Determining whether it’s appropriate to use either ice or heat for knee pain after running depends on how long you’ve been feeling the discomfort.
Ice is your best bet to ease knee pain right after your running sessions. But if it’s still lingering for a couple of days even with cold therapy, you should switch to heat instead.
Below we’ll discuss why that seems to be the case and other things you should do to eliminate running-related knee pain. Tap on the links below to get started:
- Ice for knee pain
- Heat for knee pain
- 4 Causes and solutions
- 4 Injuries that lead to knee discomfort
Ice is better for knee pain after running
Ice is the way to go when dealing with recent knee pain of any kind. It effectively slows down your nerve signals, producing a numbing feeling that helps relieve pain. (1)
It also reduces blood flow in your affected area. This is actually beneficial for you as it halts the chemicals needed to continue inflammation. (1)
There are other scenarios where using ice/cold therapy is beneficial
This includes being a first aid tool for acute injuries, preventing flare-ups of arthritis, and as a way to cool down after a hard workout.
Learn more: How to use ice for knee pain?
When can you apply heat after running?
After a fresh injury, it’s best to wait for a week before doing some form of heat therapy.
Heat works by expanding your blood vessels. This improves fluid circulation and also helps to reduce pain. (2)
But if you apply it too early, heat can worsen inflammation and potentially delay your recovery. (2)
Heat therapy can also be applied outside of running injuries.
You can use it as a way to warm up your joints before you run or as a form of relaxation before bedtime.
Know more: How to use heat for knee pain?
4 possible causes of knee joint pain from running
There are a ton of factors that come into play that could lead to running-related knee discomfort. Here are some of the most common.
1) Post-workout soreness
It’s normal to feel a bit sore after running, especially after a hard run or going past your usual distance.
See, your muscles could get damaged by overworking them. This results in microtears and inflammation leading to soreness that could last for a few days. (3)
But you don’t need to be worried about it. This is just part of the healing process and your muscles would eventually recover and get stronger from it.
Solution: Use different recovery tools
Aside from applying an ice pack, you could also try getting a massage. It’s a great way to improve circulation and lessen both muscle damage and pain. (4)
Wearing a compression sleeve also helps. This is a piece of clothing you slip onto your leg that reduces muscle swelling and inflammation. (5)
Recommended: The best knee sleeves and braces for running
2) Poor body conditioning
Running requires strong legs to keep propelling you forward. So if your muscles couldn’t handle the stress your body demands of them, this could lead to knee pain.
Pushing through the pain would result in bad running form, putting further strain on your muscles, and risks developing an injury.
Solution: Train your body
Strength workouts are useful to build resiliency and improve force production from your muscles. So try adding some squats, lunges, and core exercises to your daily routine.
Having a run/walk program could also improve your conditioning. Start with a ratio of 2 min running with 1 min of walking for 30 minutes at a time. Add more time once it gets easier.
This can help: 11 exercises for knee pain (with images)
3) Worn-out shoes
You can only put a finite amount of miles before your running shoes begin to fall apart. Insisting on using a worn-out one might cause your body to move in a less-than-ideal way, causing knee pain.
Solution: Buy a new running shoe
This may seem easy, but there are a ton of running shoes on the market.
To make it easier for you, we recommend getting your running pattern assessed by a specialist before buying, to get the best recommendations for you.
You can do this with a physical therapist. PTs are experts in identifying motion restrictions and muscle weaknesses. Based on their evaluation, they could give shoe recommendations to complement how your body runs.
4) You’re overstriding
Cadence is the number of steps you take per minute. Having a low count of this could mean that you are reaching too far forward when you run, or overstriding.
This running mistake could lead to more stress on your knee joint as you strike the ground with your legs locked out to absorb your weight.
Solution: Increase your cadence
Research shows that increasing your cadence by 10% reduces the impact on your knees. (6) By taking quicker steps, your foot would naturally land closer to your body.
One tool you could use to help you is a metronome. Here’s how to incorporate it into your workouts:
- Run for a minute and count the number of steps you take.
- Compute 10% of your cadence.
- Set your metronome to the sum of your cadence and the computed 10%.
- Sync your steps to each beat of the metronome when you run.
Pro-tip: I know this could get irritating at first. But once you get used to it, you can search for songs that match your targeted cadence to make it more bearable.
4 running injuries that can lead to knee pain
24% of running-related injuries occur at the knee joint. Below are some of these injuries and tips on how to manage them at home. (7)
PS: If none of the self-treatments below seems to work, please get your knee checked by a doctor or physical therapist.
1) Runner’s knee
Many runners often describe this as pain around their kneecap. Symptoms often get worse when going up and down the stairs, and after sitting for a long time. (8)
Some of the possible causes behind this injury include (8):
- Weak thigh and hip muscles.
- Kneecap misalignment.
- Asymmetrical leg length.
- Foot deformities.
What are my treatment options?
If you relate to this injury, then you should take a few days off of running. I know that sounds frustrating, but you need to allow your body to catch up and recover.
While you’re at it, apply ice on your knee to settle down the pain. Add some lower body strengthening exercises once your leg feels better to take some load off your affected joint. (8)
This can help: Effective exercises for runner’s knee.
2) Patellar tendinitis
This describes pain in the patellar tendon, which is in between your kneecap and shinbone. The affected area often feels more tender the longer you run. (9)
Chronic overload is the most commonly reported cause of this knee injury. This means that too much stress on your tendon causes it to become weak, producing microtrauma and pain. (9)
What are my treatment options?
You should also strengthen your leg muscles, focusing on the lowering phase of a squat or lunge, once you can tolerate some movement.
3) Iliotibial band syndrome
This relates to outer knee pain when you run and that disappears at rest. It got its name from a fibrous soft tissue connecting your hip and knee.
This tissue tightness from hip weakness. As a result, it could then rub and irritate your outer thigh bone whenever you bend your knee. (11)
What are my treatment options?
Rest, ice, taking anti-inflammatory drugs, and getting a massage help to lessen the pain. Research also shows that doing hip strengthening exercises can also aid in your recovery. (11)
4) Knee bursitis
This relates to swelling and inflammation of small fluid-filled sacs called the bursa. Suddenly increasing your running distance might have caused excess friction and irritation to these structures.
What are my treatment options?
Taking pain medications and applying the RICE protocol could help reduce swelling and discomfort. (12) The latter option means:
- Resting your knee.
- Icing your inflamed bursa for 10 minutes.
- Compressing it with an elastic bandage.
- Elevating your leg to accelerate fluid reduction.
Learn more: Knee bursitis – causes, treatments, and more.
Is heat or cold better for knee pain?
Cold is better for knee pain that’s from an acute injury. Heat therapy, on the other hand, is good for handling long-term aches and discomfort.
Keep reading: What’s best for a sore knee – ice or heat?
Should I ice a sore knee after running?
You should definitely ice a sore knee after running, both for pain management and to reduce swelling.
Does a heating pad help with a runner’s knee?
A heating pad could help a runner suffering from chronic pain.
Conclusion: Should you use ice or heat after running?
Apply ice to relieve knee pain right after running. You could use heat after a week if there is still some discomfort.
Meanwhile, other causes and injuries that lead to knee pain can be remedied by rest, medications, massage and strengthening. But if symptoms persist, please visit a physical therapy clinic.
- Malanga, Gerard A et al. “Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury.” Postgraduate medicine vol. 127,1 (2015): 57-65. DOI: 10.1080/00325481.2015.992719
- Behrens, Barbara J et al. “Physical Agents: Theory and Practice.” F. A. Davis Company, Jul 11, 2005.https://books.google.com.ph/books?id=ndjaAAAAQBAJ&source=gbs_book_similarbooks
- Cheung, K., Hume, P.A. & Maxwell, L. “Delayed Onset Muscle Soreness. ” Sports Med 33, 145–164 (2003). https://link.springer.com/article/10.2165/00007256-200333020-00005
- Dupuy, Olivier et al. “An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis.” Frontiers in physiology vol. 9 403. 26 Apr. 2018, DOI: 10.3389/fphys.2018.00403
- Heiss, Rafael et al. “Advances in Delayed-Onset Muscle Soreness (DOMS) – Part II: Treatment and Prevention.” “Delayed Onset Muscle Soreness – Teil II: Therapie und Prävention.” Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin vol. 33,1 (2019): 21-29. DOI: 10.1055/a-0810-3516
- Heiderscheit, Bryan C et al. “Effects of step rate manipulation on joint mechanics during running.” Medicine and science in sports and exercise vol. 43,2 (2011): 296-302. doi: 10.1249/MSS.0b013e3181ebedf4
- Dempster, Jade et al.” The Prevalence of Lower Extremity Injuries in Running and Associated Risk Factors: A Systematic Review.” Physical Activity and Health. 5. 133-145. 10.5334/paah.109. https://paahjournal.com/articles/10.5334/paah.109/
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Patellofemoral pain syndrome (runner’s knee): Overview. 2020 Aug 13. Available from: https://www.ncbi.nlm.nih.gov/books/NBK561507/
- Santana JA, Mabrouk A, Sherman Al. Jumpers Knee. [Updated 2022 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532969/
- de Vries, A et al. “Effect of patellar strap and sports tape on pain in patellar tendinopathy: A randomized controlled trial.” Scandinavian journal of medicine & science in sports vol. 26,10 (2016): 1217-24. DOI: 10.1111/sms.12556
- Khaund, Razib et al. “Iliotibial Band Syndrome: A Common Source of Knee Pain.” Am Fam Physician. 2005;71(8):1545-155. https://www.aafp.org/pubs/afp/issues/2005/0415/p1545.html
- Williams CH, Jamal Z, Sternard BT. Bursitis. [Updated 2022 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513340/