Runners Knee
Expert Physiotherapy for knee pain running.
Firstly, runners knee isn’t just for runners. Runner’s knee is a broad term used to describe the pain you feel if you have one of several knee problems, notably either at the front or on the outside of the knee. It is generally caused by direct trauma to the knee, overuse, faulty lower limb mechanics or muscle imbalance or wear and tear on the undersurface of the knee cap.
Here are 5 myths debunked by KRP on what contributes and what doesn’t contribute to runners knee. Contact us at KRP, knee physios Melbourne, for a consultation about your sore knee.
1) Do I need to stretch before running?
The myth of static stretching prior to running has been well summarised by our own running guru Robbie Webb: “Warm-up (raise your temperature and sweat a little) and include simple, sport-specific, ‘dynamic’ stretches. ‘Static’ stretches should be limited to 15-30 second holds, once per position. Warm-up for 10-15 minutes, or until you feel ready to rock.”
2) Runners don’t need to strength train.
There are many studies that have established that this statement is well off the mark. These include Millet et al (2002), who concluded “the addition of HWT (heavy weight training) to the endurance training of well-trained triathletes was associated with significant increase in running performance (i.e, VV02max) and an enhancement of running economy, as a result of the concurrent strength and endurance training.”
Delecluse et al (1997) comments that “Today, it is generally accepted that sprint performance, like endurance performance, can improve considerably with training. Strength training, especially, plays a key role in this process”, and Paavolainen et al (1999) state “simultaneous explosive-strength and endurance training improved the 5K time in well-trained endurance athletes without changes in their energy expenditure.” In other words, strength training makes you faster without an energetic cost.
Runners knee.
3) Running is bad for your knees.
It has been an expectation since the running boom in the 1980’s, that sooner or later we would see longitudinal studies that showed running led to joint degeneration, especially in the major weight bearing joints such as the hip and knee.
Twenty years later, no such study has been published.
That said, running is a high impact sport and knee injuries are common, especially in female runners who are several times more likely to develop running knee pain than men. The reasons for this are not completely understood, however it seems likely to be a combination of biomechanics and hormonal (especially oestrogen) influences. The bottom line is that as with the majority of running injuries, it is not running itself that causes knee injury, it is training error and/or load management. There is now good evidence that exercise, especially in the case of knee osteoarthritis, is actually beneficial in terms of pain management and disease progression.
4) Cramping and running injury.
A study by Schwellnus et al. (2004) looked at Serum electrolyte concentrations and hydration status and found they are not associated with exercise associated muscle cramping (EAMC) in distance runners. They concluded: “There are no clinically significant alterations in serum electrolyte concentrations and there is no alteration in hydration status in runners with EAMC participating in an ultra-distance race.” Fair enough, but if it is not serum potassium causing the dodgy muscle cramps, what is? Numerous studies appear to support the hypothesis that EAMC may be accompanied by heightened neuromuscular activity possibly associated with muscle fatigue”. In a nutshell, cramping probably has more to do with not training properly and subsequent muscle fatigue.
5) Cushioned Shoes Will Prevent Injury.
Let’s get this straight up front. No shoe will prevent injury, just as going barefoot will not prevent injury. You can check out our blog on ’What running shoes to buy here’. Running, as with any sport, is a stressful endeavour and risk of injury is always present for an almost infinitely variable number of reasons. Does this mean cushioned shoes are better or worse than less cushioned shoes? Not necessarily and it will completely depend on the runner. Some runners do require more cushioning, either because of their biomechanics, the level at which they train or race or their experience level. As an example, the maximalist shoe brand Hoka, which works off a zero drop but 40mm platform in a very lightweight package, has gained good acceptance in the ultra-marathon community. This is no surprise at all. The opposite side of the coin is that most runners can probably deal with less cushioning rather than more and the thing to always remember is the equation, more cushioning = more weight.
For us here at KRP, in athletic footwear, weight is the great enemy of the runner!
Keilor Road Physiotherapy are the experts at reducing symptoms of sore knee and stopping its recurrence. Servicing Niddrie, Essendon, Airport West, Keilor & Melbourne’s Northern suburbs for over 40 years, you can book with one of our highly trained expert physiotherapists below or call 93794557 to speak to one of our admin superstars.
Related links
References
Millet GP1, Jaouen B, Borrani F, Candau R. Effects of concurrent endurance and strength training on running economy and VO(2) kinetics. Med Sci Sports Exercise. 2002 Aug;34(8):1351-9.
Delecluse, C. Influence of Strength Training on Sprint Running Performance. Sports Med 24. 1997, 147-156. https://doi.org/10.2165/00007256-199724030-00001.
Leena Paavolainen, Keijo Häkkinen, Ismo Hämäläinen, Ari Nummela, and Heikki RuskoLeena Paavolainen, Keijo Häkkinen, Ismo Hämäläinen, Ari Nummela, and Heikki Rusko. Explosive-strength training improves 5-km running time by improving running economy and muscle power. https://doi.org/10.1152/jappl.1999.86.5.1527. 1999.
Schwellnus MP, Nicol J, Laubscher R, et al Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping (EAMC) in distance runners. British Journal of Sports Medicine. 2004;38:488-492.
Article by
Scott Sanders | Physiotherapist
Scott graduated from a Science Degree before following his passion to become a Physiotherapist at The University of Melbourne, graduating with a Masters of Physiotherapy in 2011. Scott has worked in private practice since as well as working with multiple sports team including AFL, cricket, basketball and hockey.