How to Prevent Knee Injury and Knee Pain

Posted by Danny Dreyer on Sat Sep 6th, 2008, 2 comments

By far, the largest complaint I get from runners about running is that it's so hard on their knees. Secretly, inside of me, I have my own complaint about running that is a little different. It's that running is blamed for all the knee problems when in actuality it's not running that is causing the injuries, it's the way people run. Every time someone's knee goes out and their friends ask them how it happened, they're quick to respond, "it happened the other day while I was running." The truth is that if you can work on your running technique so that there is minimal impact or undue stress to your knees, you'll never have knee problems. It's as simple as that.

Here are some ways to protect those precious knees and insure that you can run for many more years without the worry of having to give it all up someday because your knees are toast.

  • Avoid a heel strike. Don't over-stride and let your feet get ahead of you. Always make it a point to stay ahead of your feet and let your legs swing to the rear, not forward. If you're reaching with your legs as you swing them forward, your feet will land in front of you and you'll be putting on the brakes with every foot strike. Then all of the shock of hitting the road goes right up your legs to your knees, which were never designed to act as shock absorbers. Eventually your knees will get tired of taking all that abuse and begin to complain. If they do, I suggest you listen to what your body is trying to tell you, and change your stride mechanics, or you could end up on the bench.

    To avoid this, always lean from your ankles and let your stride open up behind you so that when your feet swing forward they land underneath, or slightly behind your center of mass, instead of in front of you. The ChiRunning DVD shows you how.
     
  • Don't pick up your knees when you run. That's right. Pay no attention to the advice of all those running magazines that tell you to pick up your knees and reach forward for a longer stride. When you pick up your knees, your lower leg will swing forward and your heel will come down in front of your body and, as I just said previously, you'll be putting on the brakes every time your foot hits the ground.

    What to do: Keep your knees swinging low. At the back end of each stride, bend your knees and let your heels float up behind you. You should always be thinking, "knees down, heels up."
     
  • Lean forward from your ankles and land on your midfoot. Remember, anytime your foot comes down in front of your body, you're putting the brakes and the shock of that deceleration is going straight into your knees.
     
  • Keep your knees soft and bent during the landing and support phases of your stride. I see many runners over-stride and then straighten their knees when they land. This creates an incredible amount of impact to the heel and the knee.

  • Keep your feet pointed in the direction you are running: If your feet splay out to the side as you run, it could create knee pain while running any distance because you're torquing your knee with every foot strike. This will eventually over-stretch the medial ligaments and tendons of the knee and lead to pain and/or injury (medial meniscus tendonitis). You'll feel it as a sharp pain on the inside (medial side) of your knee.

    Here's what happens. If your feet splay out with every step, you'll land on the outside edge of your heel and your ankle will collapse inward. This causes over-pronation and creates a torque in your lower leg that is equivalent to someone grabbing your ankle and twisting it to the outside almost 1200 times every 10 minutes! (That's about the number of strides you'll take with each leg if you run a 10-minute mile.) It doesn't take very many miles of running this way for your knees to start feeling the stress. Running this way could eventually hyperextend the medial ligaments and tendons of your kneecap.

    What to do: Learn to run with your feet pointed in the direction you're headed. But don't just point your foot forward. Rotate your entire leg inward towards your centerline until your feet are parallel and pointing forward. This will strengthen your adductors (the muscles that run along your inner thighs) and straighten out your legs. This allows your knees to hinge in the direction they were designed to, instead of twisting as they bend.

    Running with your feet turned out will also effect the illiotibial band which is attached at its lower end to the lateral side of your tibia just below your knee. Lateral pain in your knees is more often an illiotibial problem and is often mistaken for a knee problem. 

    If your feet turn out, your heel will strike on the lateral side and your ankle will pronate as your ankle supports your weight. If your feet splay out a lot, it will probably feel like you're pigeon-toed when you try to point your feet forward. If that's the case, rotate your legs medially only as far as you can, without feeling discomfort. Increase the amount you rotate your legs inward in small increments over a number of weeks or months, to give the muscles, tendons and fascia in your legs, feet and knees time to adjust to the new direction of movement. Changing the biomechanics of your body takes time and persistence, but it's well worth it if you never have to deal with knee pain again. 


Taking good care of your knees should be a high priority, especially if you want to continue to enjoy running year after year. Reducing torque and impact are the two best places to build a life insurance policy for your knees. Start today and your knees will thank you every time you put on your running shoes. 

 

  

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2 CommentsLeave a comment below

Kennedy Ron Oct 3rd, 2013 08:58am

Ice and heat applications are used quite commonly to combat pain in the knee. Usually ice pack is used for recent knee injuries or after activities that irritate chronic knee injuries. Now a days doctors have prescribed a jumper’s knee book that have various exorcise that may help in improving flexibility of knee muscle.Heat application is applied before activities that irritate chronic injuries. In addition, you can use heat packs to loosen and relax the knee.

This article made me think of foam rollers. I struggled with an IT band injury for a number of months when I first began running. It was so frustrating, I was almost ready to quit. A PT recommended I try foam rolling, and it revolutionized how I recovered from my runs!

Try it out: http://www.roadrunnersports.com/rrs/gear/foamrollers/”

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