The wondrous Marathon season is finally upon us! Many of you no doubt are in the final preparations for your challenge. Increased volume of training can leave you susceptible to the dreaded Runner’s Knee. Is it preventing you from completing the time that you would like to run?

Why do we run? Because we love it – AND – we are designed for it! Most runners love to run more and more and we all have different abilities, weight, cadence and natural athletic prowess. However, the science cannot be defeated when it comes to ground reaction force and predisposition to certain injuries. ‘Runner’s Knee’ or ‘Anterior Knee Pain’ can be caused by a variety of issues from training load, training frequency, recovery and the most important of all, lack of injury prevention and strength work.

If you are experiencing Runner’s Knee, pain is usually around the front of the knee and is worse with activity, stair climbing and long periods of sitting with the knee flexed. There are many aspects of anterior knee pain. Pain can be driven from the patella tendon, quadriceps tendon, patella-femoral joint (knee cap) and sometimes referred pain from the hip. All these areas can cause pain but pain does not necessarily mean ‘damage’.

Let’s look at the world’s leading mid-long distance runner, Mo Farah. Dr Jessica Leitch analysed Mo’s running gait to understand why and how he is so fast and efficient. Leitch identified 9 key points to Mo’s running technique. It takes time and years of coaching to achieve all these. We have picked out three that we feel can be implemented now with a positive impact on your performance and in an effort to reduce loading on the knee;

1) FOOT STRIKE: Mo uses a mid foot strike – he lands on the balls of his feet and then lowers the heel before pushing away with his toes. This running style reduces impact, thus reducing associated force through the knee and hip leading to reduced injury risk.

2) FOOT POSITION: His foot lands as close to his centre of gravity as possible (not over striding). This reduces any breaking moments during foot strike and allows the leg to be stiff and use the ground reaction force to move forward to his next stride.

3) RUN TO THE BEAT: He runs with a high cadence or step rate (amount of times foot hits the ground/min). This allows him to run faster whilst reducing impact on the body. If your cadence is low – increasing it will help facilitate the above pointers.

Technique is a huge part of injury prevention. Another key factor is strength, especially when we look at how much force is being transmitted. When you run, 2.5 x body weight is transmitted through the knee at stance phase (amount of time your foot is in contact with the ground). At this point your body requires your hamstrings, glutes, quads, rectus abdominis (abs), gastrocnemius/soleus (calf complex) and tibialis anterior (shin muscle) all to work in synergy to help absorb the force generated and produce it into your next step. Let’s put this into context using a current client of ours;

Female Training for London Marathon 2017, weighs 63kg and has a pace of 9min mile with a cadence of 180. 

So 9 x 90 (180/2 = 1 knee) 810 steps per mile

63kg x 2.5 = 157.5kg through the knee per step

810 steps x 157.5kg = 127,575kg per mile x 26.2miles

= 3,342,465kg through the knee in a Marathon

That’s 3,342.5 tonnes!!!

These figures can be very daunting and off putting, however if you are conditioned and all the above muscle groups work well, this force can be used as a positive to make you run faster. 

These figures are astronomical!!! The strength required to finish a Marathon cannot be underestimated. It is not surprising then that when training for the Marathon your body will experience a few aches and pains. Especially if proper Strength and Conditioning has not been incorporated into your schedule. Pain can be scary so close to your Marathon, however, do not fear. There are huge changes that can still be implemented to get you to that start line feeling confident you can still reach your goal – even so close to the event! With some biomechanical re-education, corrective activation exercises and injury/pain management strategies there is absolutely no reason why you cannot strive to not only finish, but finish strong in your endeavors. By utilising these measures all is not lost. So get your medal polish out, because Marathon season…HERE WE COME!!!

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