Why Do I Have Knee Pain When Walking or Running? Video Summary

Knee pain can be frustrating, especially if you're staying active and exercising regularly. But did you know that your knee pain might not actually be caused by the knee itself? In this video, our team breaks down how knee pain is often a symptom of misalignment in other areas—like your feet, hips, or posture—and how posture alignment therapy can help.

Your knees are hinge joints, meaning they rely heavily on proper support from the joints above (hips) and below (ankles) to function correctly. Misalignments like over-pronated (rolling in) ankles or tight hips can cause the knee to track improperly, leading to strain, discomfort, and chronic pain over time. Whether you notice your knee caving inward when walking or feel an uneven stride, these subtle imbalances often point to underlying postural issues that need attention.

The conversation also dives into common movement patterns—like saloon-door walking or excessive trunk rotation—that can put added pressure on the knees. If your glutes or other key muscles aren't doing their job, your knees might be compensating. When this happens, every step becomes an opportunity for improper load distribution and pain. 

To identify these issues, try watching yourself walk or run in a mirror or record yourself on video. Notice if your knees are tracking inward, outward, or if your body twists to compensate. These signs can offer important clues about why your knees hurt and what adjustments might be needed.

Posture alignment therapy helps by identifying the root cause of misalignments and retraining your muscles to support your body in optimal alignment. Our team emphasizes the importance of addressing the entire kinetic chain—feet, knees, hips, and even shoulders—so your body moves efficiently and without unnecessary strain.  

If you’re struggling with knee pain when walking or running, it might be time to take a closer look at your posture and alignment. Our therapists are here to help you uncover and resolve the underlying issues, allowing you to move pain-free and enjoy your favorite activities again!

Why Do I Have Knee Pain When Walking or Running? Video Transcript

Alright. So today, we have a question from a client who asks, “Why do I have knee pain when I walk or run, and how can posture alignment help?”

So, your knees are very affected by the joints above and below. So how you're loading your foot, number 1. So, for example, if you're somebody that maybe has a really weak glute line and your ankles roll in or pronate, You see how when I'm – what I'm doing is I'm rolling my ankles in, but my knees kind of go in automatically.

So that pulls long in here, and it shortens out here, and you're also just getting your hip, knee, and ankle out of alignment. Anytime you don't have a nice straight line, there's opportunity for pain and misloading. And the same if you're here, if you have maybe super tight hips and you're kind of walking like this all the time, you're really stuck in dorsiflexion. Your shin muscles are gonna be overworking, and that's gonna cause knee pain. So look at your ankles, look at your hips, and chances are if there's something going on in one of those joints, that is definitely affecting your knee.

Yeah. That's a great way to look at it. And one way people can do it is if you have a full-length mirror that you can look at walking towards or set up your phone and record yourself walking, then you can look as you take a step or steps, whether it's walking or running, and then just gauge, like Carrie Ann was saying, gauge where your knee is pointing when you load, especially upon that initial contact of your heel or foot to the floor. 

Then does your knee cave in? So knee valgus or or valgus stress, knock knees. Does it bow out excessively? Does your knee point in? So does it cave in – the kneecap itself actually turn in? Or does it stay out the whole time? Because all those things can set up problems for the knee.

And if you do a quick search on Google and you say, what causes knee pain? If you look on Mayo Clinic’s site, for instance, it's gonna say, well, arthritis or osteoarthritis or rheumatoid arthritis or gout or injuries… ACL or MCL or all these or loose bodies. All those things, while they call them causes of knee pain, sure, but usually those things are after the alignment or after some mechanism of injury. And so when, with again, going back to what Carrie Ann was talking about, we're talking about the kinetic chain of the body and how the parts are supposed to work in unison. So that foot and ankle position is so critical to set up the knee to hinge as it's supposed to because it's basically a hinge joint, with minor rotational and other movements, and then the hip above it.

If the hip isn't doing its job, then that's gonna create issues too. So when you look online, be careful because then you're just looking for a maybe already specified problem as the cause of the pain and then, of course, then the ultimate solution then would be like, oh, okay, well let's do surgery and fix the blah blah blah. But did we fix the problem that set us up for that in the first place? Meaning the things that Carrie Anne was talking about posturally.

Yeah. So I guess, as a test, you could record yourself. But even just if you stand up right now and watch yourself, an easy way is just marching in place. So if I'm standing here, when I lift my knees in front of me, are they pulling in front or am I walking like this, where one knee is coming out? Or the opposite way where I'm kind of pulling forward. So, and even when I'm lifting forward, not just the lower half of my body, am I am I tilting?

I feel like I look really funny on camera right now, or am I doing something else with my body that I'm not really aware of? So yes. So I mean, all of these ways, and this is just with supposed hip flexion of pulling in front, but there's all these other ways of movement. Am I am I walking and swinging in? So if I'm walking, am I swinging in?

I see a lot of that saloon door walking where people will walk, and they'll walk, and you just see this… I'm exaggerating, of course. This knee kind of flipping out and in just like a saloon door, or okay, I'll walk forward or just a big swing out. So I definitely think recording yourself helps. But even if you're just standing in place, you can look and see.

Just for me standing here, is one knee pulling out? Is it pulling in? Do I feel myself falling one direction or the other? Or do I notice, yeah, that twist and rotation? Every time I lift my left knee, my whole body caves and pulls one way or the other.

Yeah. Totally. And it's all about momentum. So, we describe walking... So, since we're talking about walking and running as it relates to knee pain, then, walking is basically controlled falling. Right? 

So there's just this momentum play. But then when you're trying to generate more speed, like running or, if you're going uphill, for instance, then now you're gonna have to generate more forward momentum. So that's where that rotation comes in or excessive arm swing or the flexion of the trunk or some other mechanism to try to do that. And if the hip's not working like Kim's saying, then, yeah, we're we're trying to create hip flexion.

So that's the swing phase, whereas before with Kim, we're describing more like the loading phase of what's going on. So that's that's great, Kim, to to bring that together. And the body basically works in hinges when we're walking and running. So if there's too much side-to-side movement like you're describing, if there's too much rotation, if there's too much in or outward movement, if we're on a really narrow stance… All those things can be signs of your postural dysfunction.

When you hit the pavement, immediately, there's a a reaction that travels up your body. And if you're in improper alignment when your foot hits the pavement, if you're way too forward, all the weight is on your distal quad, and your glute isn't gonna help you at all, and your glute should be helping you move through space. So, just setting up your entire carriage so that when that bottom force reaction goes through your body, it goes to all the right parts, and everything lights up. Right?

It should be like a pinball machine where it goes boom, boom, boom, and all the right things light up. And then you just get speed, and you're able to go really fast. And, but if one thing is off, then you go down the hole and game over. Lose a turn.

Yeah. That's a great point. And, yeah, I like the sort of video game or arcade game analogy. It's one of those things too where the argument of, oh, running's bad for your knees. Well, it's been disputed and sort of debunked to the idea that running is actually good for your knees. But it can be if your posture is off, your alignment's off, and where walking or running creates a knee problem is because, yeah, we're working in this very inefficient, misaligned, poor posture manner where the parts of the body, again, aren't working together. And that also brings up the idea sometimes we'll see people who have, or maybe they're getting headaches from running. And it's like, well, I don't understand why I get headaches or whatnot.

And, yeah, it could be the compensation, their shoulders, and into their traps and everything tightening up. But it's also that when you're talking about, the ding ding ding up the line. What I think of that is the cushioning and the ability to transmit forces evenly up through the body. So as the foot strikes, then the forces, some moving to the foot, but most of it goes up the body through the shin bone into the knee. And then that should disperse through the long bone of the thigh into the hip, and then disperse through the muscles and into the pelvis and then up the spine, and all of those shock absorbers that we have along the spine.

And if we're getting headaches running or walking, then it's like none of that's really working because we're way too tight or way out of alignment or we're just, you know, things aren't moving as fluidly or as in good functional movement that they should be.

So watch yourself walk. See how your foot lands. See how your hip lands. Look at your knee, and chances are you'll find the clue to what is wrong.

Then you can ask one of us, and we can tell you how to fix it and what needs to change.