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Guard the Knees for a Lifetime of Jogging and Running Enjoyment

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Guard the Knees for a Lifetime of Jogging

Guard the Knees for a Lifetime of Jogging and Running Enjoyment

November 21, 2006
By: Jean Johnson for Knee1 As the American Academy of Podiatric Sports Medicine (AAPSM) notes, “the most common pain associated with jogging is known as runner’s knee.”
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Thigh Exercises that Benefit the Knees – From the Gym to the House
  • Quadriceps at the Gym: Using the leg press machine helps strengthen thigh muscles. Adjust the platform so that your knees are bent at a 90 degree angle. Then extend the legs without completely straightening the knees. Repeat this bending and straightening motion slowly and smoothly, working toward three sets of 15 repetitions. Remember this rule of thumb when doing leg work: avoid locking the knees and instead keep the joints slightly flexed.
  • Quadriceps at Home: Balancing with a hand against the wall, lift one leg up toward the chest so that the knee is bent at 90 degrees. Bend the supporting leg slightly to keep the pressure off the knee. Then straighten and bend the raised leg in a continuous, slow fashion out in front of your body, starting with five to 10 repetitions and three sets.
  • Hamstrings at the Gym: Using the leg curl machine, slowly bend the knees as far as possible and then slowly straighten. Avoid arching your back or lifting your hips up off the seat.
  • Hamstrings at Home: Steady yourself with one hand on the wall or the back of a chair and with the supporting leg slightly bent, lift the other leg out in back in a smooth motion using an isometric hold. As with the quadriceps, work up to a reasonable number of repetitions and aim for three sets with short rests in between.


  • “The knee is subject to enormous workloads during sports activities,” states University of Iowa Health Care System literature on runner’s knee. “When athletes run or jump, the kneecap alone often endures forces of 1000 to 1500 pounds. The entire knee is under massive stress with these kinds of activities, especially when there are imbalances in muscle strength or flexibility. In time, overuse injuries, such as runner’s knee, may develop.” The Nature of Runner’s Knee One thing to remember about overuse injuries related to the knee is that they are progressive. Consequently, temporary measures like icing to relieve pain may work against longer term health, especially if you continue to run on the injured knee. A more effective way to be kind to your knees is to cut down on the number of days or time spent running. If this strategy doesn’t help, it is time to make an appointment with a health care professional. “That was me,” said Jessica Langely of San Bernadino, California. “I had never run or been very active before since I was a fat teen. So when I started running in my thirties, my poor knees really took a beating. Of course, I thought I could run anywhere and did all these hills almost every day. It didn’t take long until my knees let me know they’d had enough.” As Langley discovered, terrain is important. Downhill slopes are exceptionally hard on the knees, and smart runners either avoid these routes or simply walk down the inclines. At the very least, consider zigzagging down steep hills to ease the strain on the knees. Keep in mind that knee replacement surgeries are on the rise precisely because as people have rushed to get more active over the past several decades, they have neglected proper knee care. A Word on Shoes As far as what not to do, the University of Iowa Health Care System warns men and women to stay away from “wearing shoes with cleats in contact sports and wearing high-heeled shoes.” Although these kinds of shoes can seem attractive and fun, considering the state of your knees might help promote more sensible choices. On sports shoes themselves, look for sufficient heel cushioning, adequate arches, and enough lateral support for all 26 bones, 33 joints, and 112 ligaments in the foot. Keep in mind that different brands of running shoes have different shapes, widths, room in the toe box, and that all sizes and widths are not equal. It is best to replace your running shoes every 300 to 500 miles. “Wear sport-specific shoes – not cross-training, walking, or tennis shoes for running,” states the AAPSM. The professional organization of podiatrists further suggests shopping for shoes in the afternoon when feet are their largest. Try shoes on with the socks you plan to run in – preferably ones that wick moisture away from the foot, not cotton. Easing into a Training Program Here again, we’ve relied on tips from the AAPSM. The best way to avoid injury, says one of the group’s board members, Stephen Pribut, DPM, is to avoid what he calls the “terrible twos.” Too much, too soon, too fast, too often. As far as speed is concerned, a good rule of thumb is what the AAPSM calls “the talk test,” or running at levels that will allow you to carry on a conversation with your running partner. In terms of frequency, most sources conclude that running is best if done every other day in order to rest the body – the knees in particular – on off days. Also, a number of studies have noted that running or engaging in impact sports more than four days per week increases the risk of overuse injuries. Stretching and Strengthening The thigh muscles are especially critical in keeping pressure off the knees, so stretching and strengthening programs that include this large muscle group are critical. Strength training is best done on the off days from running. To stretch muscles prior to running, jog easily for five minutes to increase the blood flow and to warm up. Then do calf, hamstring, quadriceps, hip flexor, waist, glut, back, heel, inner thigh, and trunk stretches, holding each for 20 seconds and repeating six times. Stretching in this way at the end of a run is also advised because at this point the muscles and tendons are very warm and flexibility can be improved over time. As you stretch, visualize the interior of your body and try to appreciate the delicate connections between the bones, ligaments, and tendons. Medical Alert: If you have heart problems, diabetes, or are overweight, be sure to consult your health care professional before starting a new running program.

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