Running doesn't damage your knees!

Q) Lots of people tell me running is bad for my knees. I like running but I'm concerned that it may leave me with knee problems, what should I do.

A) It is very commonly stated that "running is bad for your knees". I'm not quite sure where this has come from, apart from the idea that the repeated ground contact causes a problem.

However, there are really two parts to this that need answering. Firstly, does running cause knee damage and therefore is it effectively a bad thing to do? Secondly, people get knee pain when they run, sometimes to a point where they have to stop running.

These two things are not the same, and we'll look at the differences here.

The evidence

Many studies have shown that it's perfectly OK to run and that there is no further increase in a prevalence of Osteoarthritis in the joint (1,2). While this may seem hard to fathom, a recent study has helped to answer this in a biochemical way (3). Although only a small study it showed that running helped to increase anti-inflammatory proteins in the knee and so protected it from damage, where as an increase in the inflammation is associated with long term degeneration. You're getting assistance in knee health when running.

Another excellent study (4) used a measure called 'per-distance-load'. This was used to evaluate the force on the knee during running and found that actually due to the reduced ground contact time with running compared to walking, and the faster motion through the joint, the loads on the knee were very similar. In fact, there was a decrease in load with faster running. Go and do some sprints!

So how does a knee get injured then, as lots of people have knee problems?

Well, this is usually due to injury. If you stop, start turn or twist you run a higher risk of harming the knee and most joints for that matter. Once an injury has taken place, the point of injury is more susceptible to later degeneration. (5) i.e if you spent your youth playing football three times per week, then you might find problems coming your way.

Which brings us on to knee pain.

Some people just can't run because it hurts. Without going too in depth (6), pain is the brain picking up information from different receptors all over the body, those that measure pressure and temperature chemistry. Changes that could lead to a problem will set the brain off into giving out a pain signal to that area, and so making you stop the activity you're doing - in this case running. (For a longer explanation on pain please read the link)

How can we help?

Remember running is a skill that you have learned (skill development is a whole other subject...one I love btw). If you suffer from pain, you may not have learned it very well. We can help by retraining your gait and by analysing your motion using our holistic movement assessment processes to see how you move. We can then provide the right exercises for you to improve your movement when running.

E.g one. Often times there can be a problem at the foot. The foot is a complex part of your body with many movement possibilities (it moves in all different directions at the same time). If your foot doesn't move well then the ground reaction force may be travelling up the lower leg and creating an unnecessary pressure at the knee. In this instance we'd prescribe drills to improve movement at the foot, ergo stopping the pressure transfer up your leg.

E.g. two It's possible you have a problem at the hip. This is a ball and socket joint, which also has many movement possibilities. The motor control from the hip may mean the foot isn't being placed in the right place. Some strength training or plyometrics training may significantly help in this instance. Specific ones that is not just brainless jumping about.

Don't stop running

Running is a great exercise for fitness, mental health and body composition. There's no need not to do it, and if you're struggling, all you might need is some assistance in the way you move - of course this assistance will be specific to you as that's how we role at MFT.

Til next time.

Rich, Head of Research.

1)Does long-distance running cause osteoarthritis?

Cymet TC, Sinkov V.

J Am Osteopath Assoc. 2006 Jun;106(6):342-5. Review

2)Long distance running and knee osteoarthritis. A prospective study.

Chakravarty EF, Hubert HB, Lingala VB, Zatarain E, Fries JF.

Am J Prev Med. 2008 Aug;35(2):133-8. doi: 10.1016/j.amepre 

3) Eur J Appl Physiol. 2016 Dec;116(11-12):2305-2314. Epub 2016 Oct 3.

Running decreases knee intra-articular cytokine and cartilage oligomeric matrix concentrations: a pilot study.

Hyldahl RD1, Evans A2, Kwon S2, Ridge ST2, Robinson E3, Hopkins JT2, Seeley MK2.

4) Why don't most runners get knee osteoarthritis? A case for per-unit-distanceloads.

Miller RH, Edwards WB, Brandon SC, Morton AM, Deluzio KJ.

Med Sci Sports Exerc. 2014 Mar;46(3):572-9. doi: 10.1249/MSS

5) Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review.

Driban JB, Hootman JM, Sitler MR, Harris K, Cattano NM.

J Athl Train. 2015 Jan 9. [Epub ahead of print]

6) https://www.bodyinmind.org/what-is-pain/. By Professor Lorimer Moseley