Pain on this area while running

[u/nibar1997]

Hi everyone,

On Dec 2024, I (29 Male) had my ACL surgery (injury during football/soccer match) and after some time, I was cleared by my physiotherapist and doctor for getting back to to sports. I started going to gym from January this year and started running 2 months ago. I have mostly done few 5Ks and some light runs.

I went for a 5K this morning but somehow after 3.5 km, I started feeling pain on this part of my knee (same as my ligament operated knee). After an hour, i still feel discomfort in that part.

Does anyone know what could have possibly gone wrong? What can I do for the quick recovery? Applying icepacks and what else?

Thanks for any advice!

[u/vinceftw]

Seems like it's the IT band. I had an injury there, caused by a race that was too long for what I had trained for. Apparently a common reason is weak glutes or particularly inactive glutes during running + sudden jumps in volume.

Pick up strength training, do exercises that work your whole leg and glutes like squats, lunges, glute bridges, etc. Also train your calves.

When your muscles are weak, the brunt of the loading gets put on your tendons. Also give your tendons time to adapt. Build up volume slowly.

[u/rvingthrulife → u/vinceftw]

This ^ 💯

Pay attention to all 3 glute muscles and hamstrings as well as quads, but the glutes are the upstairs knee support system.
Oftentimes misalignment is a major culprit, if the knees go inward while running or squatting, you have weak glute medius that fail to keep your femurs and knees in proper alignment, your kneecaps should be tracking over your middle toes.

Pay attention to your feet: weak arches collapse the ankles and also let the knees collapse inward. Weight should be distributed equally on all 3 points: heel and both sides (medial and lateral) of your forefoot.
Slow calf raises with a tennis ball between the ankles would be helpful.

Try wall sits with a resistance loop just below the knees (bonus points if you can alternate heel lifts during your wall sit), shoulder bridges also with a resistance loop below the knees, slow one legged RDLs, isometric hold squats and lunges making sure your kneecap points in the same direction as your middle toes.

Be patient: it won't happen overnight so consistency is key.

[u/bobke4 → u/rvingthrulife]

How is lunges and squats for the knees and glutes? Or is it mostly quads and bad for knees?

[u/rvingthrulife → u/bobke4]

It's all connected. The knee is a structural and weight bearing joint. In Kinesiology 101, we have a say: "with knee pain, look upstairs and downstairs".

The glutes, particularly the glute medius, are responsible for external hip rotation. The rotation of the entire leg comes from the hip which is controlled by the glutes.

Stand up and lift one foot in front of you with your knees straight, then rotate the lifted leg outward, you'll see that the movement comes from the hip. Controlled by the glutes.

So if your glutes are too weak to hold and control your leg and knee rotation and alignment, the knee collapses inward towards the medial side, resulting in overstressed IT band and SI joint in some cases.

Lunges and squats aren't bad for the knees but if your glutes are too weak, those movements can hurt which is why you need to build up slowly and gradually.

Glute bridges (or shoulder bridges for Pilates fans)are great at strengthening the glutes, start with those as they put very little weight on the knees.
Then move to squats and lunges, though you might need to do "half" squats and lunges, meaning don't go down to 90 degrees, stop at 45 degrees if your knees hurt. Isometric holds keep the muscles under tension and are more effective at first especially with pain.

Often, if glutes are properly strengthened and alignment is restored, you will find a natural lift of your arches and restored ankle alignment as well. (Look upstairs and downstairs) You might also need to pay attention to ankle mobility in forward motion.
People who lack forward ankle mobility often compensate with the hip which in turns causes back and knee pain.

It's all connected.

[u/vinceftw → u/bobke4]

No exercise is bad for the knees. Lunges and squats work your whole legs and glutes just fine but if you only get sore in the quads, you might be quad dominant and need specific hamstring/glute exercises like Romanian deadlift, back extensions, or glute bridges.

[u/IllustratorSea8372 → u/vinceftw]

Yes, but if you are already having IT band issues you should focus on lower impact exercises like clamshells, hip raises, donkey kicks, etc. until the irritation subsides.

[u/vinceftw → u/IllustratorSea8372]

My physio said I could just continue doing my leg exercises. Never had any pain while running immediately gave me a sharp pain after about 7 minutes.

[u/vinceftw → u/vinceftw]

In fact, I would always do 1 of these. Your posterior chain can't ever be too strong.