How can I protect my knees before running?

Protecting Your Knees Before Running

To protect your knees before running, focus on strength training of the lower extremities, proper warm-up, and gradual progression of running intensity and distance. 1

Strength Training

Strengthening the muscles around the knee is crucial for injury prevention:

• Lower extremity strengthening:

  • Focus on calf muscles, which are specifically identified as important for preventing knee and tibial stress injuries 2
  • Include hip strengthening exercises to control excessive hip adduction during running 2
  • Incorporate core strengthening to optimize lower extremity biomechanics 2, 1

• Key exercises to include:

  • Squats and lunges to strengthen quadriceps and hamstrings
  • Calf raises for gastrocnemius and soleus strengthening
  • Hip abductor exercises (side leg raises, clamshells) to control knee alignment during running
  • Core exercises including planks and bridges

Proper Warm-up Protocol

A proper warm-up is essential before running:

• Dynamic warm-up:

  • Perform a 15-minute warm-up at an intensity of 60-70% of your maximum effort 3
  • This specific warm-up duration and intensity has been shown to improve range of motion and enhance subsequent performance 3
  • Include light jogging, high knees, butt kicks, and lateral movements

• Timing matters:

  • Complete stretching within 15 minutes immediately prior to running for maximum benefit 4
  • Avoid static stretching alone as it's insufficient for injury prevention 2, 1

Running Surface and Technique

• Surface considerations:

  • Evidence regarding the ideal running surface is conflicting 2
  • Consider starting on a treadmill as some evidence suggests reduced tibial acceleration compared to outdoor surfaces 2
  • Avoid hills during initial training phases, particularly if you're new to running 2

• Running technique:

  • Consider reducing stride length or increasing cadence to reduce tibial stresses 2
  • Maintain proper form with slight forward lean, mid-foot strike, and arms at 90-degree angles

Gradual Progression

• Follow the 10% rule:

  • Increase running distance by no more than 10% per week 2
  • Progress distance before increasing speed 2
  • Start with alternate-day running, especially if you're new to running 2

• Walk-run progression:

  • Begin with a walk-run program if you're new to running 2
  • Gradually substitute walking with increasing time increments of running 2
  • Start at a slower pace (30-50% of usual pace if returning from injury) 2

Footwear and Equipment

• Proper footwear:
  • Choose running shoes with adequate support and cushioning 1
  • Replace shoes regularly (typically every 300-500 miles)
  • Consider custom orthotics if you have biomechanical issues 1

Common Pitfalls to Avoid

• Training errors:

  • Avoid excessive volume and training while fatigued 1
  • Don't ignore pain - if you experience knee pain, rest until symptoms resolve 2
  • Avoid premature return to full activity after injury 1

• Biomechanical factors:

  • Don't ignore underlying biomechanical issues like excessive hip adduction or rearfoot eversion 2, 1
  • Address muscle imbalances that could contribute to knee strain 2

Long-term Benefits

Proper knee protection not only prevents short-term injuries but may have long-term benefits:

• Recent evidence suggests running is not associated with worsening of knee osteoarthritis and may even be protective against generalized knee pain 5
• Consistent strength training helps maintain joint stability and function over time 1

By implementing these strategies, you can significantly reduce your risk of knee injuries while running and potentially improve your overall performance.