How to Prevent Running Knee Pain

Knee pain can be frustrating, especially when it prevents you doing something you enjoy. Often it feels like you have just got into a good rhythm of training…..and then injury strikes. Or that you are in a constant stop/ start cycle of injury, rehab then injury again.

In many clients I see, especially those 45 and over, there is a trend of why this is happening. They usual suspects are improper training load (no plan), muscle imbalances or weakness and inappropriate kit. Or even a combination of the above.

This blog is designed to explain why runners struggle with knee pain and what you can do to solve it.

What is knee pain/ runners knee/ patellafemoral pain?

Pain that occurs in or around the kneecap. It can also feel like its behind the kneecap. This is often the result of repeated stress on the area over a prolonged period of time instead of an acute incident. It often presents as a dull ache in the front of the knee.

It may worsen after running, sitting for long periods and/or climbing stairs.

Why do we get knee pain?

As stated above there are a variety of reasons why you get runners knee:

• Improper training load: you are either doing too much or simply have no plan. This often leads to big jumps in training volume you simply can’t recover, from resulting in injury.

• Muscle imbalances/ weakness: weak glutes and tight hamstrings are top contributors here. Alongside a general lack of strength which will mean under fatigue a greater breakdown in form. Often when there is a weakness at the hip or ankle we see pain referred at the knee.

• Poor running form: this can be a result of a lack of strength. But also a lack of understanding when it comes to technique.

• Inappropriate kit: mainly not wearing the right footwear.

• Age related wear and tear: if you are an older runner repeated stress for long periods may have affected the cartilage.

What can you do about it?

Strength training

This is probably the silver bullet for most people experiencing runners knee. Make sure you are doing a regular gym programme to support your running.

A minimum of once per week is suggested for runners who are in a building phase for a race. For those recovering from injury or in an “off season” phase then it should be 2-3 sessions weekly depending on time.

My go to movements are:

• Reverse lunges

• Single leg balances

• Hamstring curls

• Glute bridges

Get to a point where you can do 3-4 sets of 12-15 reps of each movement then add weight. You may be sore at first but as you adapt this will improve.

This should address any strength or imbalance issues and get you back on the right track.

Mobility

Another area often missed is mobility. Making sure you warm up and move the joints you are about to use before starting prepares your body for the exercise ahead. Rather than just heading out the door and hoping for the best.

Countless runners I have worked with have reaped the rewards of pre run mobility. Simple leg swings, ankle circles and upper body rotations are a good place to start.

Training load

Make sure you are following a plan that has gradual progression and rest built in. Following generic plans will only get you so far. If you are struggling with injury then you probably need something tailored to your life to make sure you can see the progress you want. Your weekly training load should not see huge jumps in volume from week to week. 

Running form

Although I think many peoples running form problems can be solved by regular strength training and mobility here are some pointers to consider.

Upper body- Stay tall, looking forward and keep your upper body relaxed. Let your arms move and come towards your centreline.

Lower body- you can play around with cadence here. Some people swear by higher cadence but test it for yourself and see. I think trying to stay soft on your feet and avoid huge strides where possible is useful especially with knee pain.

Footwear

Making sure you have good footwear is vital. Always get a gait analysis done and once you have a pair that work for you I would stick with them. 

Don’t get caught up with which shoes look pretty. Focus on which shoes feel comfortable. Because how your shoes look won’t matter if you are limping 2 miles into a marathon.

Weight

It’s also worth mentioning the heavier you are the more pressure you are putting through your joints and more than likely more pain you will experience. As someone who started running at 105kg and is now over 20kg lighter I can tell you I have significantly less pain now than I ever did when I was heavier. I think you can manage this with strength and a good running plan buts it's definitely something to consider.

Recovery

If you are experiencing runners knee I would do the following.

1. Get help from a physio/osteo- a good professional can be a gamechanger in recovery.

2. Follow rehab plan- strength train, stretch, ice area etc.

3. Gradual return to running- don’t go in full beans.

4. Continue strength training and recovery.

5. Make sure you are following a plan.

Conclusion

Improving your running comes as a result of consistency over a long period of time. Being able to stay injury free and train regularly is a key part of being able to stay consistent.

In following the advice outlined in this blog you should have a good idea of what you need to do to prevent runners knee and how to recover if you do get it.

For me the key points are making sure you are regularly strength training and following a plan. If you are doing this you are winning half the battle.

If you have any further questions the please reach out to me. More than happy to have a chat.

About the Author:

Hi my name is Ollie McCarthy and I am a Running Coach and Personal Trainer in Tunbridge Wells. I help people to build fit, robust and capable bodies that look good but also perform well. This is done through a combination of running, mobility, strength and conditioning work.

E: Ollie@mccarthysf.com

T: 07828573920