Knee pain in runners and lifters is usually not the knee’s fault. The knee is a hinge caught between the hip and the foot, and when either of those is not doing its job, the knee is where it gets noticed.
The two common patterns
Around the kneecap — an ache at the front, worse on stairs, hills, and after sitting a while with the knee bent. The kneecap is not tracking well through its groove, usually because the hip is not controlling the thigh.
Outside of the knee — sharp, often arriving at a predictable point in a run, then easing with rest. Typically the IT band and the tissue around it, again usually a hip control problem rather than a band that needs “breaking down”.
What usually causes it
- Doing more, suddenly — mileage, hills, a new plan.
- Weak or lazy glutes, letting the knee drop inwards on every step.
- Restricted ankles, which changes how the knee loads on every stride.
- Worn-out shoes, or a change of surface.
What treatment involves
Assessment first — including watching you move, because this is a problem you can rarely find by pressing on the sore bit.
Soft tissue work through the quadriceps, the lateral thigh and the glutes to release what is pulling the knee out of line, then strengthening the hip so the knee stops taking the load. Almost all of the lasting improvement comes from the hip work, not from treating the knee itself.