Safe Strategies for Returning to Running with Knee Pain

The first thing most physios or doctors will say if you're a runner who's dealing with knee pain is to stop running.

This does two things. For one, it stops you from doing something that has amazing health benefits that you enjoy. And two, it creates a negative association between running and knee injuries.

To be clear, running isn't inherently dangerous. Runners have some of the best cardiovascular health, along with some of the strongest bone densities, as an adaptation to the impact forces of running.

It's also important to note that when dealing with pain and injury, it's rarely a good strategy to stop being active. Finding ways to continue to move (even with the activity that caused the injury) is valuable and can even improve your recovery time.

Here are three principles you can use to get back to running safely and effectively.

1. Stop doing things that hurt and irritate your knee

The number one reason runners get hurt is that they do too much while ignoring the signs that they need more rest and recovery.

No matter how much stretching and cold plunging you do, it won't matter if your knee hurts and you continue, as your symptoms worsen.

Some discomfort is normal, and you probably won't be able to go through your day without feeling your knee pain at some point. A good rule of thumb is to keep your pain at worst, a 4/10 while running or doing any other activity. Again, you definitely shouldn't be pushing through anything that is making your symptoms worse over time.

For example, you may find that any distance over 5km makes your knee feel worse, or that doing lunges makes your knee hurt the rest of the day. Continuing to push through these will never allow your knee to recover.

So what does this look like in reality? It means running conservatively and finding a distance and pace that keeps your pain minor and manageable. Some other variables you can play with are:

• how often you run every week

• the shoes you wear

• the surface you're running on

• treadmill versus outdoor running

• incline versus decline surfaces

• using a walk-run strategy

• using running gear that beeps at you if you pass a certain pace

Speaking of pace...

2. Stop caring so much about your pace

There is a time and place to build up your speed and pace, but while you're rehabbing your knee isn't that time. Your number one priority isn't to hit PRs, it's to help your knee feel better so that you CAN train in a way that will lead to meaningful progress.

I often prescribe clients time-based targets in the beginning as opposed to distance or pace ones for this very reason. It may even start as a 10-minute run where you don't care how far or fast you go, as long as your pain is manageable.

This gives you a springboard to increase your distance and pace over time.

3. Use strength training to cover your bases

Running is a repetitive sport. You do the same motion over and over again, using the same muscles and joints in the same way. There isn't any variety, which can lead to overuse of those muscles and joints, which contributes to injury in the first place.

Strength training, especially of the lower half, is not only great for supporting knee rehab but improving overall strength, mobility, and performance while preventing future knee injury.

Heavy squats have helped improve my leg strength and power. Long-range lunges have helped build up single-leg strength in a fuller range of motion than running provides. Nordic curls have dramatically increased my hamstring strength, leading to better force absorption in each step while providing support for my knees. Proper strength training builds up the capacity of your knees to better handle the demands of running.

It's also important to note that upper-body training can be just as valuable. If anything, it allows you to train while giving your lower half a break.

The best rehab plans don't prescribe bed rest or ban running; they keep you moving. While every knee injury is different, following these three principles will get you back to running as quickly and safely as possible.

To your good health,

Coach Stephen

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Thanks for reading.

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