Coastal Connection Blog

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Running with Knee Pain? Let's Fix it.

knee_painWe recently finished a talk with a group of runners training for the Run for Water at Peninsula Runners in Abbotsford.  This is a summary of what we spoke about. 

It is well documented that one of the most common areas of injury in runners is the knee joint.  One of the main reasons for this is the lack of balance in the muscles that stabilize the knee.  For most runners they have strong/tight quadriceps and weak posterior chain muscles (hamstrings & glutes).  These imbalances lead to knee problems.   Using some simple exercises can help START you on the path correcting these imbalances.



There are multiple progressions to these simple yet effective exercises. Of course these 4 exercises are great but are not the complete answer to preventing all running related knee injuries.

1.       Cook Hip Lift


The Cook Hip lift was created by physiotherapist Gray Cook hence the name.  Prior to performing this exercise the hip flexors on both sides should be stretched.

  1. First start by lying on your back.
  2. Then pull your right knee to your chest and hold your leg with your hands.
  3. Contract your glutes then push your hips up.
  4. Pause at the top and lower yourself to the ground.

Note: If your hamstrings are cramping that means your glutes are not firing properly.  Therefore more activation exercises maybe required such as the double glute bridge or the clam.


2.       Terminal Knee Extensions


This exercise helps strength the Vastus Medialis Oblique (VMO) which is a stabilizer of the knee.

  1. First start by looping the band securely to an immovable object (post, squat rack etc.)
  2. Put one leg inside the band (start with non-dominant leg). Place band behind knee cap or just above.
  3. Find appropriate tension by moving towards or away from where the band is attached to.
  4. Starting position: both feet flat on the floor
  5. Start by lifting heel off the floor on side the band is on.  Keep the other foot flat on the floor.
  6. Finish movement by moving your heel back to original starting position.


3.       Nordic Hamstring Fall


Injuries to muscle occur during eccentric movements (when a tissue is being stretched too much) especially hamstrings in runners.  Therefore is it essential to strengthen muscles during eccentric movements.

  1. Put a mat down or some type of cushion for your knees.
  2. Start in a kneeling position
  3. Have someone secure your feet by putting their hands on your ankles and then pressing down.
  4. Staying as straight as you can lower your body towards the floor as slow as possible by using your hamstrings.
  5. Catch yourself by using your hands right before contacting the floor
  6. Push use your arms and push yourself back into the starting position


4.       Side Bridge and Front Bridge


In running or any other sport stabilize the upper the body is important to prevent low back pain.  The “core” should be trained as stabilizers instead of movers.  Crunches and sit-ups cause excess force on the low back. Dr. Stuart McGill from research has determined that one traditional sit-up can cause 780 lbs or 3300 N of compression on the spine (2006).  Therefore sit-ups should pretty much always be avoided.

Side Bridge

  1. Start by lining body up in a straight line on your side.
  2. Raise your hip off the ground by using your feet (stack on of one another) and your elbow as balance points
  3. Hold for 10-30 on each side.
  4. Keep chin retracted and eyes forward

Front Bridge

  1. Start by balancing on your toes and forearms
  2. Hold your hips up so that if a stick was on your back it would touch the tail bone, upper back and head with a small arch in the low back (aka neutral spine)
  3. Hold for 10-30 seconds.


In conclusion, these exercises are a start to help correct a few of the imbalances caused by running.  They are not the most glorious exercises ever invented but they do work and that is what I am after; results.  These results are what keep my athletes and clients out on the road or on the court or field. Of course there many more exercises for injury prevention for runners.   If you have questions feel free to leave a comment below or e-mail me directly at This email address is being protected from spambots. You need JavaScript enabled to view it.



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Thanks to Ryan I have a six pack for the first time in my life. Anyone can achieve their fitness goals, they just need a great coach, and I found one!


Disclaimer: Specific results may vary from person to person.