5 ways to self-manage knee or ankle pain and KEEP RUNNING

Written By: Trevor Staples, PT, DPT, CSCS

If you are experiencing knee or ankle pain while running, I am here to give you hope! I know first-hand how stressful it can be to have nagging pain pop-up while training for a race, or running in general. However in most cases, just because you have pain, doesn’t mean you have to stop running completely; you may just need to modify your training. In this blog, I will share 5 ways to self-manage knee and ankle pain so you can keep running! 

Don't stop, just modify

If you are like most individuals, you started off this season with a plan, and have done everything in your power to avoid injury and progress your training gradually. Despite your best efforts, you have found yourself among the 40% of runners who experience running-related injuries. (1

Many doctors will tell patients with ankle or knee pain, to stop. BUT I know how an athlete’s brain works (because I have the same thoughts!). “If I can still run, even with a slight nagging pain, I can’t stop- I have a race to train for!” -Sound familiar? 

Consulting with a sports specialist PT can determine the severity of injury. The good news is that many of my clients do not need to stop running completely if they incorporate a few training modifications that allow the body time to recover. So here we go with 5 way to self-manage knee and ankle pain so you can keep running! 

5 ways to self-manage knee or ankle pain and keep running

Trevor running incline
Trevor cadence
Trevor road running

#1 - Run on a Slight Incline or Decline

Depending on the injury, running on a slight incline or decline can reduce the loads associated with running and allow you to maintain training volume without flaring up pain. As a general rule…

  • For knee pain: Running on a gradual uphill reduces force through your knee. (2)
  • For ankle pain: Running on a slight downhill reduces the amount of force through your achilles tendon, but increases forces through your lower leg bones.
  • Experimenting with both incline and decline on a treadmill can allow you to figure out which will work best for you and the pain you are having.

#2 - Experiment with a Faster Cadence

Studies have shown that increasing your cadence (steps per minute) by 5-10% reduces the load associated with running. (3) This may help you to avoid flaring up your knee or ankle pain. One way to accomplish this is shown below.

  1. Set a treadmill at a constant speed
  2. Use a metronome app to identify how many steps per minute (cadence) you are performing (Commonly this number is between 140 and 180 steps per minute)
  3. Add 5-10% to the cadence you identify and try to match it while running the same speed on the treadmill.
  4. If pain improves, set your preferred streaming service to play music at that cadence while you run and match it with your feet.

#3 - Cross-Train

Cross-training is a valuable way to maintain and improve your aerobic fitness while modifying the load through your legs. (4) It can be useful during big training blocks, or when addressing an injury. A few options for this include:

  • Replacing less important training days with biking, swimming, or even rowing
  • Replacing painful running sessions with similar intensity sessions on a bike or rower
  • Replacing running volume with resistance training

#4 - Run on Trails, Treadmills or Tracks

Although not the first thing you should consider modifying. Running on a different surface can modify the load (and pain) you experience during running. Consider temporarily shifting from running on a road to running on a flat trail, a treadmill, or a track. Moving to a more compliant surface has the potential to reduce the training load associated with running, and allow you to run longer before experiencing pain.

#5 - Address Training Volume

Ultimately, training volume may need to be reduced, but only after trying some of these training modifications I have recommended. Some factors such as running form, cadence, and biomechanics can be assessed and modified and can help you get back on track more quickly. 

What can you do?

Here at Runners’ Edge we offer running gait assessments, blood flow restriction training, and ESWT, which can all accelerate your recovery from injury. If you are struggling and need guidance, come see us and we will help you understand what is happening and set goals to get you back to running pain free.

Schedule a FREE discovery visit with me today! 

Written By: Trevor Staples, PT, DPT, CSCS

Running Specialist Physical Therapist and Strength and Conditioning Specialist at Runners’ Edge Alaska 


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Sources: (Links in text for more reading!)

  1. N Kakouris, N Yener, D Fong (2021), A systematic review of running-related musculoskeletal injuries in runners, British Journal of Sport Medicine. 
  2. K Ho, T French, B Klein, Y, Y Lee (2018), Patellofemoral joint stress during incline and decline running 
  3. CJ Barton (2016), Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion
  4. Foster, C., Hector, L.L., Welsh, R. et al. Effects of specific versus cross-training on running performance. Europ. J. Appl. Physiol. 

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