Take Control Series: Does Running cause knee pain?

Tricia Hayton, Registered Physiotherapist

The evidence….

For years there has been controversy surrounding running and knee health.  The research is inconclusive, but it looks positive for runners.  In 2013, Paul Williams authored a study saying that recreational runners had less risk of osteoarthritis and credited this to a decrease in BMI (body mass index).   In 2017, this was supported by Alentorn-Geli et al, who concluded that recreational runners had a lower occurrence of osteoarthritis compared to elite runners and those with a sedentary lifestyle.

We do know that weakness and poor muscle control is associated with osteoarthritis.  In 2016, Deasy et al published a study reporting that significant hip weakness exists in people with knee osteoarthritis.  She further commented that hip evaluation should be part of clinical assessment.  Research also indicates that hip and knee strengthening can reduce the symptoms of knee arthritis (Bennell et al).  The area with the biggest gap in research is PREVENTION.

But what does all this mean?

Simply stated, if you keep your knees and your hips strong and moving in the correct way, running should not hurt your knees.  

How do you know if you know if your hips are weak?

Here are a couple of quick tests.

1. Sit on the side of a bed with your feet hanging.  Squeeze a pen between your knees.  Keeping you knees squeezed, take your ankles as far a part as you can.   You should not feel any pain in the hips this exercise.   Look at your feet, or have a friend take a look.   Your shins should be a minimum of a 45-degree angle to your thighs, and should look equal side to side.
2. Stand on one leg in front of a mirror, do a single leg ¼ squat.  Not only should you be able to keep your balance, but your knee should stay directly over your second toe, not drift in towards the big toe.

 
If either of these tests are positive, give us a call.   After a complimentary consultation, we will be able to tell you if there is a strength deficit and get you started with strengthening.   

“No pain, no gain” does not apply to your joints.    If you are hurting, let us help!
 
References:
Alentorn-Geli, et al  “Running and Osteoarthritis: Does Recreational or Competitive Running Increase the Risk”,  JOSPT, 2017, 47:6:391
Bennell et all Hip strengthening reduces symptoms but not load in people with medial knee osteoarthritis and varus malalignments: a randomised controlled trial: 2010, DOI: 10.1016/j.joca.2010.01.010
Deasy et al  “Hip Strength Deficits in People with Symptomatic Knee Osteoarthritis: A Systematic Review with Meta-analysis: BMC Musculoskelet Disord. 2007; 8: 121.
Paul T. Williams, “Effects of Running and Walking on Osteoarthritis and Hip Replacement Risk”  Med Sci Sports Exerc. 2013;45(7):1292-1297.

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