Knee pain when Uphill running

Uphill Running Knee Pain

To inform coaches about the protocol and safety precautions for uphill running knee pain, I am making this article available. It is a combination of information from many sources.

Particularly in the Philippines, I saw a lot of impromptu hill-type workouts being conducted too close to contests. Coaches run uphill in Australia, but they do it under strict protocol. I’ve included a peer-reviewed article about the risks of improperly performing uphill knee running.

  1. Supervised

  2. Optimal inclines and distances

  3. Enough Recovery

  4. Use of softer surfaces such as Grass Hills instead of Hard road surfaces.

And as a result, athletes are getting knee injuries as opposed to downhill running.

  • Pain tends to be worse when ascending stairs or hills, but may be painful both ascending and descending.
  • Pain first started while going uphill.
  • Knee problems really blow out a lot.

Many runners who experience knee pain fail to plan for the worst. They receive assistance slowly, if at all, until realizing several weeks later that it is inadequate. By then, their workout regimen has been completely destroyed (Ingraham, 2019).


Running hills is a widespread prescription by coaches for a variety of sports, including running sports.

Running is a great enough exercise on its own, being one of the best cardiovascular and respiratory improvers around, so running uphill must be even better, or at least that’s the thought behind it (Fornicola, 2013).

Since endurance is a derivative of strength, it makes sense that people would believe this

Hill running, like resistance training, plyometrics, or jump training, increases your strength and power, so it makes sense to think it would improve your running too. While this is certainly true to a point, a recent study in the Journal of Strength and Conditioning casts some doubt on the common wisdom (The Effects of Uphill Vs. Level-Grade High-Intensity… : The Journal of Strength & Conditioning Research, n.d.).

In the study, researchers reviewed the prevailing literature on this topic and realized that there isn’t much out there

In particular, they only discovered one study that didn’t compare uphill jogging to running on a flat ground; so they made the decision to conduct their own research.


The researchers wanted to know if running to exhaustion at an athlete’s VO2max wouldbe improved more from running intervals on hilly terrain (in this case 10% grade) versusintervals on flat terrain


For good reason, they selected seasoned players. The distinction between strength and cardio programs would be less important for rookie athletes than it would be for experienced athletes since beginner athletes improve across the board pretty much regardless of what they do.

It’s critical to understand whether training benefits persist as an athlete gets better and their adaptation to training becomes more focused.

Only one major difference existed between the two groups, but it was a substantial one. The group that was running flat had a lot more time to run.

The flat running group improved by 60% in the same period of time while the hill group only achieved a 30% improvement when they were able to maintain their VO2max pace after six weeks.


The reason for this is likely that running flat is less intense

The reduced intensity allows for more training. More training is a bigger stimulus for improving running performance at a VO2max pace than the relatively small difference in intensity, plain and simple. For pretty about any athletic goal you have, more training is preferable in my experience as a coach, provided you can rest properly.


One thing that and can say about uphill running is that it doesn’t quite impact flat running

It may still be a suitable addition to regular jogging because it produces good gains when done on level ground. Of course, practice is crucial if you intend to participate in any event that requires running uphill.

It turns out that the advice to run hills even when jogging on flat terrain doesn’t merit as much attention from coaches. Running on flat ground is preferable to running uphill when you are practicing for a competition.

Hill training, including the Lydiard hill circuit, helps the athlete transition from the aerobic phase into the anaerobic training phase (or General Practice to Specific Practice in our system).

Regular workouts only include this exercise during the specific work period (dynamic strength). However, other athletes have used it successfully far later in their training to preserve their speed and strength (Staff, 2011).

Abstract: Ferley, DD, Osborn, RW, and Vukovich, MD. The effects of uphill vs. level-grade high-intensity interval training on V[Combining Dot Above]O2max, Vmax, VLT, and Tmax in well-trained distance runners. J Strength Cond Res 27(6): 1549–1559, 2013—Uphill running represents a frequently used and often prescribed training tactic in developing competitive distance runners but remains largely uninvestigated and unsubstantiated as a training modality.


The purpose of this investigation

The purpose of this investigation included documenting the effects of uphill interval training compared with level-grade interval training on maximal oxygen consumption (V[Combining Dot Above]O2max), the running speed associated with V[Combining Dot Above]O2max (Vmax), the running speed associated with lactate threshold (VLT), and the duration for which Vmax can be sustained (Tmax) in well-trained distance runners.

Thirty-two well-trained distance runners (age, 27.4 ± 3.8 years; body mass, 64.8 ± 8.9 kg; height, 173.6 ± 6.4 cm; and V[Combining Dot Above]O2max, 60.9 ± 8.5 ml·min−1·kg−1) received an assignment to an uphill interval training group (GHill = 12), level-grade interval training group (GFlat = 12), or control group (GCon = 8). GHill and GFlat completed 12 intervals and 12 continuous running sessions over 6 weeks, whereas GCon maintained their normal training routine.

And used pre-and post-test meapost-test V[Combining Dot Above]O2max, Vmax, VLT, and Tmax to assess performance. A 3 × 2 repeated measures analysis of variance was performed for each dependent variable and revealed a significant difference in Tmax in GHill and GFlat (p < 0.05).

Concerning running performance, the results indicate that both uphill and level-grade interval training can induce significant improvements in a run-to-exhaustion test in well-trained runners at speed associated with V[Combining Dot Above]O2max but that traditional level-grade training produces greater gains.


How to run uphill

You have to use more effort when running up a hill in order to defy gravity. In order to overcome gravity and lift you up the slope, your body must use more muscles in your legs.

Speaking of the incline, the slope of the ground also affects how you step. forcing you to switch to a more mid-/forefoot-striking approach. increasing the forces that pass through your ankles and calf muscles.

Performance-wise, this eventually benefits you because it gives you a greater “rebound” from the ground. Your calf muscles have some energy from the impact stored there. As you straighten your leg and push off the ground, it is then released again.

Don’t lean forward at the waist.

Most runners naturally lean into hills when they begin to run up them, usually by leaning forwards at the waist.

When jogging up a hill, it is necessary to lean forwards to some extent, but many people lean forwards excessively. Your ability to run uphill is negatively impacted by this in a number of ways.

  • First, leaning forward inhibits your ability to flex your hips. And drive your knee up during the “swing” phase of your gait. You can prove this to yourself right now by standing up straight. And lifting your knee towards your chest using your hip flexors.
  • Then attempt to do the same thing if you bend forward at the waist. Note the small but perceptible increase in difficulty. An excessive forward lean shortens your hip flexor’s range of motion, hurting your efficiency.
  • Additionally, leaning too far forward inhibits your ability to produce a powerful “toe-off” during the “drive” phase of your gait. To push off the ground and take advantage of the additional energy stored in your calf muscles. You need to fully extend your leg straight behind you, which is achieved most effectively when your upper body is not slanted forward. When you “stand tall” when running up a hill. It makes it easier for your glutes to extend your leg behind you.
  • Finally, a forward lean also throws your body off-balance by moving your center of gravity too far forward without getting too into the nitty-gritty. This also makes it harder for your glutes to drive your leg backward. By increasing the leverage, they have to overcome it. The positioning of your center of gravity will also come into play. When it comes to running downhill, so don’t forget about it.

Helpful mental cues to maintain proper form

Even while you’ll noticeably lean forwards when jogging uphill, it’s a good idea to focus on “standing tall” because you won’t be leaning too far back. Even though it is technically incorrect, this mental cue is nonetheless quite useful.

The instruction to “push your hips” is another useful cue that prompts you to concentrate on using your hip muscles to propel yourself up the hill and completely extend your leg behind you. Avoid slouching once you’ve reached the top of a hill because doing so will negatively affect your performance on the flats as well (The Proper Technique for Running Uphill and Downhill, 2012).



Fornicola, F. (2013, June 1). How and Why to Run Hill Sprint Intervals – Breaking Muscle. Breaking Muscle;

How to Treat and Prevent Runner’s Knee | ACTIVE. (2018, September 5). ACTIVE.Com;

Ingraham, P. (2019, Jan 15). Diagnosing Runners Knee.

Staff, C. (2011, October 6). Hill circuit (hills) – ChampionsEverywhere. Running Coach Ireland;

The Effects of Uphill Vs. Level-Grade High-Intensity… : The Journal of Strength & Conditioning Research. (n.d.). LWW; Retrieved August 27, 2022, from

The Proper Technique for Running Uphill and Downhill. (2012, May 16). Runners Connect;





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