Knee Pain

I've been asked a lot lately about what to take if you have sore knees as a runner.  Two popular answers are ibuprofen and glucosamine, but really the problem goes deeper than that.  Unless you have a physical or medical abnormality in your knees (or somewhere else in your body), then there is no reason why you can't run pain-free for your entire life.

The real question is, what can I do to get my knees to stop hurting?  The real answer is running form and shoes.

When I first started running, the advice on form by all the shoe stores and shoe manufacturers was that you should run heel to toe.  The manufacturers also created fixes in the shoes to make sure the runner didn't roll their foot one way or the other in the wrong direction, and they added extra cushioning to "reduce" the impact on the foot.  It turns out, this formula is a recipe for disaster in the knees and other joints in the body.

When I started running long distances using this form and built-up shoe technology, my knees got sore just like everyone else.  I started taking glucosamine and ibuprofen in order to alleviate this pain, just thinking I was "paying my dues" and that eventually, like other runners, I would have to hang up my running shoes and start other exercises in the future.  Then I read Born to Run by Christopher McDougall.

Now, you don't have to be all about minimalist running or barefoot running to reap the benefits from what this book taught us about running form.  Peer-reviewed research has backed the claims in the book about form and technology in running shoes.  In the pre-Nike years runners barely had rubber to protect the soles of their feet, but when Nike came out with more advanced technology in the 70s, running injuries increased.  In fact, the more advanced the technology in the shoes, the more running injuries occurred, and the more these injuries occurred, the more the shoe companies have added technology to fix the problem.  I've posted many times about this, so I'll get off my soapbox now and give practical advice on running injuries based on the latest research and my own personal experience.

First, the shoes.  I'm not suggesting that you go out and buy a pair of Vibram Five-Fingers and start running in them.  If you want to do that, then do it later or your courting a different injury all together.  But I am suggesting to look at the more minimal running shoes, specifically shoes with little to no heel to toe height.  Running flats, which have been around for many years are a perfect choice, they're light weight and have virtually no heal.  There are a lot of companies now capitalizing on this new trend in running, so all you really need to do is start looking for minimalist shoes with flexible soles and little, no, or negative heel design.  The new Brooks Pure line is an example.  Whether you want there to be cushioning is entirely up to you, but my preference is to have as little cushioning as possible.

Next, your form.  Learning a new form will take time and patience, but with new heeless shoes, the transition will seem more natural.  Change your form to a strike more on your forefoot than your heels.  This will naturally keep your knees bent for shock absorption and will keep you leg more under your body than out in front with a straight leg.  The difference is that with the heeled shoes, your leg was more out front and straight... all the force of the footfall went straight to the knees; when you strike at the forefoot, your leg is bent at the knees and lands under your body so the force of the impact is absorbed through the whole body.  The trick is to not try to run on your toes, but start by striking the ground with your forefoot, then allowing the rest of the foot down.  Barefoot Ken-Bob  describes this technique in detail in his book Barefoot Running- Step by Step.  It's worth a try.

Finally, strength training.  It's never a bad idea to work on strengthening your leg muscles, especially around the knee.  Leg-extensions and  Leg-curls are standards on weight lifting machines, but there are other workouts you can do without equipment.  I recommend doing most of these without shoes.  Lunges, squats, one legged squats, calf raises, and wall-sits are great workouts that target these muscles and help cushion your knees from injury.

I haven't had knee pain for a long time, at least through the last two marathons which included all the miles in training, so I can recommend these changes with experience to back me up, and the fact that there's peer reviewed research only supports my advice.

So, there's my answer about how to solve the knee pain problem.