Knee Pain

Though proper investigation of any ‘ache’ requires individual face-to-face assessment, one piece of advice that I would give any new runner suffering from aching knees (as well as making sure you are not doing too much too soon!) is to check how much range of movement you have in your thigh muscles.

Of the four thigh muscles collectively referred to as the ‘quadriceps’, the one of particular interest is the ‘rectus femoris’, which I will refer to as RF. In contrast to the other three ‘quad’ muscles, the RF crosses the hip joint and starts on the front of the pelvis. It then extends down the front of the leg towards the knee, where via a tendon, it attaches to the main bone of the lower leg (the ‘tibia’). The RF is therefore unique in that it can be used to not only straighten the leg (like the other quad muscles) but also to lift the knee up in front of you.

Modern day life encourages many of us to over-work the front of the legs and under-work the muscles on the posterior leg (glutes and hamstrings). As a result, when we run our brain may over use the RF to lift the knee, when in reality we should be working more to drive the leg backwards using the glutes and hamstrings. Over use of the RF may well be connected to why you are suffering from knee pain. As I have suggested, get checked-out properly but in the meantime try the below ‘kneeling pelvic tilt' for a mobility exercise, on a daily basis, to help relax the RF.


1. Get into a kneeling position (as seen in the video).

2. Note how much tension you feel up the back leg, from the knee to up the thigh and across the hip. The chances are you will not yet feel too much but if you do this suggests your RF is particularly ‘tight’.

3. Tilt your pelvis upwards such that the waistline at the front of your trousers moves to the same height or a little higher than your trouser line at the back. In other words, tuck your backside under your hips.

4. Once the stretch sensation reaches a 6/10 ( ‘10’ represents a sensation so painful you have to stop’) , maintain this position until it eventually falls to a 3/10 (about 20 seconds). Once the stretch sensation has fallen, tilt a little more so that it rises to a 6/10 and hold as before for another 20 seconds.

For many, this tilting movement will not come easily as it requires a coordination of muscle recruitment that your body may not be familiar with. You may need to practice the movement lying down (tilting your pelvis so your lower back touches the floor) in order to engage the necessary muscles, and then try it again in a kneeling position. Don’t forget to test and compare both sides!

As always, if pain persists for more than 3 runs, get checked out by a suitably qualified Sports Therapist or Physiotherapist, preferably one who has experience of working with runners.

By Matt Phillips


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