Knee Pain and Hip Tightness: Leg Extension

If you are experiencing "runners Knee" with discomfort on top of knee, under knee, or on the medial side of the knee, you might be keeping your legs too bent.

If your legs remain too bent throughout the running gait, you are prone to stressing your quads too much and 'turning off' or not using crucial muscles very well - all leading to a vicious cycle of dysfunction:

  • Tight quads
  • Tight IT band
  • Over used bio flexor (psoas)
  • Under used glutes (medius)


Common knee issues can result, due to the tight quads pulling on the knee, causing poor tracking - the pain!

This also causes the hip flexors to over work, causing tightness and the inability to utilize your glutes for strength AND stability. You can be the strongest in the weight room, but if you are not firing and using muscles appropriately, this strength goes for not and will continue to cause imbalances.


We have been brainwashed into thinking the more we run the tighter we get or the more unhealthy it is. This is wrong.  As runners, we do not have to be chronically tight, with aches and pains.  Every running step "can be" an opportunity for strength and health.


One way to help turn this around is to include short, steep, powerful hill repeats into your weekly program. These intervals should be no longer than one minute, so you can maintain a strong and powerful gait.

I call this "strength running." The key is to focus on getting good leg extension with your stance leg like I have in the photo above.

If you do not have access to a steep hill, improvise by using a set of stairs, skipping every other step or even every two steps to get power and extension. Or simply use a treadmill and jack up the incline.


To help with the knee discomfort while you are working on the solution, foam roll or preferably do some self-massage on your quads.  Then lightly stretch the quads, holding for 1-2 minutes at a time.  Remember, this will only help relieve the pain, but will not rectify the problem.


  • 10 X 1 min repeats at 15% grade at Snow King Resort.
  • My rest interval was long, 2-3min, which is very important. The rest allows you to recover well, so you can run each one well. This is NOT a cardiovascular workout, so take the rest.

Hope this helps - E

Author of The Cool Impossible

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Comment by Catherine on June 12, 2019 at 2:05pm

Awesome read as usual. That basically sum up my challenge in the last year. First I foam roll and massage the quads but couldn't figure out what I need to change to rectify the problem. Until 3 months ago when I did a gait analysis, and found out that my left leg (the one with the runners knee) was landing with a slight bend. Had to retrain my gait. Took a while with other muscles adjusting to the correction but no more knee pain!! :)

Comment by Eric Orton on October 19, 2017 at 5:00pm

Great!  Again, make the hills very short and fast - but make them FUN fast. If you are not having fun and not feeling good, they are TOO fast.  Then notice how good you feel afterwards.

Comment by Rachel Clayton on October 19, 2017 at 4:54pm

Brilliant thanks Eric.
I'm definitely not heeling striking so will try short hills with lots of rest and see how it goes.


Comment by Eric Orton on October 19, 2017 at 3:57pm

Rachel - keep in mind that this is just one remedy.  Certainly run form comes into play, which the hills will help.  So if you are really extending your striding and reaching out too far, heel striking - this too needs to be addressed.

Comment by Eric Orton on October 19, 2017 at 3:51pm

I would really focus on massaging and stretching the quads, AND then begin to work in the hills, just shorten them to 10-15 seconds with lots of rest in between each.

Comment by Rachel Clayton on October 19, 2017 at 3:40pm

Hey Eric - what can we do if we're not at the point of running that many hills yet but are still getting knee pain?

Comment by Robert Burpee on October 17, 2017 at 4:56pm
Always great to read & reinforce
Comment by Michael Baczkowski on October 17, 2017 at 1:55pm
Will do brother, thxs!

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