DOES RUNNING CAUSE KNEE PAIN? (PART 1)

283
The benefits of being active are endless!

[dropcap]H[/dropcap]ow safe is running? If you listen to friends and relatives you will hear all sorts of negative talk about the dangers of running. So, like most people these days, you turn to Google for the truth only to be confronted by even more conflicting advice. On the other hand, speak to anyone who runs, for pleasure or sport, and they will tell you that running is among the most exhilarating and exciting activities. Some will admit it took a while to actually start pounding those pathways but, once they started, they never looked back. What started as a way to get fit, with low overheads and complete control, became sheer fun. Some people even went on to participate in charity runs and marathons.

So who’s right? Don’t throw those running shoes to the back of the cupboard to collect dust just yet. I am going to dispel some of the most common myths and give you some useful advice based on sound research. Over the next three weeks we will look at some common myths and present the facts and the research that support/dispel them. In this first article we will look at running and knee pain.

Running causes knee pain: This is the most common misconception that people talk about. Many people, who have never been runners, suffer from knee pain. At one time the buzz topic centred on the dangers of the impact and stress on the joints when running on footpaths, grass and sand. Running is classified as high impact exercise, alongside jumping, plyometrics, skipping, jumping jacks and jogging, as opposed to low impact, where one foot typically stays in contact with the ground, such as walking, step aerobics or climbing. Then, to add to the confusion, there are no-impact exercises such as swimming, riding a bike or using an elliptical machine.  All of these can improve cardiovascular fitness but they also have benefits worthy of consideration. As well as improving cardiovascular fitness and muscle strength and endurance, high impact exercises also strengthen bones. So what does the research say? Studies have been conducted to determine the effects of running on the knee joints and some of these studies have spanned over 20 years. The consensus is that there is no significant difference in knee problems between those who run and those who don’t. In fact, a few of the studies showed that those who ran at some point had significantly less incidence of pain than those who had never run at all.

Running can generate forces of up to 2.5 times body weight and it was this that was initially thought to be the cause of knee pain. But if we follow the research and understand that no significant differences were found between runners and non-runners, we can therefore conclude it’s not the constant pounding on the ground that causes runners knee pain. What does cause the problem is muscle imbalance, muscle weakness and being overweight.

Muscle Imbalance: This is the balance of opposite muscle groups, for example: the quadriceps (muscles at the front of the thigh) and the hamstrings (muscles at the back). Running can cause imbalances as certain groups of muscles have to work harder than others. But our lifestyles and our jobs can also cause imbalances before we even set foot outside the door. If you spend your day sitting at a desk, it’s not uncommon to have shortening of the hip flexors and lengthening of the gluteal muscles (butt muscles).  The glutes are important in running, and lengthening of these muscles can affect how they are activated when running. This, together with tight hip flexors, can affect extension of the hips. This is why it’s important to understand our bodies and also incorporate other forms of exercises into our training schedule.

Muscle Weakness: This is often discussed alongside muscle imbalances but I feel it deserves a heading all by itself.  Some of the most common injuries in running are caused by weak muscles. As well as weakness in opposing muscle groups, there are also areas, such as the core, that tend to be weak. It’s also common for our bodies to show differences in strength between our right and left sides. As a runner do you find your injuries occur on one side more than the other?  In order to prevent injuries and improve strength there are some basic things to add to your training programme and running route:

o Add exercises to strengthen your core and upper body. Don’t forget, we use our arms and shoulders when running. If you don’t believe me, just try running on the spot without swinging your arms. Not so easy, is it?

o Include exercises that strengthen the muscles around your hips: side leg raises, straight leg raises, glute raises and hamstring curls. Make sure you are able to do equal repetitions on each side and that one side doesn’t tire quicker than the other. Vary your route.  We all have that destination marker in mind and quite often we will run as far as we can in one direction and then walk back or change the pace on the return journey. This doesn’t allow the muscles to adapt to the terrain or bends in the road.  The solution: determine the maximum distance and then divide it in half. This way you’ll be able to reverse the effort on the way back.

Being overweight does not help. As I mentioned earlier, the extra force generated when running can be 2.5 times our body weight; that’s a lot of pressure on the joints. Although running is an excellent way to burn calories, it can be very stressful on the joints. If you are overweight, before you include running into your training programme consider either low impact or non-impact exercise to begin with to help you shed those extra pounds.

Conclusion: Running is safe if you take into account your starting fitness levels, work to improve your overall strength and flexibility and are not excessively overweight.

Next week we’ll consider more myths about running and strength training.

 

Kim Jackson is a UK-trained physiotherapist with over 20 years of experience. She specializes in musculoskeletal pain and dysfunctional, including back pain and sciatica, stroke and other neuro conditions, plus physiotherapy. She has worked with local, regional and international athletes and teams, treating injuries and analysing biomechanics to improve function and performance.

Ms Jackson is registered with the Allied Health Council and is a member of PASL. She currently works at Bayside Therapy Services in Rodney Bay.

www.baysidetheraphyservices.com