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Why Do I Feel Knee Pain When Standing or Running

2019 09 26 1049
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Have you ever felt some nagging knee pain while you go about your usual activities? If you wish to find relief, first, it is important to be aware of the possible reasons behind this. 

A recap on the kneecap

The patella or kneecap is the movable bone on the front of the knee that rests between the thighbone and shinbone and is cushioned by the articular cartilage. It comes with two tendons attached to it, the quadriceps tendon on top and the infrapatellar tendon below it. These two are largely responsible for leg flexion and extension. The patella also protects the front portion of the knee from trauma.

The kneecap can be a source of knee pain when it fails to function properly. The usual culprits are alignment and/or overuse problems which can lead to wear and tear of the cartilage. This results in pain, weakness, and even knee swelling. 

While trauma is an obvious suspect, we are often caught off guard when what you thought was negligible discomfort gradually turns into chronic nagging knee pain. These sensations can be cause for concern especially when it affects usual movements like standing, walking, or running.

There are 2 possible reasons behind this kind of knee pain: repetitive strain injuries and degenerative joint disease.

Repetitive Strain Injuries

Repetitive strain injury is used to describe the pain in the muscles, tendons, and nerves caused by repetitive movement or overuse. Microscopic tears in these tissues, which the body is unable to repair, cause an inflammatory response that leads to painful sensations.

Repetitive injuries of the knee include Patellofemoral Syndrome and Iliotibial Band Syndrome.

Patellofemoral Syndrome – Runner’s Knee

Knee pain linked to Patellofemoral Syndrome is the most prevalent orthopedic condition seen in sports medicine. It is the type of pain felt at the front of the knee around the kneecap. Since it is common in people who participate in sports that involve running and jumping, it is also dubbed the “runner’s knee.”

Knee pain linked to Patellofemoral Syndrome is felt at the front of the knee, around the kneecap.

While it may be common among highly mobile individuals (e.g. athletes), and is aggravated with more knee movement, patellofemoral pain can also affect anyone who sits for long periods of time. Constant knee flexion by sitting for several hours can cause kneecap fatigue. So, if you are bound to your office table for hours every day this should be good reason for you to do stretching breaks to relieve knee tension. 

Women and the anatomical makeup of their pelvis makes them twice as likely as men to develop patellofemoral pain syndrome. It is also more common in adolescents and young adults. 

Iliotibial Band Syndrome

Another cause for nagging knee pain is Iliotibial (IT) Band Syndrome. The IT band is the thick portion of the connective tissue that stretches down the outside length of your thigh muscles. When you bend and extend your leg, this band also moves over the outer lower edge of your thighbone. Repeated flexion and extension may irritate surrounding tissues, causing you pain. 

The pain felt from this type of injury dominates the lateral side of the knee and usually doesn’t radiate beyond this hotspot. So, you will feel that the pain begins at the outer portion of the hip and continues down to the top of the shin. 

The pain felt from this type of injury dominates the lateral side of the knee and usually doesn’t radiate beyond this hotspot.

Injury to this area occurs when you overload the knee by increasing training mileage or intensity. You will start to feel the discomfort with repetitive walking uphill or downhill. Sitting can also worsen the pain after you have been doing so for a while – roughly around an hour. As the injury worsens, the pain may continue even long after you have finished doing a certain sport or exercise, even while you simply stand still. 

IT Band Syndrome is common among athletes, especially distance runners. Others who may be at risk are those who run in uneven terrain, worn-out shoes, in cold weather, and those who are bowlegged.

Degenerative Joint Disease

Degenerative joint disease is also known as osteoarthritis. It is caused by inflammation, damage and breakdown in your joint cartilage which are processes that all result in knee pain. It may develop as a result of an overuse injury or as part of the aging process. 


Osteoarthritis is a common form of arthritis that affects the knee. It is also referred to as a “wear and tear” disease that happens at the underside of the patella as the cartilage deteriorates. With the cartilage wearing away, it will basically be bone rubbing on bone, and pain only worsens as the disease progresses. This condition can affect anyone at any age, but it’s more common in women over 50. 

The pain associated with osteoarthritis worsens with activity. Knee stiffness, swelling, and pain also occurs after prolonged sitting or resting. The number of people affected with symptomatic knee osteoarthritis is likely to increase because of the aging population and obesity epidemic. 

How to Relieve Knee Pain 

There are different pain management options for these conditions. The list can range from home remedies to surgical interventions.

Patellofemoral Pain (Runner’s Knee) Iliotibial Band Syndrome Osteoarthritis
  • Rest your knee
  • Cold compress, several times a day
  • Compression to prevent additional swelling
  • Elevate your knee higher than your heart
  • Medications (pain relievers and anti-inflammatory drugs)
  • Choose knee-friendly sports
  • Rehabilitation exercises
  • Supportive braces
  • R.I.C.E (Rest, Ice, Compression, Elevation) technique as initial treatment
  • Medications (pain relievers and anti-inflammatory drugs)
  • Stretching
  • Massage using foam rollers
  • Quadriceps training
  • Make changes in your activities
  • Medications (pain relievers and anti-inflammatory drugs)
  • Weight loss
  • Exercise
  • Braces
  • Physical therapy
  • Lubrication injections
  • Bone realignment
  • Assistive devices
  • Braces or shoe inserts
  • Hot and cold therapy
  • Transcutaneous electrical nerve stimulation (TENS)
  • Joint replacement

When to Call the Doctor

If pain does not subside for 3-7 days after R.I.C.E therapy and pain medications, it is a good rule of thumb to schedule a consultation with a sports medicine doctor or orthopedic surgeon. 

Read: Patient’s Guide When Seeking Orthopaedic Care in Singapore

Talk to a Harvard Fellowship trained orthopedic surgeon, Dr. Andrew Quoc Dutton, today.  His clinical interests include joint replacements/reconstructions, arthroscopic/keyhole surgery for the knee, cartilage regeneration and sports injuries. Call us at (+65) 6836 8000 to book a consultation, or drop us a line, here.

About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

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