Running is one of the most accessible and rewarding forms of exercise — but knee pain is also one of the most common reasons runners end up at Pinnacle Physiotherapy. The good news is that the vast majority of running-related knee conditions respond very well to physiotherapy, and most runners don't need to stop running entirely during treatment.

"The vast majority of running-related knee conditions respond very well to physiotherapy. Most runners don't need to stop training entirely — the goal is to load the right structures at the right amount, not to rest indefinitely."

Common causes of runner's knee pain

Patellofemoral Pain Syndrome (PFPS)

Often called "runner's knee," PFPS causes pain around or behind the kneecap, typically during or after running, going down stairs, or sitting for extended periods. It's usually caused by the kneecap not tracking properly in its groove, which can stem from hip weakness, poor foot mechanics, or a rapid increase in training load.

Iliotibial Band Syndrome (ITBS)

A sharp or burning pain on the outside of the knee, typically appearing after a consistent distance into a run, is a hallmark of ITBS. The iliotibial band — a thick band of connective tissue running from the hip to the shin — becomes irritated as it rubs over the outer knee. Weak hip abductors and sudden mileage increases are frequent contributors.

Patellar Tendinopathy

Pain just below the kneecap, particularly when loading the knee (jumping, squatting, or the push-off phase of running), often indicates patellar tendinopathy. Tendons respond poorly to sudden spikes in load, which is why this condition is especially common at the start of a new training block.

What physiotherapy involves

Treatment at Pinnacle Physiotherapy begins with a thorough assessment of your running mechanics, strength, flexibility, and training history. Rather than simply treating the site of pain, we identify the underlying drivers — whether that's hip weakness, foot pronation, calf tightness, or training error — and address those directly.

A typical program will include:

  • Targeted strengthening exercises for the hip, glute, and lower limb
  • Load management guidance to keep you running while you recover
  • Manual therapy where appropriate to reduce pain and improve mobility
  • A graduated return-to-run plan tailored to your goals and timeline

When should I see a physiotherapist?

Don't wait until the pain forces you off the road. If knee discomfort persists beyond a few days, is getting progressively worse, or is affecting your gait, it's worth getting assessed early. Early intervention almost always means a faster return to full training.

Book an appointment with the Pinnacle Physiotherapy team at any of our Windsor, LaSalle, or Lakeshore clinics — no referral needed.