Build Better Knees

How can runners protect their knees?
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better knees for running

Most people like to be talked to in a way that will make them go weak at the knees; runners prefer the opposite. According to a Runner’s World poll, 40% of running injuries are knee injuries. 40%! That’s enough to win a general election! This doesn’t do anything to dispel the myth that running is bad for your knees. It is a myth, by the way; a non-runner is just as likely to develop arthritis as a runner. Tracy Ray, MD, an associate professor of orthopedic surgery at Duke University School in Durham, North Carolina, makes the excellent point that cardiovascular health improves at a faster rate than cartilage and joints. Therefore, whether you’re following a Couch to 5k program or training for a marathon in three months, it is particularly important that you read this article!


What are the common injuries or issues runners face with their knees?

There are several, but I’ll tell you about the four most common ones:

Iliotibial band syndrome – The IT Band is a thick piece of connective tissue that joins your hip to the outside of your knee. When the knee bends, the IT Band slides over a bursa – a fluid filled sack on the outside of the knee joint. When the IT Band is tight, the bursa gets squeezed, causing pain on the outside of the knee.

Patellofemoral pain syndrome – Depending on which side of the Atlantic you’re on, you’ll either know this, or IT Band syndrome, as ‘Runners Knee’. Your patella is your kneecap and your femur is your thigh bone and a poor relationship between the two causes patellofemoral pain, at the bottom of, and underneath, the kneecap.

Patellar tendinitis – the patella tendon links the knee and the shin bone. The impact of running can cause the patella tendon to become inflamed, causing pain underneath the kneecap, at the top of the shin bone, or both.

Meniscus tear – The meniscus is a piece of cartilage that acts a bit like a washer between the patella and femur. Unfortunately the meniscus weakens with age, so the older you are, the more likely you are to tear your meniscus with a sudden movement or change of direction. It’s an injury more likely to happen by playing rugby, football or any activity which requires quick changes of direction, but it can also happen whilst running. A meniscus tear will cause pain, inflammation and an inability to straighten the leg.

How can runners protect their knees?

You may see runners with an open patella knee support (a bandage with a hole for the kneecap,) or some kinesiology tape supporting their knee. This will alleviate the pressure on the knee and reduce the pain of an ongoing injury. However, the real solution is to find a way which will remove the cause of the injury. This could involve shortening and quickening your stride, it could involve foam rolling or stretching, it nearly always involves strength training.

Remember you can’t actually strengthen a joint so doing the next best thing; improving the strength of the muscles attached to the knee, particularly the quads, can help to prevent knee injuries occurring. Don’t leave this until you’ve got a knee injury, as you’ll then need to wait until the knee is fully recovered.

What elements of running can cause knee injuries?

Muscular imbalance is an important one here – all of your main leg muscles meet at the knee. If one is stronger or less tight than another, then clearly problems can occur.

Running technique can also be at fault, for example hitting the ground with a straight leg will jar the knee. Poor downhill running technique can also be to blame for excess pressure going through the knee.

Increasing your mileage too quickly can bring out the problems I highlighted in the introduction; your joints and cartilage not being ready to sustain the level of running your cardiovascular system is able to provide. I find that completing all training runs at the same pace can also cause knee injuries through the monotonous repetition of the exact same movement.

Finally, running on uneven surfaces and changing direction too quickly can be unpopular decisions as far as your knees are concerned.

what you need to know
  • Cardiovascular fitness can improve more quickly than joints and cartilage are able to withstand

  • Knee injuries can be cause by muscular imbalances, poor running technique, increasing mileage too quickly, sudden changes of direction or running on uneven surfaces

  • Strength training and stretching can reduce the likelihood of knee injuries

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