Runners often tell us some version of the same story: "I've trained for ages, I'm in decent shape, but after a certain distance my knee hurts every time." The truth is, knee or back pain from running is almost never caused by a single factor — it's usually the sum of several small things quietly stacking up without you noticing.
The 5 Most Common Causes
Before you can fix the problem, you need to know where it's actually coming from. See which of these apply to you.
- Poor running form — overstriding, or landing too hard on your heel with every step, which sends impact force straight up into your knees and back.
- Muscle imbalance — weak leg, hip, or core muscles that simply can't absorb the impact of running properly.
- The wrong shoes — running in regular sneakers that weren't designed for running and don't offer enough shock absorption.
- Inconsistent running surfaces — running on hard or uneven ground too often without ever varying the terrain.
- Overtraining — increasing distance or pace too quickly for your body to adapt.
Why "Just Rest It" Isn't Always Enough
Many runners take a week off when pain shows up, then go right back to running exactly as before. The pain usually returns at a similar distance or time, because rest calms the inflammation but doesn't fix the underlying cause — the running form is still the same, the weak muscles were never strengthened, and the same shoes are still the wrong fit.
If you feel the same knee or back pain every time past a certain distance, that's your body telling you to stop and investigate — not just push through because you want to hit a training goal.
So Where Should You Actually Start Fixing It?
The best place to start is having a physiotherapist analyze your actual running form to pinpoint exactly where the abnormal impact is coming from. From there, they can design a strengthening program for the muscles you're missing, gradually correct your running form, and recommend the right shoes or gear for your foot type and running style — a very different approach from resting and going right back to the exact same routine.
How We Help Runners at Bless Space Physio
We always start with a proper assessment — your running form, muscle strength, and joint flexibility — before building a targeted recovery and strengthening plan. The goal is simple: get you back out there running with confidence, without worrying that the same pain is waiting for you at the same mile marker.
