Runner's knee pain and physiotherapy

Knee pain affects 1 in 5 people in Australia, with the incidence increasing steadily with age. Osteoarthritis and overuse of the structures around the joint account for a huge slab of these.

But what about knee pain with running? Is it really true that running is bad for your knees?

OK, granted the load through your knees is greater with running than with walking, but how do other activities stack up? Here are the approximate forces that pass through the knee for each activity. This is according to 2 studies  - Lenhart et al. (2014) and Sanchis-Alfonso et al. (2016)

• Walking on level ground - 0.5 x body weight
• Cycling on level ground  - 1.5 x body weight
• Stairs, both up or down - 3-4 x body weight
• Running  - 4-8 x body weight
• Squatting unloaded  - 7-8 x body weight
• Jumping - 20 x body weight

I really believe that running gets a bad rap for the reason knees become sore, or why, for some, running is never given a good chance. Like any tissue in our body, our knees can adapt to the loads and stresses we put on them. How do we do this? With:

• exercise and indiviualised programs to correct, control and restore pelvic, hip and lower leg imbalances and bio-mechanics
• graduated programs of running, practicing the 'pace it, don't race it' method
• cross training and running specific strengthening, where loads are controlled but delivered to the knee to adapt and become more resilient to the loads we ask of them when jogging.  

There is no one perfect recipe for exercise when it comes to knees and running. We are all different and  the way we move is so varied. Thorough assessment, holistically looking at each moving part, running analysis and breakdown, training program adaptations are all crucial in getting knees happy to play their part with running. This, thrown in with a persistent and motivated runner-to-be, can become the runner without the dodgy knees.  

If you really desire to lace up the shoes and start jogging, get your knees to a good running physio!

If you are a new Mum and are super keen to lace up the joggers and head for a jog, take the time to ask whether your body is truly ready. You may be 6 weeks after labour, your OB may have given you the green light, but what about your leg strength, your pelvic floor health and your fitness? Are you really ready to go running?

There are many considerations before lacing up the shoes and heading out for your first runs. These include:

👉 your birth outcomes

👉 your leg and hip strength

👉 your pelvic floor health, strength and endurance

👉 your hormones ( are you still breastfeeding?)

👉 your support of your pelvis and spine (integrity of your inner core strength)

👉 your pre-natal and pregnancy exercise types and levels

👉 your body type.

Moore et al (2021) published a study with tests as guidelines for strength required for running. Here are the tests for your pelvic floor recovery and strength after pregnancy and birth. You can try them at home if you think you're near to these measures.

✅can you achieve 10 quick on/off ( or lift up/drop down) contractions?

✅can you hold 10 maximum pelvic floor contractions for 6 seconds, each all being equal?

✅can you hold a gentle contraction for a full minute, continuing your breath? ( 30% contraction effort)

These tests are no means exhaustive. There are many other tests assessing strength, balance, running specific and pelvic floor muscle control.

See our other recent posts for more running preparation advice for new Mums.

#runningmums #returntorunning #postnatalexercise #postnatalrunning #postnatalpelvicfloor

✅"Widen gently across the collar bones!" If you've heard this at your posture or Pilates classes, this anatomical picture may help you in visualising why you are being asked to do just that.

✅ Notice how the collarbones here stretching from your breastbone to your shoulder tip. By focusing on lengthening across her, you will help to place your shoulders and shoulder blades in a better alignment and posture.

✅ This cue also allows for you to gently build endurance to work against the effects of gravity and the slumped shoulder postures. This is done by the subtle yet ongoing work of your upper back and shoulder blade muscles.

✅ This means happy days for your trunk posture, your shoulders, your neck and upper back!

If you feel you are too stiff and tight across your chest or upper back to achieve this, see a physiotherapist. Pilates classes and posture-based exercise will help you achieve the endurance and strength required to maintain these postures right throughout your day.  

 #mindfulposture #thecollarbones #pilates #clinicalpilates #thefixprogram #thefixprogramonline #physiotherapy #physio