) just getting the first knee aches from sudden wannabe Seal-like running exercises in forests after many years of doing nothing (like myself here lol :D) this page and your nice way of explaning things is just priceless information about the fundamentals of the problem. Probably the first time I can find the knee actually fascinating in some way after this. Thanks, and maybe I’ll be switching the maximum runs into swimming for a week (?) to get rid off this little flashes in my right knee during hard pressure. Couldn’t believe it could even be related to my hips etc in any way. Wow, I do walk with my feet quite outward too….yikes, I’m screwed probably. Want to get running again. ;)

    Reply
    1. Hey Aleksi,

      Seal-like running exercises haha, what an awesome visual.

      Haha no worries, just take it easy and when you can, try to get some time to improve hip and ankle flexibility, and work on those butt muscles. Doing some lunges, squats, or deadlifts will help with that. Swimming is a great idea!

      Shoot me an email if you ever have any other questions.

      Best,
      Alex

      Reply
      1. Hi Alex, haha yes exactly, slightly midrange soggy male jogging/walking in the forest with the totally blank stare from ultimate max effort, inner voice still screaming “the only easy day was yesterday, learn to love pain, you can do it and you KNOW IT” haha :D But hey, whatever works, right! Thanks Alex, you’re the man, I’ll be happy to contact you if something comes up. I’ll try the advices!

        PS. To everyone else also, I stumbled across this “4-step Seal mind technique” article for mental toughness and it really did change my own life in terms of self-image, selk-talk and self- motivation. It’s truely amazing how you can push yourself through almost anything with very simple steps. (These got myself out of the sofa into forests and swimming pools so something’s surely up)

        http://peakperformancetheblog.blogspot.fi/2010/11/navy-seals-understand-and-use-mental.html

        It works in daily life too, like example going to the post office by foot for many kilometers etc and carrying a ridiculous sized box back home etc. Happy hunting, hopefully everybody finds their own “inner voice” through something. :-) Cheers!

        Reply
  3. So refreshing to get advice from someone that suffers from runner’s knee rather than the ‘rest it’ health professionals who have no idea what it feels like. Since going through childbirth twice, I tend to scoff at pain and push through any discomfort I’m having, but my right knee is too bad to ignore now that I’m running longer distances (15km+). Some of the other websites suggest its the camber of the road I run on but after doing your little ‘walk around the house for 30 seconds’ test, I can see my right knee points in slightly. My gluts are practically non-existent and I would never have figured out that it was a contributing factor to my knee pain, but it absolutely makes sense. And your explanations are so straight forward. I’ve taken all your advice and exercises on board and I will keep you posted if I have any improvement. If they have worked for you then there is no harm in giving them a go. Thanx!

    Reply
    1. Hi Harmony,

      Haha you’re welcome :). Yeah, I definitely would not suggest ignoring pain. It’s there for a reason – something is not working right.

      Definitely let me know how it goes! Work those glutes — the more, the better. And then make sure to improve hip and ankle flexibility. Anytime my knee pain comes back, it’s because I haven’t been regularly stretching my left hip and left ankle (both have a horrible range of motion). Within a few days of stretching them, I’m back to normal. It’s amazing.

      Feel free to shoot me an email if you have any questions!

      Best,
      Alex

      Reply
      1. Hey Alex,

        Just wanted to get back to you with my progress. Started off with super setting all your exercises and stretches in 3 sessions a week for the first fortnight and doing the trigger point and roller massage in the evenings maybe 3 times a week too. Had improvement from the end of that fortnight so cut back to super setting the lunges and single leg dead lifts as well as all the stretches (except for the kungfu stretch which doesn’t do much for me) just before my runs 3 times a week as well as 20 mins of the stretches after. I also included a pretzel stretch in the routine to stretch my glutes as they were getting tight. I still do the trigger point most nights and the rolling massage maybe twice a week. Anyway, my knees have improved in leaps and bounds and I just completed my first half marathon! I can’t believe I was ready to give up running before reading your blog. I nearly let my knee pain sink me into a depression, but you saved me. It was an effort at first integrating your exercises into my schedule but now they are part of my routine I can’t believe how simply this pain was fixed. Thank you so much for your invaluable advice. You are a saint for sharing! You’re a champion!!! :)

        Reply
  4. What I sometimes get after dancing Flamenco is pain right around the patella. It feels as though it is displaced, but if I attempt to move it around slightly, the pain doesn’t go away. It simply goes away with time. It doesn’t happen after every practice either. I’ve tried to pinpoint the cause, but either I don’t pay attention to what I’m doing or I’m not really sure what to pay attention to.

    My knees might be rotating slightly because of bad technique. If I’m not squeezing my butt muscles, or bending my knees enough, or if I’m bouncing up and down too much, the force I experience in my legs after powerful stomps might not be evenly dispersed throughout my legs. My knees might experience too much of that force resulting in a slight rotation. This is speculation, but I’ll try some of the things you suggest and see how it goes.

    I didn’t know that the cause of the pain could be that the knee is rotating when it shouldn’t really be doing that. It could also be a flexibility thing, but I’m not so sure that that’s my problem. Anyway this gave me a new perspective on the pain and how to avoid it.

    Just know that you might helping dancers, too! Thanks for this post!

    Reply
    1. Hey Antonio,

      Cheers! Glad you liked it. Definitely let me know how it’s going. I also tend to get knee pain from another rotational sport (Judo). We’ve gotta be extra careful because we often don’t even realize we’re doing it.

      Best,
      Alex

      Reply
  5. You gave me great help, thank you very much! Been starting to practice martial art at home recently, stopped for many years ever since I was a kid. Now my right knee to start to feel pain whenever bending my legs. Your article reminded me that I forgot to practice the most essential basics in martial art, stretching. After this knee pain lesson, I will remember how important it is to warm up before any exercise.

    As for the Myofascial Release exercises in your video, I do have a alternative recommendation for such exercise, and this is a very common stretching exercise in martial art practice and ballet dances. Place one of your legs on a counter (table, balcony fence etc) that is about the height of your waist that your two legs would form almost a 90 degrees angle. Hold it for as long as you can, this will greatly help stretch the whole lower body. For more advance, try to touch your toes with you hand and your head and back bend toward the leg on the counter.

    Once again, thank you Alexander Heyne!

    Reply
    1. Hey Ivan,

      Aha, a fellow martial artist!

      I agree, that is a fantastic stretch for the hamstrings and hips. I use it every day myself – it’s great because you can do it while working if you use a standing desk.

      Feel free to shoot me an email if you have any other questions!

      Best,
      Alex

      Reply
  6. Yikes~that’s a lot of information! But appreciated. I pulled my groin in february and since I’ve started running again, I started to get bad knee pain. I was doing 15 miles a few times a week when it happened, and now 9 or 10 make my knees hurt – but they never used to. Is there something I can focus on, or do you just recommend it all?
    Thanks for the videos – they really are helpful.

    Reply
    1. Hi Farah,

      In a nutshell: Make sure to do butt work (butt work – not leg work) 1-2x a week. And then stretch your hips and ankles regularly (improve their range of motion). Within a week or two you should see improvement from the stretching work. Give the butt a few weeks to get stronger and then keep going.

      Sums it up! :)

      Best,
      Alex

      Reply
  7. What a great article! Well done Alex for writing this. The whole knee pain (I get in my left knee) makes much more sense now…
    Off to work my butt off now ;)

    Reply
    1. Hey Preeti

      Haha, you’re very welcome. Let me know how it goes!

      Best,
      Alex

      Reply
  8. Alex,

    After two intense sessions of your recommendations, I was able to run again…incredible!

    All this made me realize I’m not in shape or flexible like I need to be. So even though I can run again, I’m going to continue your recommendations and add some light weight training.

    Thanks again,

    Xavier

    Reply
    1. Xavier,

      Awesome! These are the messages I love hearing from people.

      Definitely keep me posted with how your knees are doing and how your runs go. Great to hear from you.

      Best,
      Alex

      Reply
      1. Alex,

        Turns out, I had two issues.

        The first one I fixed. It was a tight knot on the inside of my right leg.

        The second one I’m still working on. It’s another tight knot that is on the top of my right thigh muscle. This one is taking longer to fix.

        Today I start week three of my PT.

        Xavier

        Reply
        1. Hey Xavier,

          Fantastic! Keep me updated with how it all goes. When you say on the top of the right thigh muscle, is it the same one I described in the trigger point video?

          Best,
          Alex

          Reply
  9. Alex,

    Great page, it’s nice to finally see an explanation for why things are going wrong and why the methods you put forward work, instead of blindly following exercises with little success. I’ve just begun doing the things you recommend and mostly it’s gone well however I end up feeling most of the ghetto booty exercises in my quads. I know it might be difficult to put forward advice if you can’t see what i’m doing wrong but is there any advice you can give me? Thanks

    Reply
    1. Hi Nils !

      This is actually very common.

      The way to make sure your butt is getting stronger, rather than your quads, is to slow down the movement and do these two things:

      Make sure your weight is on the heel of your foot, on the back, rather than the toes on the front. Drive by pushing up with the heel.
      Think about mentally using your butt to push up – not your quads. Usually if we just push up without thinking about it, we’ll use our quads since those muscles tend to become dominant. Imagine that your butt is pushing up, and surprisingly, your butt muscles will activate much better.

      Hope that helps!

      – Alex

      Reply
  10. My doctor told me I have runners knee and he gave me some exercises…which didn’t seem to help all that much. So your page is a huge help! I am 15 so I have to do lots of running for sports and my knees hurt so badly after that I have to take Aleve and ice my knee for a long time. My knee is especially bad after tumbling practice. I was wondering if you found any braces or wraps that worked well because I need to be able to complete my workouts without having to stop so many because of my knee. Thank you so much for these exercises! I am going to follow your advice so hopefully I can run the Color Run next year!

    Reply
    1. Hi Caitlin,

      Personally I haven’t tried wraps (although I’m going to get some myself soon, I do judo). Just remember though that they will only slow down whatever damage is happening. Chances are wraps will only help in a very minor way.

      - Alex

      Reply
  11. Thanks so much for all of this information. I always wanted to “be a runner”, and by training over the last few months, I am on my way to that goal. However, I also developed some really painful tendonitis in my right knee. I’ve looked all over the Internet and spoken to professionals about it, without much help, but I’m definitely going to try all of your suggestions. I even took notes in my phone so that I can look back at them at the gym, haha!

    Thanks again!

    Alex (the female countertype)

    :)

    Reply
    1. Hey Alex,

      Haha let me know how it goes! Shoot me an email if it still gives you any problems.

      - Alex

      Reply
  12. Thanks for the insightful information! I have had left knee pain for a long time now and when I finally decided to follow up on it a few months ago the doctor recommend an xray and the results came back with nothing wrong. I was told it was ligaments rubbing together and he printed me off a bunch of stretches. I was meant to leave for the military a month ago and when I told them about my knee pain on enlistment day they would not let me go without seeing a sports physician (even though it was cleared by a doctor). Turns out my problem is exactly what you’ve stated on this website and now I have to undertake 3 mnths of physio before I can go. To say I was shattered is an understatement. My xrays clearly showed my knee problem. Its so frustrating that it took a sports physician to point it out!! My main concern at the moment is my knee feels worse now then before i started physio and stretching. Now it hurts during my jog and I can’t finish whereas before it used to hurt after a jog.. but I could always complete it. Is this to be expected??

    Reply
    1. Hi Cassie,

      That doesn’t sound good.

      Where specifically does the knee hurt? Maybe I can help give you more specifics.

      - Alex

      Reply
  13. Hey Alex,

    Just started running after a long break, abd started to experience pain in the left knee – kinda hard to pinpoint but it was deep and behind the cap, towards the inside of the leg. Like your post, some of the most practical info I’ve come across.

    Here’s my 2 cents worth:

    Stimulating Liver 11 (acu point in the groin that travels down the leg – see Deadmans, Manual of Acupuncture) has had a big affect on clearing the pain for me.

    Points open by using meditative attention, or by an acupuncturist, acuenergetics practitioner and by accupressure.

    Cheers

    Josh

    Reply
    1. Hey Josh,

      Sweet, that sounds awesome I will definitely try it out! Is there an online version of this manual?

      - Alex

      Reply
  14. Thank you so much Alex!!! Great great article

    Reply
    1. You’re welcome Tulga :)

      - Alex

      Reply
  15. Honest to god I have never really been to a health professional about problems with my knee. The most I did was see a physio about 3 years ago when I first had issues with it, his advice was on the right track (included the stretches) but nothing else. It’s incredibly refreshing to see a proactive and targeted approach to addressing this issue, it’s definately helped me with my marathon training.

    One thing I’d probably alter though would be to hold the glute bridges a little longer. The ‘couple of seconds squeeze’ and back down again is great for if you’re feeling stiff before a run, but to strengthen, either hold it for at least 10 seconds, or rest your calves on a swiss ball and hold it for longer. That REALLY puts some power into your glutes.

    All in all this is a great article though and I’m currently sharing it around my running club. Thanks for doing a great job and I hope to see you tackling many more 21st century ‘injuries’ to get more people off the couch and out exercising!

    Cheers!

    Tom

    Reply
    1. Hey Tom,

      Totally agree with the glute bridges. Honestly, if I were personally training someone in person I would go on to real glute development exercises like box squats or prison squats, but for some people they’ll just end up over developing their quads and not focus on the gluteal muscles. Barbell squats will give you a ghetto booty real quick haha. WHen I first started squatting I tore several pairs of boxers mid-squat, before finally learning to wear spandex underneath my gym shorts. Ahhh, the rookie mistakes.

      Thanks for stopping by!

      - Alex

      Reply
  16. Great article and it’s basically a round-up of what I’ve been learning since my left knee really started giving me jip. I started playing roller derby about 12 months ago and my knee pain really kicked in around 9 months ago!! I’ve been battling it ever since with no help from my doctor and not much more from my physio.
    I had gotten my knee to a good point using the above stretches/strengthen/regular massage/foam rolling but went away and let it slide and I am back to square…… maybe not square one but a lot further back than I was before :( My training intensity isn’t even that high at the moment so I am not buying “overuse injury”!
    So I literally need to get my ass back into gear :)
    xx

    Reply
    1. GirlScissors,

      Work that booty! :D Seriously, the glutes have such prime importance in knee alignment that it’s scary… and many modern people have flat butts! Even doing leg exercises, people often focus on the quad rather than the glute , and the glute is usually more important.

      For me, after about a month of regularly working out my glutes 1x per week, I noticed a major difference, and after a few months I don’t even remember where my knee pain went.

      Best,
      Alex

      Reply
  17. Hi Alex. I’m a 43 yr young man who has recently lost 2 stone and taken up Japanese jiu jitsu . Have had sore knees for a few yrs now from kneeling at work laying wooden floors and tiling floors ( and being overweight ) . Am struggling with squats and even to perform a hip throw ( the part where u lower into opponent and stick butt backwards ) pls tell me that these exercises will help or do u think I’m in danger of aggravating matters worse ( I do NOT want to quit ) !! Have changed career so am hoping this may help a little . Ur input appreciated . Regards .
    Decky

    Reply
    1. Hey Decky,

      Actually I do Judo too, so I’m well aware of knee issues related to the sport. They’ve bothered me too.

      First advice: wear knee pads that both provide support (rigidity) and padding.

      Second: Work on your flexibility. In the article I talk about the hips and ankles – make those your priority. Even just 5 minutes per day will help a LOT.

      If you have time/interest, also do some leg workouts outside the gym. They’ll help stabilize your knee, and work on your butt muscles which will improve the knee alignment.

      Last: I would say yes, you are in danger of making things worse. It doesn’t mean you need to quit, but just be SUPER conscious when you do your throws. When you load the other person’s weight on your legs, make sure you feel the proper leg alignment – feel the weight centered over the foot, feet your quad activate, feel the butt activate, and make sure you’re not rotating on your knee when the foot is planted. Go very slow and focus on the technique.

      Be safe and let me know how it goes!

      - Alex

      Reply
      1. Hi Alex. First of all, thanks for taking the time to reply. As of yesterday eve I had already started stretches and flexibility exercises as mentioned and really hope to feel the benefits soon.
        Will keep you posted, thanks again. Regards,
        Decky

        Reply
  18. Hey,
    Your web site and information is terrific. I have found very sore trigger points in all the massage areas that you recommend and have started on your massage program today.

    I am an older lady in reasonable shape and although attending gym classes regularly started jogging a few months ago and along came sore knees…getting worse as the weeks progressed. The most discomfort is the process of sitting and rising from a sitting position

    I have great faith that the massage therapy you recommend will assist as the tendon areas you pointed out in your video are very sore

    Thanks for the information

    Reply
    1. No problem Jann!

      Let me know how it goes, and feel free to shoot me an email if you have any questions.

      Best,
      Alex

      Reply
  19. Hey man, great post. I came home from the gym with some awful knee pain, and this was the first really helpful result I found. However, I was wondering what your opinion is on running barefoot vs with running shoes. I know that a lot of shoes try to compensate for our inclination to pronate, but once one achieves the ghetto booty and the hip/ankle flexibility hopefully extra support shouldn’t be needed right?

    Reply
    1. Hey Davis,

      I’ve personally run barefoot to test it out, so here are my thoughts:

      1. It’s not a magic bullet.
      2. It will require a lot more ankle flexibility… so go REALLY easy. Lots of people strain their achilles jumping right into barefoot running.
      3. Good form is good form – with shoes or without. You can have good form in shoes too, but barefoot it makes you more aware of it.

      Hope that helps!

      - Alex

      Reply
  20. Thanks for the amazing explanation and demonstrations. I just went through and performed each of the exercises. I am hopeful that it will help with my right knee pain. Over the past week I have been unable to do my regular run (3-5 miles, approx. 4 days a week), about halfway into my first mile my knee begins to hurt badly. As a result I end up walking back. Thanks again, hopefully this will get me up and running again!

    Reply
    1. Hey Sara,

      No problem! Where specifically on your knee does it hurt?

      Best,
      Alex

      Reply
      1. Hi Alex. It hurts on the outside and the back of my knee, but only when running. I’ve been able to use the elliptical, do various workout videos, lunges and squats, and plyo type exercises all without pain. It only hurts when I run, which bums me out because although I do cross train, running is my favorite. I performed all of your suggested exercises again today and skipped the running. I hope to get back to it soon! Thanks so much for your time!

        Reply
  21. Hey thanks for the info i am 32 yrs old and healthy but i have had chronic knee pain for yrs, doing nothing but working physical jobs. My rear is very flat and i had no idea that is probably my problem along with flexibility issues. I cant wait to get started as i am trying to run again. Thanks again Jack

    Reply
    1. No problem Jack! Keep me updated with your progress.

      - Alex

      Reply
  22. Thank you very much for this. It’s very helpful. I have been gaming most of the day for at least the last 7-8 years… Im 18 now. :P
    -Though this takes that you have fun doing it so you create a good habit too. I bought a foam rool… And it’s awesome for massage! Though it can get painful. :P
    -But in the good way – Knowing you’ll get better.
    Again thanks, you have a very helpful site. And it’s all free. :D

    Reply
    1. No problem Mark – Let me know how it goes!

      - Alex

      Reply
  23. Thank you for this! I went walking and jogging outdoors with ankle weights (bad, bad, idea) not to mention I hadn’t worked out in months. On top of that I was hitting squats pretty hard. My knees were feeling awful. I’m chunking the ankle weights and working on my weak ankles and getting the butt together! I’ve been way hard on my knees. I may also start doing some beginners yoga. I have flat feet that go outward so it’s going to take me a while to get my body in line but all of your informaiton was a huge health. Thanks again!

    Reply
    1. You’re welcome! Let me know how it goes, and shoot me an email if you have any questions.

      Cheers

      Alex

      Reply
  24. Hey alex I have question. So week ago while playing basketball I hurt my left knee somehow without knowing. I didn’t had any big impact on knee during the games but I noticed I couldn’t bend my left knee. Now, every time I bend my left knee over 90 degree it click. Feels like my bone is about to pop out but it pops it when i bend it. I found this really really helpful and I will try this like right now!! I really appreciate for all the effort you put on this and I hope I will have good result.

    Reply
    1. Hey Dat,

      Is there any pain associated with your knee bending? Have you seen your doctor?

      Best,
      Alex

      Reply
      1. It might be my ankles. I sprained my ankles couple times already and I wear ankle braces. Like you mentioned in the writing maybe my knee were taking lot more pressures than it used to be. I will see my doctor this Tuesday to find out what going on to my knee.

        Reply
        1. I also want to ask is it okay for me to do this exercise everyday

          Reply
  25. I am a physician and a long time runner (30+ years). I have had on and off bouts of runner’s knee, never bad enough to sideline me but recently worse. I have recently changed shoes, placed arch supports and placed a compression band below the kneecap with variable results. I was convinced that the affected leg did not rotate nor “toe-in” properly despite various stretches and consciously trying to twist my foot in. I found your website thru Google and was impressed with the information. I ran two days ago resulting in some of the worst knee pain in recent memory. This morning I did one cycle of the butt exercises and the stretches (I had been roller-ing my legs for about two weeks on the advice of a different website) and noticed an immediate reduction in pain and “pressure” in the knee. I just went out for a late walk/run just to test it out and it’s so much better even without the strap. When I looked down my foot was rotating inwards very nicely without even trying. No pain with flexion and a deep knee bend is near normal. Even if it never completely subsides I can definitely run like this without fear of damaging my knee. Thank you so much for your help.

    Reply
    1. Hi there Dr. K,

      You are very welcome! Keep up with the glute exercises & stretches and I can guarantee that in 6 weeks you will notice some incredibly improved tracking in the knee. Shoot me an email if you ever have any other problems!

      Best,
      Alex

      Reply
  26. Hi Alex,
    I was passed your information from a fellow running club member (Tom who commented above) and I’m certainly going to give these a go.
    I currently have a sharp pain to the bottom left of my right kneecap in the groove beside it and have suffered from pains below that kneecap several times before. When I was at uni 4 or 5 years ago I had radiotherapy on it as the pain was too much to bear. Now, it flares up every 4 or 5 months and with a weeks rest and lots of deep heat it seems to go.
    This last time it has come about by me doing only the recommended weekly mileage increase of 10% to 52 miles. Towards the end of my long Sunday run (weekly miles = 49-50) I started feeling this pain and I couldn’t even get half way through our recent club sprint session.
    For some reason I do have slightly oversized quad muscles compared to the rest of my small body frame and doing the Vastus Medialis self massage just now I have found a sore point about 3 to 4 inches up from the top of my knee. I’m wondering if my quads are pushing down on my knee causing the pain and which stretch in particular would be best?
    Thanks in advance,
    Ben

    Reply
    1. Hey Ben,

      Have you seen a doctor and confirmed that this is chondromalacia, or is it something else? Does it feel like it’s a pain “inbetween” the top and bottom of your knee?

      Have you checked how your right leg is loading weight? In other words, just run slow, naturally, and look at your knee as it runs. Is it turning towards the inside as you run? What about your ankle. Is it caving in left or right, rather than loading the weight evenly? Start with those and let me know how it looks.

      Best,
      Alex

      Reply
  27. Well I have given up n running due to the pain I get from the IT Band on my left knee. I started your exercise and stretching program today as I’ve been unable to get help via doctors or strength training of legs.

    I hope it works!

    Thanks for the informative post.

    Reply
    1. Let me know how it goes Kevin!

      In my experience, improving the tracking and alignment of your knees will dramatically reduce (or eliminate) IT Band pain. Chances are, your left femur is rotating inwards as you run, putting a lot of strain on the outside of the knee. But try it out and let me know how it goes!

      - Alex

      Reply
  28. I just completed my first night of your program! Man is my butt weak! Two years ago I started my weight loss journey and in just over a year of clean eating and running I lost over 100 pounds and FINALLY had my size 4 pants on. Then the knee trouble began :( I had to stop running a year ago due to an “over use” injury. Dr told me to take 6 months off. A year later they still hurt and I’m still not able to run much without pain. :( all my hard work gone. I am hopeful that your exercises will allow me to run again! Ill update you in a few weeks! Is it ok to do daily?

    Reply
    1. Hi Michelle,

      Wow, 100 pounds lost is insane! That’s awesome, congratulations.

      Yes, this is totally okay to do daily.

      In the mean time, why not do yoga or something with no impact that still lets you exercise?

      Let me know how it goes with your knees, and how this regime works out for you.

      - Alex

      Reply
  29. Hey Alex,

    I’m excited/intrigued/hopeful about finding this information. I have never been a runner but decided to sign up for a 5k in October because hey, I love a challenge! Three weeks into my training, my good old PFPS kicks in. I have been RICE-ing and also have doing some of your stretches and glute exercises since Saturday. Fingers crossed! I must must must get this dang knee thing back on track and fast (no pun intended)…. ; )

    Thank you for sharing all this info. I’m eager to try anything.

    Reply
    1. Hey Lauralei,

      Let me know how it goes and if you have any questions! PFPS is CLASSIC poor tracking of the knee. This is what I had before I started doing this regime. I’m pretty positive it will help, but let me know how it goes.

      Best,
      Alex

      Reply
  30. you must be jesus

    Reply
  31. Dear Alex,
    your site is the first one that makes sense on the issue of exercise pain. So much advice – as you note – simplistically says “If it hurts, rest it”. That’s fine until you start exercising again whereupon the pain takes up where it left off. That leaves us with a choice of either being unfit or exercising in pain. Some choice!

    Your explanation of the mechanics of our joints is very clear and I will use your recommended exercises with the hope of being able to regain my old running ability. It was the only athletic activity I was any good at.

    Reply
    1. Hey Deano,

      YOu’re right, it’s really difficult to stop doing what hurts – especially if it’s the only form of exercise. But why not try this knee regime I have, and do yoga for 30 days? Chances are, you won’t gain weight, and it’ll improve your running because of the better flexibility and relaxation.

      Keep me updated with how it goes okay?

      - Alex

      Reply
  32. Finally my poor knee is starting to feel better. Thanks so much for this :)

    Reply
    1. No problem miss cristal! Let me know how it goes.

      - Alex

      Reply
  33. Is there an order that these exercises should be done in? Glutes, then hips, or what? Stretch glutes, work glutes, stretch hips, work hips, ???

    Thanks

    Reply
    1. Hi Hollie,

      No, no specific sequence matters. Instead, just focus on the big picture – improve the hip and ankle mobility and then strengthen the butt. If you can do the stretches every day for 5 min, that’s ideal, the glute work takes a bit longer and is ongoing since muscle building takes time.

      Hope that helps!

      Best,
      Alex

      Reply
  34. Hi,

    I’ve had knee pain since the first week of July this year. To give you a quick background how I got it – I usually run once a week for 5 miles while I work out for 6 days a week. Then we went on vacation, and didn’t do any workouts and ran 8 miles. That’s when the pain started. I tried completely resting my knees but it didn’t help. It would always hurt when my legs have no movement, like sitting for a long time. My right knee would click when walking too but doesn’t hurt. 2 weeks ago, I decided that it might be time for me to exercise my legs. So I did stationary bike for 15 minutes a day, 3 times a week, in medium resistance. After the stationary bike, I also did exercises for my lower body – hips, quads, bun. And then I ice my knees after that. The next day after my second stationary bike and lower body exercise, the pain has significantly diminished. My knees no longer hurt when I sit for a long time. Also, I noticed the clicking sound on my right knee disappeared. I would only feel pain when going up and down the stairs (if I can’t avoid it), and sometimes when standing or sitting, depending on the height of the chair.

    When I go up and down the stairs, there would be minimal pain on my left knee (I used to have more pain on my right knee but now for some reason, I have more pain on the left), and it would last for a couple of days. Usually when I am feeling pain, I would just rest my knees and not exercise. And when I do that, the pain will be gone.

    I guess what I’m trying to find out is if the pain will be completely gone and I have my old life back? Or will I have to stay away from stairs for the rest of my life and other things that would or could cause knee pain?

    Reply
    1. Hey Belle,

      It’s really impossible for me to predict how your knees will be down the line without more information.

      First things first – anything that bothers your knees, stop! Chances are your knees were feeling better because you iced them that one time which reduced inflammation. But to see how they are really doing, just leave them alone for about a week and tell me if there is residual pain after exercise or during exercise. Any unusual clicking or popping is not good, too.

      The only way to figure out if you’ll have your “old knees back” is to stop doing any lower body impact exercise. Switch to Yoga or something else for a month just to see how the knees go, and then go back to some light volume with the bike or running. If it bothers you, get your form evaluated or stop.

      Hope that helps!

      Best,
      Alex

      Reply
      1. Hi Alex,

        Thank you for getting back to me. When you say leave them alone, does that mean just rest them and don’t do any exercises?

        The clicking/popping on my right knee has now disappeared. I don’t know since when but I just realized that I no longer hear the clicking/popping probably last week.

        And yes, if I can avoid the stairs, I don’t use them. I usually take the longer route just so I can avoid it.

        I don’t think I am doing any lower body impact exercises. I do stretching for quads, IT band, and hamstring. I also use foam roller on my calves, hamstring, quads, and IT band. I mostly do exercises for my lower body lying down or sitting – like clamshell, bridge, etc. but I don’t do any squats or lunges. I do a couple of exercises for my hips standing and using resistance band (I use the lowest one, I think 2 lbs) which I found on this site http://www.runnersworld.com/injury-treatment/all-hips?page=single. I found the seated hip external rotator exercise with resistance band hurt my knees so I do it without resistance band.

        I also do ab exercises but all are done seated or lying. I also don’t use any weights. Are these not considered lower body impact exercises?

        Also, one thing I am interested to find out, is running again the only thing that will heal my knees completely?

        Thanks!

        Reply
  35. Love your website. I have also suffered from Runner’s Knee for over 10 years and have always been very skinny. Same story as you with the Docs….and all xrays and MRIs Ive had done show there is no arthritis and nothing anatomically wrong the knee joint itself. I too ignored it for years hoping it would get better, but a year ago I had a kid and now I spend a lot of time with him on the floor and the knee pain has been super noticeable. I’ve been doing exercises, stretches and foam rolling for about 6 months now, but after seeing your website I realize I may have been doing the wrong exercises and stretches. For the first time today, I did your exercises and stretches and I realize that my butt is very weak and my hip flexors are TIGHT! I really felt it in that first stretch you demonstrated. I’m bookmarking your website and will start doing these religiously and my fingers are crossed that these work….I’d really like to play with my kid on the floor without pain. I have to agree with the previous poster about your videos….not great quality; if we are talking proper body mechanics with all the exercises and stretches we really need to see your entire body, I’d reshoot them if I was you because they are valuable information. Looking forward to a couple of weeks to see how I feel.

    Reply
    1. Hey Heather –

      Let me know how it goes! And yeah I will probably re-shoot these because at the time I didn’t have an external mic for good audio quality and was in a noisy gym.

      Reply
  36. Alex,

    Wonderful information here. Recently got back into running and I experience pain in my right knee after 20-25 minutes, as if on schedule. Seems to be centered in my knee cap or a little below it. Always difficult to pin point pain in some of the bodily regions! Anyways, I plan on beginning your structured recovery program tonight but how do you feel about the Myrtle Routine? Do you feel that would accompany your recommendations well? Is doing both of the programs too much?

    Reply
    1. Hey Tomas,

      To be honest I don’t know anything about the Myrtle routine, sorry ! I would just use common sense, focus on one thing at a time (to see what actually improves your knee health), and be scientific.

      Reply
  37. Hi Alex, I have had the experience with doctors — stop running. Seriously, what are they even thinking? I actually googled and landed here. I did some of the exercises for 10 mins twice a week and I am already feeling better. Amazing how our body realigns itself with a little stretches. I ramped up my mileage for my first half which is one month from now and hoping that my knee pain does not return.

    Reply
    1. Hey Te,

      That’s awesome! Thanks for sharing. How is it going now? Make sure to keep up with the stretches and improve butt strength. It will keep improving!

      - Alex

      Reply
  38. thankyou for posting this i will try it, i was diagnosed with plantarfaciitis last year and then got orthotics, which pulled my knee out of alghinment and a year later i am barely able to walk, i am thankful you poted all of the exercises most sites dont post, or post a little and you have to buy something in order to get the rest , i will start the stretches right away:)

    Reply
    1. Let me know how it goes Jane!

      Best,
      ALex

      Reply
  39. hi alex, about how many weeks do i have to do this until i can start running again? my knee only hurts when i jog, but when i do elliptical i don’t feel any pain in my knees. my knee hurts on the back portion of my right knee and when i jog the pain starts mild and keeps on getting worse when i continue to jog.

    Reply
    1. Hi Nikko,

      Do it until it doesn’t hurt when you run anymore :) That might be an answer you hate, but the only way to recover is to rest and improve your running form.

      Best,
      Alex

      Reply
  40. I can’t express my happiness that I came across this article! I have knee tendonitis as well as a misaligned kneecap I guess it shifts to the side rather than foward. I’ve been to my orthopedic many times, had an MRI, and have been to physical therapy. I guess it helped a little at the time but then i came to college and starting to sprint more frequently than in high school and eventually I had such excruciating pain that I had to go home and meet with my orthopedic and he gave me helpful advice but it was just the usual advice rest, take Advil, stretch and all that stuff. So this summer I rested by not running and focusing on stretching but nothing helped I was getting furious and felt like I wasn’t going to get rid of this pain im only 19 I felt I was too young to have this much pain but now I’ve been focusing on butt and those muscles and I’m amazed with how much it’s truly helped I can’t believe it’s the one thing I always stayed away from! As well as stretching my upper quads, the lunge helps stretch my quads but not my upper quad. I hope ill be able to run again with moderation of course. Anyway thank you so much for this!

    Reply
    1. You’re very welcome Cara :) Keep me updated on your progress and shoot me an email if you ever have any questions.

      Best,
      Alex

      Reply
  41. Hi Nate! I’ve started working on these exercises since I apparently sustained a knee injury. It doesn’t hurt at rest but when I run it’s excruciating. Some of these exercises are super painful on my knee, like lunges, when the knee is extended behind me. Should I push through anyway or stop? I’m devastated bc I’ve been training for my first HM and I’m sure weak muscles are probably the culprit. Any suggestions?

    Reply
    1. Hi Jamie,

      If you have pain, definitely stop doing the exercises. Have you already had your knee checked by a doctor to rule out any serious injuries that might require surgery?

      - Alex

      Reply
  42. hi alex, it’s me again, i’ve been doing all this exercises and tried to run on treadmill yesterday after my workout. i’ve been using the chi running form and i feel a little bit of pain under the back of my right knee but i can still continue, is that fine? and some people says that its good to run until you reach your limit and slowly increase your mileage. thanks for your reply last time :D

    Reply
  43. sir,,,,
    i had severe injury in my knee while working in gym……..last one month i really suffers a lot….i hav done quadriceps,and also hamstring exercises…..osteo arthrities also is there for me……please give me a favour advice…to get recover from klnee pain………………..thx a lot

    Reply
  44. Thankyou so much for this article!
    I was almost ready to give up and accept chronic knee pain (over-exuberence and ongoing issues post acl surgery) But after my first attempt with Trigger point therapy & self myofascial release my knee pain has reduced enough to give me some hope and I am eagerly anticipating a run tomorrow morning! I will definitely be following through with your other suggestions too now that my knee is actually responding to something. Words just don’t cover it. Thankyou!!!!

    Reply
    1. You’re very welcome Linda :)

      Reply
  45. Been having trouble with my right knee for about a year. Fysiotherapist did make me do leg exercises (strength and coordination) but ignored the booty and core and got me to buy corrective shoes… After 3 months there was SOME difference but still had trouble with my knee after 3kms. Not too impressed with my return-on-investment there…

    I switched to minimalist shoes (because I felt adding more padding under your feet does not make sense, fysio disagrees…), which helped somewhat.

    Then I happened to end up on this page and things finally made sense. The mechanics of ankle/knee/hip and how the booty-muscle needs to start doing something.

    Did your exercises for 1,5 weeks (ouch, butt-muscles hurt which told me something was happening!) and immediately felt a difference when doing short runs. I was simply amazed.
    Now 4 weeks later I just ran my first half marathon AND took 1 minute off my 5K personal best, all in the same week. 2 things that would have caused massive mechanical issues 6 months ago.

    I’m sure my fysio-therapist was right about needing to strengthen my legs, but took a narrow view and just didn’t cover all muscles that needed attention.
    Your articles just did the magic… Thanks You So Much!

    Reply
    1. Arjan, you are very welcome :). I’m glad I could help you become pain-free. Feel free to email me if you ever have any other questions.

      Best,
      Alex

      Reply
  46. Sir, I have to say after a week of doing your exercises and stretches my fitness life has transformed back to the way it was. I have been running every day for years when last month my knee was agonizing after randomly going down the stairs after a workout.

    I thought I knew everything after this time, but I never considered working out my hips. Those exercises just nailed it for me. Thanks for helping people like me recover. I hope you are getting paid well for your expertise.

    Reply
    1. That’s awesome! Glad to hear your knees have improved so much. You are very welcome – email me if you ever have any other problems.

      Best,
      Alex

      Reply
  47. Loved your article! Could use your help/opinion. I’ve played basketball my whole life- always been active. I’m 28 now and was training for my first half marathon. I know I increased my mileage too fast in the first few weeks and now my left knee cap is in pretty severe pain. (No twist, no pop, no immediate injury cause) I’ve given it three weeks of stretching, ibuprofen, ice, heat, chiropractor, leg exercises, etc. I tried running again tonight and I can’t make it 4 steps without getting the stabbing in my knee cap. Is there anything else beyond your article that you suggest? Thank you for your help- anything you can provide would be appreciated. Three weeks on an elliptical is about all my sanity can handle.. :)

    Reply
    1. Hi Lindsay,

      Rest :)

      In the meantime you can work on these stretches too – which will improve the alignment and biomechanics of your leg.

      Reply
  48. hi – just got back from medical consult. told me that my knee pain is coming from my hip and that they would give me an injection which should take away the pain. I had an ACL repair done several years ago and now having problems with knee pain. Pain on walking; no pain after the knee warms up and I am able to run, play racket ball and cycle. Ok so I suffer afterwards esp after racket ball. Your info makes sense and I’m absolutely gonna give it a go and see what happens. cheers

    Reply
  49. Thanks a lot for the info in the article. It reminds me of the warm-up I used to do when practising Taekwondo (we used to have 30min stretching!). However when I go for a run I dont tend to stretch that much cause I just want to go out and run… MISTAKE!

    I have been suffering from knee pain almost from the beginning of the year. First my knees will get all red and hot, but now they are just painfull. An MRI dictated that I have chondromalacia patella grade I (of 4). So yes, need to take care of my knees.

    Reply
  50. Hi having my knees replace from arthritis both knees laying on top of each other. Love the ideas but some are way to painful to do. Do you have any ideas for someone who’s knees are so far gone. Also would I be doing these same exercises after new knees are put in. I do a lot of stressing with feet up on the way. Knee bends and leg lifts, cross over knee to other side, feel that in my hips. Thank you

    Reply
    1. Hi Sheryl,

      Have you tried Qigong? I would recommend checking out this one: http://www.springforestqigong.com/

      Best,
      Alex

      Reply
  51. Hi Alex,

    This is a great article, and I’ll definitely be trying these exercises. I’ve been foam rolling for a few weeks already, and I was attending yoga class regularly (need to get back into that.)

    Anyways, I’m training for my first marathon. I’ve always been an athlete, but never run this high of mileage before. A few days ago on a 17 mile run at about mile 9, I suddenly started feeling pain starting in my ankle that went up my calf and stopped just under my knee. I had to run at least 3 more miles to get home. It wasn’t bothering as much at 13 miles, so I finished my run. At the end of the run it wasn’t my calf or ankle that were bothered it was my knee. I rested two days, and then tried 4 miles today. It’s not that it is terribly painful. It just feels stiff like I don’t have full range of motion in my knee. And it feels like it needs to pop, but it won’t. I also think my knee is swelling slightly. Is this something your routine would help with?

    I’d appreciate any advice you can give. I don’t have health insurance, so going to the doctor really isn’t an option. I should also mention that this is the same knee that I tore my meniscus in about 14 years ago and had surgery to fix that. I’m just really scared that’s what I’ve done again.

    Reply
    1. Hi Jenn,

      If your knee is already swelling, then there is already likely “damage” and inflammation going on. The only thing you can really do at that point is rest it and ice it. Overall though, you might want to check your form (using this guide), and take it easy on the mileage.

      Best,
      Alex

      Reply
  52. Horrible RT knee pain, still pushing thru it to run but its killing me! Start these steps tomorrow…Hope it works…physical therapy is not helping at all

    Reply
  53. I just wanted to say thank you for such an outstanding article! I can’t believe all of this great information was in place, and best of all it was free. Thank you so much!!

    Reply
    1. No problem jared !

      Reply
  54. Thank you for this very thorough entry! My knee is killing me and many of these things actually apply to me and why I probably injured it. Thanks again!

    Reply
    1. Cheers Melysa!

      Reply
  55. I just got my very first knee injury from walking and jogging everyday for a week. It’s been 3 days and I still feel sore on my right knee. I hope this works :(

    Reply
  56. Looks like a great article!! i will def. read it and put into action the exercises..thanks! =)

    Reply
  57. Hi Alex,
    I am a 16 year old boy, and I just finished playing a varsity season of soccer. I developed knee pain about a week after school started. I don’t remember one incident where I got hurt, but I did take a lot of phyisical hits during the games. I played on the injury for a month.

    I started playing basketball immedietaly after soccer ended, even on my hurt knee. I just decided two days ago to rest my knee for two weeks before my season starts on Dec 7th.
    From the past month of playing, I noticed that if I went light it wouldn’t hurt too much during the exercise, but I was slightly sore the next day. Because this injury can get really bad if I play too long on it(espicially during games)I am doing my best to give myself a chance to recover before my games start. If my leg isn’t one hundred percent before games in two weeks, am I eliminating all chances of recovery if I decide to play? Or would it be wise to take off one more week before playing? The location of the pain is on the left knee, on the interior side of the kneecap, but when it gets bad, I can feel pain throughout the whole knee. It is a sharp pain.

    Although I am excited about the stretches you gave me, my knee is a bit sore when I do your glute stretches. Is that supossed to happen?
    Thanks for everything you do.
    Andrew

    Reply
    1. Hey Andrew,

      If something bothers you, take it easy on the stretches. Do you feel some tension on the outside of your knee when you do the runner’s stretch?

      I won’t tell you something you haven’t already heard before – if it’s not 100% and you’re going into competitions, you’re just raising the chances of injuring your knee again. My advice would be to pay close attention to your form (and if you’re in the weight room, do leg exercises with perfect form).

      - Alex

      Reply
  58. Dear Alex,

    I am 46 years old female and am pre-diabetic (lifestyle change no medicines). I walk daily and swim 3 times a week. Have been experiencing this right knee twist since 3 months. Tried doctors (ortho – he says it is minor and prescribed some pain killers. Need to have major problems to impress doctors ohhh..), felt better with physiotherapy exercises (ankle stretch and hip stretch) but no complete relief. Your article is real eye opener though I have googled and tried lot. The knee inward rotate is right when I walked in the house. Tried 2 sets of each exercise and stretches while reading. Feeling lot relief and strength in my troubled leg. Will work on it consistently and update !! Loads of thanks!! God bless u!!

    Reply
    1. Hi Prabha,

      You’re very welcome :) keep me updated with your progress and how it goes.

      Also, don’t forget – diet is the most important thing to reverse pre diabetes and diabetes.

      Best,
      Alex

      Reply
  59. Man thanks for sharing, it’s very informative. I just started running 5 days ago, one day I just felt pain on both knee so I made a research about runners knee, glad I found your site. Question: is it okay to try your work out while I still have knee pain? Should I take some medicine or pain reliever to cure my runners knee? Thanks!

    Reply
    1. Hey Tom,

      The stretches should be fine – just make sure to avoid anything that causes knee pain. If it gets worse, stop. If it’s really bad right now, take a week or two off before beginning it.

      - Alex

      Reply
  60. Great article! Thanks for sharing this information. This is my second bout with knee pain, and like the first time, I assumed it was my IT band and went back to strengthening my hips. But after 2 months I saw no progress and finally decided to see a physical therapist. Had no idea that my booty was causing all these problems! I’m hopeful I can start running again in a few weeks.

    Reply
    1. Try it out Laura and let me know how it goes :)

      - Alex

      Reply
  61. Hi Alex,
    Awesome advice. I have been perennially struggling with Runners knee. To lay all this out in layman’s terms is wonderful. Thanks for the effort and for sharing this info. Away i go for my ghetto reps..:)

    Reply
    1. You’re very welcome Sam :) Let me know how your knees are doing after!

      Reply
  62. Hi Alexander,
    I have been training for the 2014 Miami Marathon and reached a point where my right knee felt tight with pressure and with pain at times going to my foot. It is very disappointing to think one has to stop training due to unforseen injuries. At times I slowed down and stretched that leg more. I reached my 22 mile mark in training this weekend and felt good until I stopped for water..the pain seems to get worse when I slow down after prolonged running. I decided to google my issue and found what I already know was the solution : rest and go to doctor. However, I stumbled on your site and was happy to see the information you provided. I felt like someone understood my problem. Just having done the rubbing/massage on my thigh muscles completely alleviated all pain and pressure after my 22 mile run. Thank you so much for the information you have provided. I will be doing the stretching and buttocks exercises to help avoid any further injuries.

    Reply
    1. Awesome Natalia! Love seeing people get better quickly. Let me know how you progress and email me if you have any other issues.

      - Alex

      Reply
  63. Nate your a knob.

    Reply
  64. Hi Alex – I enjoyed reading this article. In your experience did your recommended stretches / exercises solve your knee tracking issues? Also, have you used a knobby foam roller to massage the trigger points? Regards, Heather

    Reply
    1. Hi Heather,

      Yes, this article helps you get started on fixing muscular imbalances. The stretches in addition to the gluteus strengthening will help restore normal tracking.

      Reply
  65. Hi,

    I am having this runner knee for over a month ( I was running 8k every day for the past year and before it was about 8 to 10k with a break in every mount and every three month and etc ) and I tried whatever that I read or heard about it but no effect. My runner knee got serious after a foggy day that I could not run through my regular path which has medium up-down hill. And, I had to run down from fairly deep hill. Now, I can not run at all or sometimes do long walk:-(.

    I just found this article and I am going to try all exercises and stretches that Alex has suggested in this article. I hope it works as I am so fed up and concern about gaining weight.

    I will try to come back and write the results hopefully in few days ( or weeks).

    Cheers,

    KH

    Reply
  66. Hey, first time reading this and it seems really helpful. I literally have been having really horrible pain on my both knees for some time now. I’ll definitely do your advices. I need to feel better for the marathon coming up in a month. I hope I could get better from my knees by then.

    Reply
    1. Let me know how it goes Maria!

      Reply
  67. awesome work mate. i was thinking at the end of the mail u gonna ask for money to download guide and all those craps but it was truly very well explained guide .thanks for your good work.

    Reply
  68. Hi Alex..

    Thank you for the great info on exercising runners knee etc however, I am wanting to improve my glutes but, the lunges are something I tolerate right now…do I just continue doing all the other excercise you are demonstrating and then once I start feel some type of endurance/stamina, then start trying to do the lunges? Also what if I use a door knob for my stability when doing lunges? Good Day Alex!

    Reply
    1. Hi Kalisa,

      You’re saying that the lunges you can do, or you can’t do right now?

      Reply
  69. Hi Alex,

    First, thank you for sharing all this after testing it out on yourself. I completely identify with the frustration of going to doctors that don’t help (and cost a lot). I have only been doing this program for a week, but here are my initial thoughts and questions in case you or any other readers have some insight. (1) I have decided to stop doing the lunges because they hurt my left knee (the problematic one) when it is in the back and my right knee is in the front. I have tried small tweaks to the positioning, but I can’t seem to stop this exercise from aggravating that back knee. Has anyone else had this issue? (2) For trigger point massage, I find that the foam roller isn’t quite enough to do anything (because it isn’t specific enough), and a tennis ball seems too soft when used on the mats at my gym, so I have been using a lacrosse ball. This is definitely more precise, and more painful. A concern I have is that I could be doing more damage by using too aggressive a treatment. It’s not so painful that I can’t stand it, but it does make the areas more tender for a few days after the massage than they were to begin with. I have just started reading about trigger points and self massage, so any input would be appreciated. For instance, what is a normal amount of pain to have after doing the self massage (e.g. how many days) and when should I expect these to become less painful if it is working. The most tender areas are along the IT band in the middle and on the Vastus medialis close the the knee.

    Reply
    1. Hey Erin,

      Definitely avoid anything that directly hurts the knee. Focus on the stretches instead to improve the biomechanics of the knee.

      Personally, for trigger points I use a hard massaging cane, OR even a golf ball. It’s really hard, so you need to be careful around the knee joint itself, and make sure you’re focusing on the muscles.

      The IT band tends to really hurt in most people, but if you’re sore fora couple days after I would take it a bit easier. Just focus on doing it regularly.

      Where does your left knee usually hurt throughout the day?

      Reply
      1. I think it varies where my knee hurts, but I haven’t paid much attention to where exactly up until this point. Right now, it seems to hurt on the inside of the knee, not under the kneecap but close to it. I usually do some kind of cardio exercises 2-3 times a week, and for the past 2 months that has been the elliptical machine at the gym, not running, and even that can hurt sometimes – never a lot, but enough to notice it.

        I most definitely have poor biomechanics. I have golfer’s elbow in my left elbow from rock climbing, though I’m not sure if/how this relates to problems in my left knee. I can tell that during the single-leg dead lift I am a lot less stable on the left leg.

        I will certainly keep working on flexibility and just do the exercises that don’t hurt. I added lateral walks with a band in place of the lunges. I have also excluded some of the “lunge-like” stretches because I find them uncomfortable. I did some googling to find other alternatives such as a kneeling hip flexor stretch and butterfly stretch (several stretches shown on this site http://www.fitbodyhq.com/fitness/12-great-stretches-for-tight-hip-flexors/).

        I can say that I have not specifically worked on glutes or really any type of leg strength for many years now, and I have a desk job, so your method for correct the problem makes a lot of sense to me. I plan to keep it up and ease up on the trigger point massages by going back to something softer.

        Reply
  70. Great article Alex,thanks

    Reply
    1. Cheers Ray!

      Reply
  71. Hi, this is a really good article, my knees weren’t bothering me until a few weeks ago. When I went to the gym I did hip thrusts with a barbell squeezingy glutes as hard as possible and since then my knees have been bothering me. You seem to say that the two are closely related. A any idea what I can do to help it out it seems both knees have been sore. If I stretch and warm up it seems I can squat down nice and easy. If I lay down and pull my knee to my stomach there’s no pain the actual most I feel it is walking down the steps in the patella area. On my right knee I was have some cracking to the outside that wasn’t just air or gas. But wasn’t excruciatingly painful either. That was from trying to squat after the fact. If you have any ideas I would appreciate it !

    Reply
    1. Hi John,

      When you’re squeezing your glutes as hard as possible doing the thrusters, you might be mis-aligning your knees (thus putting more strain on them). Drop the weight a bit, and focus on slower reps that are more controlled.

      They usually only bother you when you go down stairs though?

      Reply
      1. Yea, I feel them when I get out bed also after sleeping and going down the stairs usually the most. If I’m kinda tight I’ll feel it slightly walking up stairs. But walking I never feel it. It really does seem like a misalignment problem. When I did the supine groin stretch with the leg elevated I was there for almost 45 mins it didn’t seem to test well doing the thigh contraction like the pain free book says but when I let the blood flow back in and felt less wobbly from laying down I walked down the stairs and barley felt it at all.

        Reply
  72. Hi Alex,

    Thank you so much for this post. It was so thorough and I went through all of it. I hurt my knee three weeks ago after increasing from 2 to 7 miles in a month (I’m training fora half marathon). I took a few days off and then started biking and swimming and it wasn’t getting better. After a crazy ultimate frisbee tournament this weekend, I have taken 7 whole days off of exercise and the pain has only gotten worse. I am going to try your stretches and work on proper form as I use a half marathon app to slowly start running/ walking. I am going to buy a brace from CVS and will do your stretches and stretch before and after workout. Just a few questions though- should I ice, and when? How often would you wear the brace? If I haven’t worked out for a week, is it okay to run once every couple of days, or how should I best get back into it? Any help would be so appreciated- and thanks again for the tips!

    Reply
    1. Hey Julia,

      I would use ice as mostly a short term preventative measure. So right after you exercise, if there’s pain or swelling, I would ice the knee then.

      Regarding braces – they can be really useful, but I wouldn’t treat them as a replacement for fixing proper form. A proper brace can’t ensure proper form 100% of the time anyway. Getting back into running – just see how your body does. If it starts hurting after one run, decrease the mileage or increase the rest time in-between workouts. Your best bet is to just listen to the pain – if it hurts, stop, because you’re causing more damage. rest rest, focus on proper biomechanics, and you’ll be back on the road to recovery ASAP.

      Hope that helps!

      Reply
  73. Alex … Does runner’s knee EVER go away? It’s been 2 months … I’ve been stretching and rolling like crazy … And have been seeing a PT for the past 3 weeks.

    Did you ever take time off running completely?

    Reply
    1. Hi Arthi,

      For me, it’s been an ongoing process. If I ignore the flexibility work, and the foam rolling, it comes back as my old patterns of movement happen again.

      Reply
  74. This info is great and sounds like just what I might need to do. Just one query though, is it safe to do the exercises which involve bending the knee? I read elsewhere to only do straight leg exercises.
    Thanks.

    Reply
    1. Hi Cathi,

      It really depends on your knees, so I can’t give you a clear answer, but generally speaking yes. Believe it or not, properly squatting (emphasis: bodyweight) is one of the best things you can do for your knees. Lots of research showing that strengthening the butt, and to some extent, the muscles around the knees, will help prevent long-term knee pain.

      Just go very slowly and anything that hurts, stop.

      Reply
      1. What about an exercise bike – Cyclists always have huge teardrops and tight butts? I would think you’d have to make sure your toes point forward though rather than out….like mine do.

        Reply
  75. Thank you so much for this! I have been searching for hours and couldn’t find a straight answer. I knew it was something to do with my feet turning in but didn’t know how to fix it (long term! “Just ice it” seemed like a short term solution). I’ll be doing the stuff in the videos on a regular basis now. Thanks so much for the research and well written article! The pictures helped a lot too!

    Reply
  76. Hi Alexander
    WOW thank you so much for writing this. What a fantastic set of guidelines. Will try them all and update.. I appreciate people like you who love helping people. Have a great week and thanks again… :)

    Reply
  77. Excellent tips. Thanks

    Reply
    1. You’re welcome Eoin!

      Reply
  78. Thank you. After two docs and an MRI my knee is finally getting better thanks to you and a rolling pin.

    Reply
  79. Alexander… I have been suffering knee pain for over 4 years now and I had people/professionals telling me I had arthritis but I’m only 22 so thats obviously not it! Like you, the doctors were telling me all this garbage but after reading your article everything makes sense! I am going to try these religiously because its gotten to a point now where some days, my knees are insanely full of fluid and I have trouble walking.. I am a fit young person so it just doesnt make sense to me why my knees are hurting like I am 100 years old!!
    Anyway I am going work work on that bootay and strengthening those specific muscles hopefully it will help!
    I have been advised that swimming is better than running for the knees for everyday exercise to keep fit is that true? I normally run and play soccer but have stopped that now as my knees are in bad condition.. what everyday exercise would you recommend so I can stay fit while working on strengthening the specific muscles you talked about?

    Thank you for the article !

    Best
    K

    Reply
    1. Hi K,

      This sounds flippant, but basically do any exercise that doesn’t really aggravate your knees. Personally, I think weight lifting is a good option for this. Even basic box squats (where you don’t go too deep to begin), will help improve your knees as you re-train the proper ways of moving.

      Reply
  80. hi,

    with runners knee can I do the butterfly or breast stroke for swimming? I was told by a physio to avoid these as your knees go out at angle & come back in which could do further damage?

    Thank you so much for the information it’s very useful.

    Reply
    1. Hi Shahina,

      Ultimately, see if it aggravates your knees. If not, you should be fine.

      Reply
  81. I’m new here, very interested and impressed. I found your site while searching for information about my current knee pain (new to me). The medial, anterior side of my knee, just below the patella I experience pain ONLY WHEN I WALK. I can swim, ride a bike and move the knee through a full range of motion and experience no pain. Put my foot down with weight (walking) and there’s the pain. The pain is new only after I started strength training & jogging last week. Exercises that might have contributed were 2 leg squats, hamstring curl, leg extensions and leg press. Any thoughts on this? Thanks in advance for your opinion and help.

    Reply
    1. Hey John,

      First impression: most likely internal rotation going on. This happens a lot.

      Most likely both contributed to it if the knee isn’t loading weight properly.

      This didn’t bother you when running or doing leg exercises?

      Reply
  82. Hi Alexander,

    I’ve already sent you an email, but I will also ask my questions here, because I want to start asap with these exercises and I want to be sure I’m doing them right :)

    @ Hip and groin exercises:
    It’s possible you explain this in the video, but as I’m hard of hearing, could you explain in writing what I’m supposed to do? I especially don’t understand the first one. Should I bend forward while the knee touches the floor or? (you show two positions in this vid, hence my confusion). And for how long do I have to hold these positions? How many repeats etc.

    @ The ankle and calf exercises: do you mean that I have to go up and down for 30 seconds and then switch to the other leg? (that’s what my PT taught me). Idem voor the strap calf stretch.

    Reply
    1. Hi Renske,

      Just hold the position stationary (static) for about 30 seconds, then switch.

      Reply
  83. Thanks a lot dude!
    This is the first site I’ve been to that actually tells you what’s up and how to fix it. I’m a cyclist and have been having problems with knee tendonitis (right knee) for a few months. So far I’ve done exactly what most people recommend, rest and ice. Yes, the pain goes away only to come back a gain 2–4 weeks later. From now on I’m going to make sure to stretch all my muscles daily, massage my quads and strengthen my butt.

    Thanks a lot!!

    Reply
    1. Cheers Jade! Let me know how you’re doing.

      Reply
  84. I found the exact same problem with going to doctors for my chronic knee pain! I have a question. In your opinion, is it okay to run on it if it leaves it a little sore later in the day, but there isn’t actual sharp pain? Thanks for your input!

    Reply
    1. Hey Suzanne,

      Generally pain = damage occurring, so it’s best to avoid anything causing pain!

      - Alex

      Reply
  85. 14 years ago I fell over a box at work, injuring the same knee not just once but 3 separate times, time off from work, crutches, then off with workman comp. 6 monhs of workman comp with being denied over and over. the knee doctor that I was going to belived it was a torn meniscus. gut all the tests that were done, workman’s comp said were inconsulive and I was denied. during that time I took pain killers, steroids, ice, wrapped etc. no relief. up until that time I was a walker. 4-5 miles daily. my roof starting leaking and needed to be replaced so I had to go back to work. I hobbled, and limped. sometimes my knee would swell. sometimes I couldn’t walk and was in a wheel chair for a few days. the pain was always there plus due to steroids and no exercise I gained 50 pds which I am still battling. at times I walk with a cane. lifting my knee to get into and out of a car is agony on most days. so is walking up stairs. and if I stand or sit for too long ( about 45 min ) I limp badly. I also have hip pain. both of these cause trouble sleeping. my husband died 3 weeks ago. he was on hospice and I took care of him at home. before that I was my dad’s caregiver 24/7. I have not worked at an outside job for 5 years. there is no health ins. no money. I am a little afraid of doing anything. but I am going to try your exercises. what do you think of yoga also ?

    Reply
    1. Hi Willie,

      Just check with your doc to make sure these are ok for your knee first – and yoga is great! Go for it.

      Reply
  86. Thank you for sharing your insights and research so generously, Alex! I completed my first Ironman at age 59 this year, with no aches or pains. Now, as I continue working out (for fun now!) my knees are beginning to bother me. I do very little strength training or stretching apart from my swim/bike/run workouts, and I can see (after reading your article) that my knees are just getting tired of doing the work that other parts of my anatomy should be doing! Duh!!! And THANKS!!!!!!!!!! p.s. Took a yoga class this morning. :-)

    Reply
    1. you’re welcome Melissa :-). let me know how you’re doing!

      Reply
  87. Alex,
    This article has offered me so much hope! I thought that the knee pain would force me to give up running forever. I can’t wait to start trying the exercises! Thank you very much!

    Reply
    1. You’re welcome Courtney! Let me know how it goes.

      Reply
  88. Try a golf ball muscle roller, it really helped my muscles and now i wont run without it, check it out! http://www.zzathletics.com

    Reply
  89. Oh my gosh, thank you so much for this guide! I realize this was published a year ago, but I didn’t have the need for it earlier, so I only found it now. I was recently diagnosed with PFPS, and I went to PT for a while and I’m continuing to do the exercises that were given to me, but I’m still having pain. I’m definitely going to try your guide, and I really hope it works! Just started running regularly, which currently seems to be aggravating my knee pain, so I’m hoping that your exercises will help. Thanks in advance; it’s awesome that you’ve put this together (and for free)!

    Reply
  90. Hello! This comment may be a little outdated, but these forms of stretching helped me think a lot! Exercising is one of the most difficult things for me since asthma/allergies account, but also what you mentioned above. I’ve grown up with flat feet and caught it too late already as an 18 year old. I know have inward knees, a rotated hip, ankle injuries, lower back scoliosis, slight upper, and TMJ ): So pain all around for me. Thank you for the tips and video though I will definitely give them a try. A few years back I was almost crushed by a gym machine (my spotter left me unattended in the middle) and I went down. All I heard was my knee crack. Doctors said the only thing they saw was water in the knee, but it took five months to even be able to bend it again and I can’t keep it bent for too long anymore without it either getting stuck or being sore. So all hopes this can relieve a lot of the pain I get!

    Reply
    1. Keep me posted with how your Knee is doing Andrea!

      Reply
  91. I realize this is an old post but I’m training for my first marathon and my knees are suddenly giving out. I will definitely take your advice and get to work on those glutes but was wondering how long it usually takes. As my marathon is coming up I don’t want to miss out on too much training and not be able to complete the race.

    Thanks!

    Reply
    1. Excellent Tiffany! Please let me know how it goes for you.

      Reply

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