Knee Pain While Running Downhill

Written by James Roland

28 November, 2018

Running routines sometimes bring more than just the benefits of a good workout and an endorphin rush. They may also bring knee pain, especially when you run downhill. It’s likely one of two common knee conditions. Don’t wait until the pain is so bad that you can’t run anymore. Seek treatment as soon as possible.

ITB Syndrome

Pain while running downhill is a classic symptom of iliotibial band syndrome, also known as ITB syndrome. It occurs when frequent flexing of the knee irritates the iliotibial band. The ITB is a thick, fibrous tissue that starts at the hip, runs the length of the leg and crosses over the knee. Inflammation feels like a dull ache initially and turns into a sharp knife pain across the knee cap. You’ll feel the pain more intensely when you run downhill and put pressure on the ITB.

Pain while running downhill is a classic symptom of iliotibial band syndrome, also known as ITB syndrome.
You’ll feel the pain more intensely when you run downhill and put pressure on the ITB.

Treating ITB Syndrome

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The first step in treating ITB syndrome is rest. Your doctor will want you to stop flexing your knee, ice it for 20 minutes at a time and use anti-inflammatory medication such as ibuprofen and cortisone shots. When the pain subsides enough to work with a physical therapist, you'll strengthen the muscles that support the ITB, such as the gluteus medius on your pelvis. Unfortunately, ITB syndrome is hard to treat. If conservative methods fail, you can have surgery to cut the ITB where it crosses the knee cap.

The first step in treating ITB syndrome is rest.
If conservative methods fail, you can have surgery to cut the ITB where it crosses the knee cap.

Runners Knee

Runners knee is another syndrome you feel intensely when you’re running down a hill. The official name is patellofemoral pain syndrome. This irritation is caused when the femur, the bone in your thigh, makes frequent contact with the patella in your knee cap. It presents as general knee pain that worsens with each step, especially as the femur makes more of an impact when you're going downhill. Runners knee is often the result of overuse.

Runners knee is another syndrome you feel intensely when you’re running down a hill.
It presents as general knee pain that worsens with each step, especially as the femur makes more of an impact when you're going downhill.

Treating Runners Knee

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Just like initial treatment for ITB syndrome, the key to treating runners knee is resting the knee, using anti-inflammatory medication and icing. This condition responds well to physical therapy. The focus is on strengthening your quadriceps in the front of your thigh. They will absorb more of the impact when you run and help stabilize the knee cap to keep it from moving too much. Surgery is a last resort and involves an arthroscopic procedure to smooth the underside of the knee cap.