Runners: How to Reduce Your Knee Stress

john miller physiotherapist

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.

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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.

Knee Pain

Ankle Injuries

Foot & Heel Pain

Groin Pain

Hip Pain

Back Pain

Muscle Pain

Neck Pain

Running Injury FAQs

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • What Causes Post-Exercise Muscular Pain?
  • What are the Best Core Exercises?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why Does Heat Feel So Good?
  • How Does an Exercise Ball Help Back Pain?
  • How to Strap an Ankle
  • Post-Run Soreness: Should You Be Concerned?
  • Runners: How to Reduce Your Knee Stress
  • Running Recovery: 6 Helpful Tips
  • Sports Injury? What to do? When?
  • What are Common Adolescent / Children Leg Injuries?
  • What are Growing Pains?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When is the Best Time for a Pre-Event Massage?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
  • References:

    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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    Last updated 17-Mar-2019 01:23 PM

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