Knee pain explained – and three ways to train your way out of pain

Knee pain can take many women out of action, from beginners to seasoned female athletes. Here’s what causes it and what you can do to prevent – or recover from it….

All too often, we push through knee pain, pushing it away thinking that it will go away or that the pain is just in our head. But when it turns into a persistent, dull nagging ache, sharp pain or even feels like ground glass under the kneecap, you know that the situation is going to need more than just taking ibuprofen.  Here we explain the mechanisms behind knee pain and how to work through it. 

What Causes Knee Pain?

 The knee is composed of two joints: the tibiofemoral joint, between the femur (thigh bone) and tibia (shin bone), and the patellofemoral joint, between the femur and patella (knee cap). Each works as an anchor point for multiple tendons, fascia, and other structures, including the IT band – or illitobial band.

If you have poor biomechanics – essentially, the way your body moves – this is caused by a muscle imbalance, and repetitive movement on poor imbalanced muscles can irritate the knee and result in anterior knee pain—a catchall category for general pain in the front of the knee.

What causes muscle imbalance?

While you may be forgiving for thinking that this stems from weak muscles around the knee, the actual stabilising muscles for the knee are found in the hips – the gluteal muscles. When these muscles are weak or imbalanced, your knee can not keep proper alignment when you land or take off from the floor when running, for instance, or when pushing through a pedal on a bike.

And to further complicate matters, once the pain signals to your brain that there is a problem, your body can shut off key muscles and this can cause further stiffness. 

Can You Train Your Way Out of Knee Pain?

If your knee pain came on gradually over time and you have no excessive swelling, some of the moves below may help increase the functional strength and mobility of the muscles that  support your knee and improve your biomechanics.

Try this test ; stand on one leg and do a couple of one legged squats and watch how your leg moves. ‘If this causes pain, or your knee wobbles or rolls inward, these exercises could help,’ explains Dawn Buoy, lead physiotherapist on Girls Run the World digital platform.

Try these exercises, or if you have been diagnosed with ITBS try our online programme, ITB Rehab and Return to Running, a fully comprehensive physiotherapist designed programme to rehab and prehab knee pain, ideal for female runners.


Calf and ankle mobility greatly affect how the rest of the leg responds. Exercise: One leg at a time, place the ball of your foot on the edge of a step and lower your heel to gently sink into a calf stretch. Keep pelvis level.. Hold for 30 seconds on each leg. Repeat 3 x
Fire Hydrants: Helps you gain core stability and works the glute muscles:
Foam roll every day: for videos on how to, visit our free foam rolling guide on YouTube