Knee Pain On Impact: Why It Hurts to Land
Knee Pain that flares on every footstrike. Possible causes, when it's a stress reaction, and what to do today.
What this pattern usually means
Pain that spikes specifically on impact is a yellow-to-red flag. Bone, joint surface, or stress reactions hurt with vertical load. This is the pattern that most often precedes stress fractures.
What to do today
- Stop running today — walk back if needed
- Use the single-leg hop test (gently): pain = stop
- Reduce weight-bearing activity for 5-7 days
- If symptoms persist 7+ days, get imaging
When to worry
- • Pinpoint pain on a bone
- • Pain walking on stairs
- • Pain that woke you up the night after a long run
Common causes of knee pain
- Runner's knee (PFPS)
- IT band syndrome
- Patellar tendonitis
- Sudden mileage spikes
- Weak hips and glutes
Could it be one of these injuries?
Patellofemoral pain syndrome (PFPS) — 'runner's knee' — is pain around or behind the kneecap from poor tracking and load distribution at the patellofemoral joint. It accounts for roughly a quarter of all running injuries.
IT band syndrome (ITBS) is irritation of the tissue at the outside of the knee where the iliotibial band crosses the femur. The band itself doesn't 'tighten' — the underlying tissue gets compressed and inflamed from repeated knee flexion under poor hip control.
Patellar tendinopathy — 'jumper's knee' — is degeneration of the patellar tendon just below the kneecap. Common in jumpers and sprinters; in distance runners it usually shows up after spikes in hill work or speed.
Other knee pain patterns
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