Running outside is a great way to stay in shape right now, for endless reasons. It will allow us to get fresh air, enjoy nature, boost our immunity, improve cardiovascular health, while also allowing for social distancing. However, we need to be able to manage and prevent injury at the same time.
Knee pain is one of the most common symptoms with running and accounts for about half of running-related injuries. If you are a runner who is experiencing knee symptoms or you are a runner who wants to prevent future injuries, there are several ways you can reduce impact or load on the knee joint.
One of the most common causes of movement impairment in running is lack of control or strength of the hip extensors, which can ultimately lead to knee pain. In order to facilitate use of the hip extensors and reduce demand on both the knee and quadriceps muscle, we can slightly increase our trunk flexion angle to 8-10 degrees. In a research study by Bonacci et al in 2013, they found increasing trunk flexion angle by 7.2 degrees resulted in 140% higher hip extensor energy generation in addition to a decrease in quads energy generation and absorption. Another reseach study in 2014 by Teng and Powers showed that a 10 degree greater trunk flexion angle also resulted in decreased peak stress on the patellofemoral joint.
We can also reduce forces on the knee during running by increasing our cadence. Bryan Heiderscheit et al (2012) found that increasing cadence by 10% can significantly reduce loading to the hip and knee. There are several metronome apps that you can use to record your current/preferred cadence, and you can gradually train yourself using a metronome in order to increase your cadence and make a permanent change. I would recommend trying the “fixed tempo” feature on the Weav Run App, which will play music that will guide you to run at a specific cadence of your preference. You can also keep it simple by recording your cadence using a Metronome App.
If these methods don’t work for you, we can also retrain your gait pattern from a rearfoot or midfoot strike pattern to a forefoot strike pattern. Research has shown that average load rates are reduced by 60% in forefoot strikers and lateral forces are reduced by 55% (Samaan et al 2014). A study by Wearing et al in 2018 also showed that habitual forefoot strikers have stiffer Achilles tendons, which are more resistant to injury.
These small changes in our running can create substantial improvements in symptoms as well as prevent future injuries, while also allowing us to stay active and healthy!
We currently offer running assessments at Thrive where we would watch you run in order to determine what type of motor pattern you are using and whether it is efficient or not. In combination with objective measures including functional task assessment, driver testing, muscle tests, and special tests we can create an individualized treatment plan for you with the goal of improving your form to prevent future injury and/or treat a current injury.
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Morgan Locker, PT, DPT, MSCS, OCS, LSVT BIG Certified Clinician, utilizes a combination of driver testing and functional movement analysis to specifically diagnose the cause of her clients’ symptoms. Her treatment approach includes a combination of manual therapy techniques and movement re-education in order for her patients to achieve symptom-free, optimal function. Morgan is an adjunct faculty member at Dominican College’s Doctorate of Physical Therapy program.