Runners: How to Reduce Your Knee Stress
Article by John Miller
Can You Change Knee Running Stress?
It has been shown by simply changing the way we run can have a large bearing on how much stress goes through our knees... and who’s knees wouldn’t mind that?
Heiderscheit et al (2011) found that simply by increasing the step frequency during running you can "offload" your knee joint stresses.
Simple things that you can change:
- Decreasing your step length to avoid overstriding.
- Less up and down movement of your centre of mass.
- Less "braking" force on your lower leg.
- Less knee bend at foot strike.
What is an Efficient Cadence?
Most efficient marathon runners take roughly 180 steps per minutes (90 each leg). If you take fewer steps than this, your knees, shins and heels have more impact stress per stride to disperse plus you tend to overstride.
The detrimental implications of overstriding are multifactorial. Primarily as you overstride you require more hip flexion to pull your foot and knee further forward. This effectively inhibits the opposing gluteal muscle group. Your gluteals have a vital hip extension, external rotation and hip abductor control, which leads to hip control. Ineffective gluteals lead to hip “collapsing” issues. Overstriding also increases your heel impact rather than midfoot impact, which can lead to stress fractures in your heels or shins.
Edwards et al (2009) research showed that reducing your stride length decreased the probability of stress fracture by 3% to 6%. And, who wouldn’t want to decrease their risk of stress fractures?
Overstriding also has an impact on the oscillation of your centre of mass. Essentially you’ll bounce up and down more. The effect is that the ground reaction force absorbed by the ankle, knee and hip at foot strike again increases. You’ve surely seen how some runners simply glide across the air with their feet touching the ground. Compare that to the struggling collapsing runner who I'm sure you also encounter on running paths.
This increases the braking force on the stance limb which effectively increases the ground reaction force imparted onto the knee.
Finally, overstriding requires additional knee bend during your stance phase. This increases the likelihood of your kneecap compressing into the trochlear groove of your thigh bone. Do that enough and you’ll have painful clicking kneecaps.
How Can You Increase Your Step Cadence to Improve Your Stride Length?
Step cadence can be easily measured and re-trained by running on a treadmill and either watching a step counter (eg Garmin) or listening to a metronome set at 180 to 190 steps per minute. Smartphone apps can be downloaded and played back as you run. Other research, by Wily et al (2105) has shown that this can be effectively done in a two-week block running four times per week.
For more advice, please ask your running physiotherapist.
Common Running Injuries
Running is one of the easiest and most popular ways to stay fit. It is also one of the easiest ways to develop an injury. Running injuries are common and
often affect the hips, knees, ankles, and feet of runners. The impact and stress of running is sometimes hard on the muscles and joints; especially
if you ignore early injury signs.
- ITB Syndrome
- Knee Ligament Injuries
- Patellofemoral Pain Syndrome
- Patella Tendonitis (Tendinopathy)
- Chondromalacia Patella
- Osgood Schlatter’s
- Sinding-Larsen-Johansson Disease
- Meniscus tears
- Bursitis Knee
- Knee Arthritis
- Plica Syndrome
- Anterior Ankle Impingement
- Peroneal Tendonitis
- Retrocalcaneal Bursitis
- Sprained Ankle
- High Ankle Sprain
- Tibialis Posterior Tendinopathy
- Plantar Fasciitis
- Sever’s Disease
- Heel Spur
- Morton's Neuroma
- Stress Fracture Feet
- Hip labral tear
- Femoroacetabular Impingement (FAI)
- Gluteal Tendinopathy
- Hip Arthritis (Osteoarthritis)
- Piriformis Syndrome
- Proximal Hamstring Tendinopathy
- Stress Fracture
- Trochanteric Bursitis
- Poor Hip Core
- Back Muscle Pain
- Bulging Disc
- Degenerative Disc Disease
- Facet Joint Pain
- Sacroiliac Joint Pain
- Pinched Nerve
Running Injury FAQs
Edwards et al (2009) Effects of Stride Length and Running Mileage on a Probabilistic Stress Fracture Model. Med Sci Sports Exerc. 41(12):2177-2184.
Heiderscheit et al (2011) Effects of Step Rate Manipulation on Joint Mechanics during Running. Med Sci Sports Exerc. 2011 Feb; 43(2): 296-302.
Wily et al (2015) In-field gait retraining and mobile monitoring to address running biomechanics associated with tibial stress fracture: In-field gait retraining and monitoring. Scandinavian Journal of Medicine and Science in Sports 26(2).
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