A Runners Guide to Knee Pain

Usually, when I tell people I have taken up running, they respond with some variation of “Gee, isn’t that hard on our knees.” Well, actually, no. At least until recently.

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About three weeks ago, I started developing a distinct soreness in my knees. At first, I tried denial. It’s not really that sore, I tried to tell myself. But as I continued to run, the soreness worsened.

Then I thought that perhaps I was just over-training. I know it will come as a big surprise, but sometimes I tend to over-do things a bit. So, I backed off and decreased my mileage. Still no luck.

So, I decided to have another look at Danny Dreyer’s book, Chi Running: A Revolutionary Approach to Effortless, Injury Free Running. This is my favorite book on running.

Danny maintains that human beings were made to run. Pain and injuries come from doing it incorrectly. He specifically talks about knee pain in chapter 7, pp. 164—166. He lists the three most common causes:

  1. Foot turnout. If your feet turn out to the side as you run, it torques your knee with every foot strike. Your leg isn’t designed to work this way. This action overworks the ligaments and tendons in the knee and eventually leads to pain.

    He says that the key to fixing this problem is to imagine you’re running on a tightrope, with your feet hitting along a line stretched out on the road directly in front of you. Here’s an illustration from the book:
    Foot Turnout
    I started paying close attention to this. It appears to have completely fixed my problem. I have had zero knee pain for the last week.

  2. Heavy Heel Strike. Danny says that, in his experience, this is the single most common cause of knee pain. Hitting the ground heel first is a braking action. He says that if you’re running like this, it’s like trying to push on a car’s accelerator while simultaneously hitting the brake.

    He elaborates, “If your foot stops and your body keeps moving, your knee becomes the transfer point for all that force. Well, your knees were designed to be hinges, not shock absorbers.”

    The remedy, he says, is two-fold. First, remember to pick up your feet with each stride. Second, run with your upper body in front of your foot strike, so that you are landing on your midfoot instead of your heel. I have also found it helpful just to lead forward a little more than usual. Let gravity do the work.

  3. Downhill running. When you are running downhill, you are putting more pressure on your legs than usual—up to ten times your body weight with each step! This is particularly a problem in Tennessee where I live, because we have so many hills. As Danny points out, this puts a lot of stress on your quads and knees. (It is also another reminder why runners need also to be doing basic strength training.)

    He says that the best way to deal with this is to draw attention away from your quads and knees and focus on the backs of your legs, which is where the main shock-absorbing muscles are located. Contrary to the advice in his second point, when you’re running downhill, land with more of your weight on your heels than on the front of your foot. He also says to relax your legs as much as possible when running downhill.

I’m sure there are situations that these techniques won’t work. But I don’t believe knee pain just goes with the territory. Like Danny, I believe we were engineered to run and knee pain is an indication that we need to adjust our technique. If that doesn’t work, then, by all means, see a doctor. But before you give up, you might want to give these techniques a try.

By the way, you might want to consider attending a one-day Chi Running Workshop or hook-up with a certified instructor. Unfortunately, we don’t have any instructors in Tennessee, but I am going to try and find a workshop to attend.

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