Knee Pain & Running Injuries
Knee pain can look very different from person to person — from a sharp pain behind the kneecap when you run or squat, to swelling after sport or a knee that’s been niggling after prolonged sitting or going downstairs. At The Physio Co., we take the time to work out why your knee isn’t coping, not just where it hurts. Our North Shore physios will assess the problem, explain what’s going on, and give you a clear plan to get your knee stronger, more capable and back to doing what you do best.
ACC ACCREDITED
NO REFERRAL REQUIRED
Does Any of This Sound Familiar?
Pain at the front of your knee during or after running
A sharp pain when you squat, kneel, or climb stairs
Clicking, locking, or giving way in the knee
Pain on the outside of your knee midway through a run
Knee pain that started gradually and just won't go away
Aching behind the kneecap when you sit for too long
A knee injury that didn't heal properly the first time around
Swelling or stiffness after activity
What's Actually Going On?
The knee is one of the most complex and heavily loaded joints in the body. It sits between the hip and the foot, meaning it bears the consequences of what's happening above and below it. Weakness at the hip, poor foot mechanics, or tight muscles anywhere along the chain can all contribute to knee pain, even when the knee itself isn't the primary problem. This is why knee injuries that don't respond to simple rest often need a more thorough assessment to get to the real cause. Running injuries deserve particular attention here. The repetitive, high-load nature of running means that even minor biomechanical inefficiencies can accumulate into significant injury over time. Conditions like runner's knee (patellofemoral pain), IT band syndrome, patellar tendinopathy, and shin splints are all closely linked to running load and movement patterns rather than just bad luck. Acute knee injuries, such as ligament sprains, meniscus tears, and cartilage damage, tend to have a more obvious cause: a twisting movement, a collision, or a fall. These require a different approach to the gradual-onset overuse injuries common in runners and active people, but both respond well to the right physiotherapy programme. The encouraging thing about knee pain is that it's rarely a life sentence. Whether your knee started hurting last week or has been problematic for years, the right treatment can make a significant and lasting difference.
Common Causes of Knee Pain
Knee pain can stem from a single incident or build up over weeks and months. These are some of the most common causes we see at the clinic.
Runner's Knee
(Patellofemoral Pain Syndrome)
Pain around or behind the kneecap, often worse with running, squatting, or sitting for extended periods. It's typically caused by a combination of muscle weakness, poor hip control, and training load, rather than any structural damage.
IT Band Syndrome
The iliotibial band is a thick band of tissue running down the outside of the thigh. When it becomes tight or irritated, it causes a sharp or burning pain on the outside of the knee, particularly during runs at a consistent pace. It's one of the most common injuries in distance runners.
Patellar Tendinopathy
Also known as jumper's knee, this is a condition involving the tendon connecting the kneecap to the shin bone. It causes pain just below the kneecap and is common in athletes who do a lot of jumping, sprinting, or heavy lower body training.
Meniscus Injury
The menisci are two C-shaped cartilage pads inside the knee joint that act as shock absorbers. They can be torn acutely through twisting movements, or degrade more gradually over time. Symptoms include pain, swelling, locking, and a feeling of the knee giving way.
ACL & Ligament Sprains
The anterior cruciate ligament (ACL) and other knee ligaments can be sprained or torn during high-impact or twisting activities. These injuries range from mild sprains to complete tears requiring surgical repair, but all benefit significantly from physiotherapy.
Weak Hips & Poor Biomechanics
Weakness in the glutes and hip stabilisers is one of the most common underlying contributors to knee pain in both runners and active people. When the hip can't control the leg properly, the knee takes on excess stress with every step.
Training Load Errors
Doing too much too soon is one of the leading causes of running injuries. A sudden spike in weekly mileage, adding speed work before a base is built, or returning to training too quickly after a break can all overload the knee before it's ready to handle the demand.
How We Treat Knee Pain
Every knee injury has its own story. We'll find yours, and build a treatment plan that gets you back to doing what you love.
Assessment & Diagnosis
We assess not just the knee itself but the entire lower limb chain, looking at how you move, load, and run to understand what's actually driving your pain. This bigger-picture view is what separates effective treatment from chasing symptoms.
Manual Therapy & Soft Tissue Work
Hands-on treatment helps reduce pain, ease muscle tightness, and restore normal joint movement. For acute injuries, this might focus on reducing swelling and restoring range of motion. For chronic conditions, it targets the tissues and structures contributing to ongoing load.
Weakness in the quads, glutes, and hip stabilisers is a common thread in knee injuries. We'll build a progressive strength programme that addresses your specific deficits, improving both your recovery and your resilience to future injury.
For runners specifically, we can analyse your running technique and identify any biomechanical factors contributing to your injury. Small changes to cadence, foot strike, or hip control can make a significant difference to how much load your knee absorbs with every step.
For stubborn tendon pain or persistent muscle tightness around the knee and thigh, dry needling can be a highly effective addition to your treatment programme, helping reduce pain and improve tissue response.
What to Expect at Your Appointment
1. Consultation
We take the time to understand your knee pain, your training history, and your goals, so we know exactly what we're working with.
3. Treatment
A combination of hands-on therapy and targeted exercises, delivered in our clinic and on-site rehab gym.
2. Personalised Plan
We design a personalised treatment plan based on your assessment, whether you're dealing with an overuse injury, an acute sprain, or a long-standing issue that's never been properly addressed.
4. Ongoing Care
We'll set you up with a home exercise programme and a clear return-to-activity plan so you can get back to training with confidence.
Why Choose The Physio Co?
Based in Wairau Valley, we're Auckland's North Shore physio team.
We look at the whole picture, not just the painful part. Understanding how you move is how we find the real cause.
On-site rehab gym, so treatment and rehab happen together, in real time.
Our team are athletes and coaches themselves. We know what it takes to get back to training at the level you want.
Where to Find Us
46a Porana Road, Wairau Valley
Auckland 0627
New Zealand
Monday - Friday: 7am - 7pm
Saturday: By Appointment Only
Sunday: Closed
Knee Pain & Running Injuries FAQs
When Should You See a Physio For Knee Pain?
A lot of runners and active people try to push through knee pain, hoping it'll sort itself out with a few easy days. Sometimes it does. But often, ignoring it allows a manageable issue to become a more stubborn one.
You should book an appointment if:
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Your knee pain has lasted more than two weeks without improving
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Pain is affecting your running, training, or daily activities
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Your knee is swollen, particularly after activity
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You've noticed clicking, locking, or a feeling of the knee giving way
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Your pain came on after a specific injury, fall, or twisting movement
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You've had knee pain before that keeps returning
You should seek urgent medical attention if your knee is severely swollen following a traumatic injury, you are unable to bear weight at all, or the joint appears visibly deformed. These situations require an immediate medical assessment rather than a physio appointment. For most people, an early assessment means a faster, more straightforward recovery. The sooner we understand what's going on, the sooner you can get back to what you love doing.
ACC ACCREDITED
NO REFERRAL REQUIRED
What You Can Do in the Meantime
While there's no substitute for a proper assessment, there are things you can do at home to manage your symptoms and support your recovery.
TIP 1
Reduce Load, Don't Stop Completely
If running is aggravating your knee, cutting back your mileage or switching to a lower-impact activity like cycling or swimming is a smarter move than stopping altogether. Keeping some activity going maintains fitness and helps the tissues adapt.
TIP 2
Ice After Activity
If your knee is sore or swollen after exercise, applying ice for 15 to 20 minutes can help manage inflammation and reduce pain. Wrap the ice in a cloth to avoid direct skin contact.
TIP 3
Strengthen Your Glutes
Weak glutes are a contributing factor in a wide range of knee injuries. Simple exercises like glute bridges and clamshells can be done at home and help take some of the load off your knee during activity.
TIP 4
Check Your Training Load
Look back at what changed in the weeks before your pain started. Did you increase your mileage quickly? Add a new type of training? Return from a break? Identifying the load change that preceded the injury often points directly to what needs to change.
TIP 5
Avoid Running Through Sharp Pain
A general rule: mild discomfort during activity that settles quickly afterwards is usually manageable. Sharp or worsening pain during a run, or pain that takes more than an hour to settle after stopping, is a signal to rest and get assessed.
We are a registered ACC provider for physiotherapy in Auckland
Yes, we are ACC accredited. To find out if you are eligible or for more information, click here.
Note: these tips are general guidance only and may not be appropriate for every type of knee injury. Your physio will give you specific advice based on your individual assessment.
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