Is distance running bad for the knees? This is one of those joint-related debates that never quite goes away – especially at this time of year, as the athletics world laces up its trainers for events like the London Marathon.
Anecdotally, you often hear people say that running a marathon is a recipe for knee trouble. But the science isn’t actually so clearcut. When we look at athletes who run and train at competition level, we don’t tend to find a high rate of knee injuries. In fact a number of recent studies have suggested that regular long distance running may actually be beneficial for the knee joints.
But… a reality check: most of us aren’t world-beating professional runners! That means we do need to exercise some caution when it comes to training for a marathon. So how would a knee surgeon (and occasional marathon runner!) approach it? Here are my top tips…
Don’t overdo it
How do knee injuries most commonly occur? Answer: through sudden bursts of new activity. If you’re taking up long distance running for the first time, for example, or coming back to it after a decade out, be careful not to ask too much of your knees at the start. Equally, if you’re switching from road running to uneven grass and tracks, take it easy – at least to begin with. Choose a steady training plan and build up gradually.
Test the muscles
Warm-up routines are interesting. Do they prevent injuries? The medical picture is fairly mixed – though I know many runners swear by them. Some gentle flexibility exercises before you run are undoubtedly a good thing, however. Here we’re talking about things like flexions (bending), extensions (straightening) and gentle hip stretches. Doing a quick ‘self-screening’ to check your muscles are comfortable is a good way to prepare for a long run. Which leads to the next point…
Listen to your body
If you start to experience any discomfort while running, slow down and minimise impact on the joint until you get home. Then rest for 48 hours. Apply some ice if there’s swelling. Take some simple pain relief such as ibuprofen if needed. Once you feel ready to resume exercise, build up gradually again. Perhaps try to lessen the hills and inclines on your first runs, or use a treadmill to get your knees working on a more even surface.
Take pain seriously
Persistent or severe knee pain may indicate a more serious problem. For new runners, a common culprit is patellar tendinopathy (sometimes known as Jumpers’ Knee). This is where the tendon underneath your kneecap becomes inflamed through overuse; you tend to feel it as a pain at the front of the knee, just below the kneecap. A sharp pain on the medial (or inner) side of the knee, on the other hand, could indicate a meniscus problem. If you do experience these kinds of pains, it would be sensible to get them checked out.
Invest in footwear
While I don’t want to sound like an advertising exec here, decent shoes are important! Particularly if you’re planning to spend a lot of time in them. So make sure your runners have good padding and protection. Spongy, shock-absorbent soles will help to spread the impact as you pound the track; there’s good evidence that arch support can prevent injury, too. Serious running shops offer video-based ‘gait analysis’ of your running style – if you’re new to the whole discipline of long-distance running, this might be a good place to start.