Question: I’ve been a runner for several years and never really suffered from injury. But lately I’ve noticed that a few miles into a run my knees start to feel sore. I’m in my late-30s and wondered if this was a result of years of running? Or is there something I can do to strengthen my knees or reduce the pain? Matt, London

Our experts answer

Thanks for your question. This is really common and we hear it a lot from runners. Firstly, don’t assume that running has caused “wear and tear” and that knee pain is inevitable. It’s not. Research has proven that running helps to keep knees healthy through better blood flow to the knee joint and lubrication, and can help reduce the risk of developing arthritis. The cartilage usually only wears down if there’s been an old injury (a side impact from rugby or skiing for example) or there’s some sort of biomechanical imbalance causing irregular tracking or stress to the knee joint.

Knee pain is very common in runners and presents in various ways, with some runners complaining of pain under the kneecap, when going up and down stairs, or of pain to the medial or lateral side of the knee. Either way, it’s not to be ignored and there are lots of ways you can address it.

Given that your knee pain has come on more gradually and it’s affecting both knees, I’d suggest it’s more muscular and probably coming from tight quads muscles in your thighs. The first thing to do is get yourself a foam roller and work very hard on releasing your quads with some self massage. Have a look at Trigger Point Therapy on YouTube and search for “Unlock Your Quads with The Grid” which is a great educational video. Spend about 3–5 minutes working on each quad every day. It’ll hurt to begin with, but should quickly start to improve and within a few weeks you’ll really start to notice the benefits.

A few massage sessions with a sports therapist is also a good idea, and get them to focus on your quads. But don’t just focus on your knees – the location of the pain is just the symptom, you need to find the root cause. The body is a kinetic chain and everything is linked. Look higher up to your pelvis to address the true cause of the problem.

Runners that get knee pain often find they have weak glutes and hamstrings and lack of hip extension – which can cause a heavy foot strike and for the quads to become overworked. Try to include a wide range of conditioning and stretching exercises along with a good warm up and some drills. Have a look at James Dunne’s videos and exercises on, which are excellent.

The most important thing is not to ignore it. There’s a lot you can do to help yourself – foam rolling, hip flexor stretching/releases, glute stability and core stability work will all work wonders if you do it regularly enough. Aim for little and often every day. A few minutes of hip stretches while brushing your teeth, a few glute exercises while waiting for the kettle to boil, for example, will build up and will help. Aim for 15-20 mins a day in total.

Don’t underestimate the power of the foam roller. I recommend The Grid by Trigger Point Therapy. You can also use a massage ball on your glutes which helps with pelvic mobility. Warm up before a run with plenty of hip release work, leg swings and lunges too. Hope this helps and keep us posted.

Sarah Russell has over 20 years experience in the fitness industry as a running coach, trainer, freelance writer and athlete. She has a Masters degree in Sport Science and is a England Athletics running coach.

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