knee injust physiotherapy

Knee pain in runners and how Physio and Pilates can help

Runners commonly present to physios with pain on the outer aspect of their knees. The cause of this pain is usually related to the Iliotibial band, or the ITB. The ITB is a thick band of connective tissue that runs down the side of the leg, between the hip joint and the knee. It attaches into the lateral aspect of the knee joint and just below.

Why does the ITB get sore?

There are usually several factors contributing to why the ITB becomes tight and irritable around its attachment point on the lateral aspect of the knee. These include:

  • Muscle imbalances – weak gluteal muscles and weak VMO (part of the quads) will lead to knee pain as your running distance increases and muscles begin to fatigue
  • Poor flexibility – tightness through claves, quads and glutes may increase load through your ITB
  • Incorrect footwear – old, non supportive shoes will lead to increased load through the ITB
  • Poor foot biomechanics – excessive pronation or flat feet will increase the load through your lateral aspect of your knee as the knee will fall inwards during the strike phase of running.
  • Overtraining – increasing running load too quickly
  • Running technique – over striding and low cadence

How can physio help?

At PMPP we can assess your running technique, discuss your training load with your coach and refer you to a podiatrist if we feel your foot biomechanics or running shoes are a contributing factor to your knee pain. We can also treat tight surrounding muscles, such as the glutes/quads/calves with soft tissue work and dry needling, and determine if a strengthening or flexibility program is required.

How Pilates can help?

Clinical Pilates focuses on building core strength to stabilise your hips and pelvis, which will assist to improve running technique and endurance. During a Pilates session we focus a lot on gluteal strengthening to reduce muscle imbalances and reduce muscle fatigue, to allow your body to tolerate longer running distances. Pilates is also a great way to stretch out tight leg muscles!


A multi disciplinary approach is usually needed to help you recover from lateral knee pain. Check out the links below for further information on other services.

Chris White – Running Coach at Go Run Australia

Up and Running Podiatry


To book in with one of our physios to discuss your knee pain click here



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