Knee Pain while Trail Running

There is no better way to start your weekend, than getting on a trail early in the morning for a run. The sun faintly shining through the trees, the dew still settling on the ground, and a chill in the air. The perfect image for a trail runner...until you take your first steps and your knee pain reminds you something is not perfect. As you warm-up, the pain is a dull ache. You can almost convince yourself it is not present. Unfortunately, after 10 minutes of running, the dull ache has turned into a sharp, anterior knee pain. The sensation of swelling is present and the knee doesn't feel strong. Ultimately, you push through the run. The thoughts of the damage done to your knee linger in your conscious. Humans are meant to be runners, but why are so many runners having knee pain? ​ 

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The problem is not with the action of running. The problem is with one's biomechanics as they run. There is a big difference. Running places 2-3x your body weight across the knee joints with each step. The repetitive compressive forces causes microtrauma if one's running form, shoe style, mobility, and stability are compromised.  Running requires proper trunk stability and good distal mobility. One must exhibit good lower abdominal strength, hip control, and proper ankle mobility. A combination of prolonged sitting, improper diet, and lack of full range of motion exploration hinders us. Knees are predisposed to injury due to thier location on the body. The knee is a modified hinge joint with motion in a single plane limiting the ability to absorb abnormal stresses.

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Since the knee only moves in one plane, the position of the hip and ankle have a profound affect on the forces that meet at the knee. We challenge the hip and ankle in our activities, allowing them to become stiff. This requires us to stretch and loosen the joints to remain healthy and pain-free. When we don’t attend to the demands on the hip and ankle, the detriments often appear in the knee. If motion is lacking above or below the knee, the abnormal forces dispersed on the inherently unstable knee will result in pain. 

The treatment for knee pain from running is multifold. Addressing the mobility of the hips and ankle as well as addressing core strength and specific running form is crucial. For a full functional movement evaluation or physical therapy services, contact Heafner Health directly.  Trail running season is quickly approaching! Make sure you have the knees for that perfect run. ​

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E: [email protected]
P: 618-604-3293

-Jim Heafner PT, DPT, OCS

Jim Heafner PT, DPT, OCS, 
Jim earned his Doctorate of Physical Therapy from Saint Louis University. He is a certified Orthopedic Clinical Specialist and trained in the Selective Functional Movement Assessment (SFMA) and Functional Movement Screening (FMS) systems. His educational and clinical background have made him an expert in manual and manipulative physical therapy as well as functional movement. When Jim is not treating patients in the clinic, he focuses his attention on educating fellow physical therapists in the profession, teaching manual therapy courses in Arizona. In addition, his physical therapy based blog attracts upwards of 65,000 views per week. ​

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