What Are The Best Running Shoes For Knee Pain?

Let's talk about the role of shoe design and why stack height and heel stability matter when it comes to finding the best running shoes for knee pain.

Knee & ankle pain are some of the most common complaints among runners. Whether it’s a dull ache after a long run or sharp discomfort that starts within the first mile, the problem often gets blamed on “bad joints” or overtraining. But one overlooked factor can make a big difference: your running shoes — specifically, stack height and heel cup stability.

What is stack height?

Stack height refers to the amount of cushioning material between your foot and the ground. A higher stack height means more foam (think of the marshmallow-like feel in certain high-cushion shoes). A lower stack height brings you closer to the ground, with less material compressing under each step.

Cushioning can be a double-edged sword. While it absorbs impact, too much foam can actually reduce stability, especially if the material is highly compressible. For runners with knee pain, this can lead to:

• Increased knee joint stress due to instability at landing.

• Delayed proprioceptive feedback (your foot and ankle don’t “feel” the ground as well).

• Excessive motion at the knee if the shoe allows the foot to collapse inward or roll outward.

Low stack – Minimal cushioning, better ground feel.

Medium stack – Balanced cushioning and stability.

High stack – Max cushioning, softer feel, may sacrifice stability.

What is heel cup stability?

The heel cup is the molded section at the back of the shoe that cradles your heel. A firm, well-structured heel cup can help control excessive side-to-side movement and keep your rearfoot stable during landing and push-off. This stability is critical for keeping the chain of joints (ankle, knee, hip) aligned.

If your heel moves too much inside the shoe, your knee often pays the price. Over time, that can contribute to irritation in the patellofemoral joint (front of the knee) or IT band issues.

What hypermobile or "bendy" runners need to know:

If you’re naturally flexible or have hypermobility (your joints move beyond the normal range), you may think you need more cushioning to protect your joints — but in many cases, the opposite is true.

For hypermobile runners:

• A less cushy shoe (lower stack height) can actually help improve stability by reducing wobble at landing.

• A firmer midsole provides more consistent support, so your joints don’t have to work as hard to stabilize.

• A secure heel cup is essential to prevent excess motion that could irritate your knees.

Think of it this way: if your ligaments are already a bit “loose,” a soft and squishy shoe is like running on a waterbed — your muscles have to overwork to control movement, which can lead to fatigue and joint stress.

Knee pain is usually not about the knee itself. The foot, ankle and hip must work together to ensure stability both up and down the kinetic chain.

One thing we urge our runners to consider is: rather than asking "What is the best running shoe for knee pain?" Ask yourself if there could be a deeper reason for your knee pain--besides the shoes you are running in!

At Stability In Wellness, we specialize in addressing the root cause of pain and dysfunction. We are specifically well-versed in addressing knee pain in hypermobile runners!

If you are a runner who is struggling with knee pain, please reach out and book with us in Jupiter, FL!