Can You Train Through Knee Pain?
By Georgie, Long Run Collective
It is one of the most googled questions by runners. Can I train through knee pain? Should I push on or should I rest? Is this serious or is this just part of it? I have been sitting with this question a lot lately. Not because of my own knees, but because of Rafa Nadal.
What Rafa taught me
I had never really given much thought to Rafael Nadal’s journey before watching the Netflix documentary. I knew the results, 22 Grand Slam titles, 14 of them at Roland Garros, but I had no idea what lay beneath them.
Throughout his career Rafa battled chronic knee pain that forced him to withdraw from tournaments, undergo repeated treatment and fundamentally adapt his game. He also has Mueller-Weiss syndrome, a rare degenerative foot condition that doctors told him should have ended his career in 2005. He became reliant on anti-inflammatories just to function and as a consequence, now has small holes in his intestines. “If I hadn’t explored all that, I probably would have ten fewer Grand Slams. Not one or two. Ten or twelve. This is the reality.”
He used chronic pain as a reason to find another way. Not to stop. To adapt, to ask more questions and to keep going.
I am not suggesting we all adopt Rafa’s approach. The cost to his body was enormous and elite sport operates in a very different world to the rest of us but his story made me think differently about the question of training through pain and whether our default response of stopping is always the right one.
The real question is not can you — it is should you
My default as a coach and as an athlete has always been pain equals rest and for acute injury, that is absolutely right. But there is a difference between pain that signals damage and pain that signals adaptation, tightness, weakness or imbalance.
Knee pain in runners is rarely simple. There are real physiological reasons why it happens, particularly for women. As oestrogen declines during perimenopause it directly affects joint stability, ligament health and recovery. Studies show that up to 47% of women over 40 report increased joint pain, particularly in the knees and hips. Women also tend to have a wider pelvis than men, which alters the angle at which the thigh bone meets the knee, putting additional strain on the joint during running and very often we see runners with strong quads but underactive glutes and hamstrings, which means the knee absorbs far more load than it should. In many of these cases, stopping entirely is not the answer. Understanding what is causing the pain and addressing it is.
After three years of navigating knee pain, two MRI scans (which showed no damage ) and a lot of exploration into my movement and hormones to finally become knee pain free, I wrote in depth about why so many women struggle with knee pain when running and what you can actually do about it. If this is something you are navigating right now, it is worth a read before you decide whether to stop or keep going.
Why So Many Women Struggle With Knee Pain When Running and What You Can Do About It →
What Rafa actually teaches us
The lesson from Rafa is not that you should push through pain at all costs. It is something more nuanced than that. It is that we are often too quick to accept a simple answer. Pain appears, we stop, we wait and we hope it goes away. We do not always ask what is causing it, whether we can modify our training around it, whether we need more strength in a specific area or whether this is a signal to change something rather than to stop entirely.
Rafa asked every possible question of his body before he accepted any limitation. He worked with the best medical teams, adapted his technique, changed his training load and found ways to compete that worked with his body rather than against it.
Most of us do not need to compete at Roland Garros but we do deserve to run well and feel good doing it and that starts with being curious about what our bodies are telling us rather than simply halting at the first sign of pain.
The conclusion
We are all unique. Our bodies respond differently, our pain thresholds are different, our histories are different. There is no universal answer to can you train through knee pain but what I took from watching Rafa is this. Ask more questions. Get more answers. Trust your body a little more and fear it a little less. Pain is information, not always a stop sign.
And if your knees have been holding you back, start by understanding why. That is always the first step.
Georgie, Long Run Collective
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