Got Knee Pain While Running? How’s Your Cadence?

Got knee pain while running? How’s your cadence?

Knee pain is a common complaint amongst runners, and often one of the most prevalent reasons for keeping a runner sidelined. Such aches and pains are usually the result of a number of factors, but a common denominator related to such injures is a suboptimal cadence (1-5). Cadence refers to step rate or foot turnover, and measures the number of times both feet make contact with the ground over the course of one minute. This is an important factor to measure when evaluating runners with running related injuries, especially those with knee related complaints, since foot turnover directly influences the amount of ground reaction forces (GRF) that the body must absorb with each foot strike. The lower the cadence, the longer the step length, and thus the greater amount of GRFs that the body must absorb with each step (1-4). Multiply that over the course of multiple miles, and you can see how cadence is important to address for injury prevention and when returning to run after recovery.

So what’s the most ideal running cadence? Great question. Research shows that optimal step rate is approximately 180 steps/min (2,4). Yes, that’s much faster than most people think, especially when most recreational runners self select a cadence between 120-140 steps/min. This slower cadence causes an increase in time spent on each leg with each step, which results in poorer running economy as a result of over striding, increased vertical displacement (ie the amount one bounces up and down while running), and decreased shock absorption at the knee (1-4). The good news is, you only need a 5-10% increase in your current step rate in order for your body to begin to feel the biomechanical advantage of a higher cadence, and thus reduce excessive loading at the knee joint as a result (1-4). This is beneficial for both reducing the risk of developing an injury, as well as, facilitating recovery from an existing injury (1,2).

When working with my runners, I first evaluate them while running at a self-selected speed on a treadmill to observe their form and calculate their cadence. This gives me a lot of important information and a baseline measurement to work from. If their cadence is below 180 steps/min, I begin by increasing their rate by 5%, and use a metronome app to help them train into this new rhythm (1-4). If that feels comfortable, we try increasing their rate to 10% higher than their self-selected rate and evaluate their form (and symptoms if relevant) again (1-4). It is important not to increase cadence by more than 10% at a time as such significant changes have been shown to require an increase in oxygen consumption and compromise performance without having an adequate adaptation period over time (1,2).

The best way to train your cadence is by using a metronome while you run (5,6). Research shows how tempo is beneficial for both retraining, as well as, achieving consistency throughout your run. Here’s an example of how I advise my runners to practice their cadence training (note: if you’re working through an injury it’s best to seek guidance from a movement professional about how to adapt a program that is right for you!):

  • Practice on a treadmill or at a track. These closed environments allow you to focus on your step rate and metronome without having to share your attention with your environment like you would on an open run around your neighborhood. Adjusting cadence requires more mental focus, especially in the beginning, so it’s important to minimize extra distractions when possible
  • After completing a light warm up, run in place for 30sec matching the beat of your metronome app with it set at your new cadence, repeat for another 30sec without the metronome while trying to keep the rhythm consistent. Do this for two to three rounds as a warm-up.
  • Next: run 200yrds with your metronome on, 200yrds with your metronome off x1mile. Second mile, run without your metronome while working to maintain your new cadence throughout. On your final mile, run 400yrds with your metronome on, 400yrds with it off. Then complete your cool down.
  • Perform this type of workout twice a week to help your body train up to this new cadence and begin to choose this higher step rate as your new self-selected cadence over time.
  • For those cases where you are not yet around 170-180 steps/min, I advise gradually increasing your cadence 5-10% each week over a period of weeks, assuming you don’t experience any adverse effects, until you are within 170-180 steps/min. As you become more proficient with your cadence training, another great app to use that arranges music to match your cadence preference is Weav Run.

In the beginning, this new step rate will feel more exhausting, both mentally and physically. That’s ok, and completely normal. Within a few workouts, you’ll begin to notice how this increased cadence helps you become more energy efficient over time and most runners also notice an increase in their pace overall – win win! So go figure our your cadence (count your steps over the course of a minute, or have a friend do it for you while running on a treadmill) and see where you’re at. Then play around with adapting your pace overtime to increase efficiency, decrease extra loads on your knees, and decrease your risk for injuries!




  1. Schubert, Amy G et al. “Influence of stride frequency and length on running mechanics: a systematic review” Sports health 6,3 (2014): 210-7.
  2. Heiderscheit, Bryan C., et al. “Effects of step rate manipulation on joint mechanics during running.” Medicine and science in sports and exercise2 (2011): 296.
  3. de Brito Fontana, Heiliane, et al. “Effect of gender, cadence, and water immersion on ground reaction forces during stationary running.” journal of orthopaedic & sports physical therapy5 (2012): 437-443.
  4. Perl, Daniel P., Adam I. Daoud, and Daniel E. Lieberman. “Effects of footwear and strike type on running economy.” Med Sci Sports Exerc7 (2012): 1335-43.
  5. Van Dyck, Edith, et al. “Spontaneous entrainment of running cadence to music tempo.” Sports medicine-open1 (2015): 15.
  6. Bood, Robert Jan, et al. “The power of auditory-motor synchronization in sports: enhancing running performance by coupling cadence with the right beats.” PloS one8 (2013): e70758.