Running provides a great cardiovascular workout, eases stress, and improves fitness but for some may come at a cost.
It is estimated that 19-79% of all runners get injured in a given year (1). To put that in perspective, at the least 1 in 5 runners you know will sustain an injury this year.
Surprisingly, of all the running injuries that occur, it is estimated that 50% of them will occur at the knee joint (2). That is something to pay attention to.
So, if you or a runner you know is dealing with knee pain, you are likely searching for answers on the best and fastest way to end your knee pain. There is tons of information out there about running, running form, and ways to help knee pain. Distilling the data down to actionable items with top return on time investment would be a lengthy endeavor...
...luckily I have done the work for you!
The Many Choices On How To Improve Running To Decrease Knee Pain
If You Need Quick Results...
Let's be honest, we are all looking for the "quick fix". Our days and to-do lists are already packed enough and all we want to do is exercise without pain. It's not much to ask right?
First off, it needs to be said that changing running form takes time, practice, and a planned progressive program that addresses weak links. Optimizing running form, like perfecting the javelin throw or becoming a top violinist, demands hours of training.
Olympic athletes and track stars have all day to practice their running form. For most who work 9-5 and have a family, finding time to get a run in can be a real scheduling miracle.
This article is for those who may have a 10k coming up in two weeks or have limited time to train and need to decrease their knee pain NOW in any way possible.
The 2 Fastest Running Form Changes
Of all the possible changes you can make to improve running form to decrease your knee pain, the fastest and best bang-for-your-buck are...
- Cadence Manipulation
- Forward Trunk Lean
Changing these two variables takes no additional equipment and can be done on your very next run!
One of the best ways to decrease impact loading on the knee joint during running, which can fall between 2.5-7x your body weight normally, is to increase your running cadence.
Cadence refers to the number of steps taken per minute. Often times, this number is likely to be 150-180 steps per minute. To measure cadence either count every step in a 1 minute time span or count steps to 30 seconds and multiply by 2 (or just use your Garmin running watch which can accurately track cadence...I have no affiliation with the company by the way).
Many recent studies have shown that increasing your preferred step rate per minute by 10% can significantly reduce stress on your knee joint.(3)
Most studies agree that a cadence of 172-180 is optimal for reducing stress at the knee. If your cadence is more than 10% less than this range, don't try and increase cadence by more than this percentage as likely performance will drop secondary to increase muscular demand.
One of the most common running errors observed, that greatly increases loading at the knee, is over striding. Over striding occurs when your lead foot lands too far in front of your center of mass and usually is associated with a straight knee position and increased ankle dorsiflexion. A lower cadence has been associated with a greater likelihood of over striding. Increasing your running cadence by 10% will help bring your stride length to optimal ranges.
If you are looking to improve your running cadence be sure to use a free metronome app that will provide an auditory sound for every step associated with a given cadence. You can also download music that carries a beat at a specific step rate...this second option is much less monotonous!
Forward Trunk Lean
The other fast way to decrease loading at the knee is to run with your torso inclined forward.
Leaning your trunk forward does not result in bending or flexing your trunk forward but instead moves the breastbone slightly in front of your hips. To further understand this position, you can imagine "running into a strong headwind" which is a great way to remember what an inclined trunk angle should look and feel like.
It will look something like this...
Example of forward trunk lean with running
So WHY does a forward trunk lean help decrease knee pain?
Research has shown that running with an upright trunk posture increases loading at the quadriceps muscles and thus increases loading at the knee. Conversely, a forward trunk lean decreases demand at the knee muscles and transfers the work to the gluteal muscles and calf.
The result...decreased knee loading and decreased knee pain.
This is the idea behind chi and pose running which describe the notion of "falling forward" during running.
Just like increasing your preferred running cadence by 10%, inclining your trunk forward during running is a quick adjustment that will pay a high return.
How much trunk lean is enough??
Most resources describe a forward trunk angle of 8-10 degrees. Since this amount is very hard to gauge, start with a very slight increase in trunk lean. Likely, leaning forward just a bit is enough to bring you to the optimal range.
Beyond The Knee Pain Quick Fix
The two strategies described, forward trunk lean and increased cadence, are great quick running form changes you can make today to help decrease your knee pain. These two changes will work great to get you to a fast approaching race or through your next long run without limiting knee pain.
To really end your knee pain for good it is likely you will need to employ additional running form changes or training variables. These two strategies described here are optimized for time and to reduce knee loading but they do not address excessive knee rotation, gluteal weakness, or shock absorption through the lower extremity kinetic chain.
Once you've completed your race, with less knee pain thanks to the two quick hit strategies above, it would be best to consult with a local running specialist physical therapist who can analyze your running gait and propose a plan to help you achieve optimal running.
....In the meantime, you can check out this FREE resource on eliminating knee pain and other running tips to improve your form and get back to racing and training.
Kevin Vandi, DPT, OCS, CSCS
Dr. Vandi is the founder of Competitive EDGE Physical Therapy — with his background in physical therapy, orthopedics, and biomechanics, he is a highly educated, compassionate specialist. Using state-of-the-art motion analysis technology and data-driven methodologies, Kevin has assisted a wide range of clients, from post-surgery patients to youth and professional athletes. When he isn’t busy working or reading research, he spends his time with his wife Chrissy and their five wonderful children, often enjoying the outdoors and staying committed to an active lifestyle.