Knee pain? How changing your running technique may help

Running technique can play a role in the development & persistence of knee pain. (Neal 2016). Gait retraining may therefore be a useful part of the management for this condition.

There have been a number of studies that have looked at the use of gait retraining in patellofemoral pain (Runner's knee):

• In those with patellofemoral pain (PFP), gait retraining improved hip mechanics, reduced pain & improved function which were then maintained at 1-month post retraining. (Noehren 2011)

• Knee pain & knee abduction was significantly reduced post gait retraining & at 1-month follow-up. (Roper 2016)

• Gait retraining resulted in greater improvement than orthotic use. (Bonacci 2017)

• Reducing impact peak when running resulted in a reduction of patellofemoral pain incidence (29% in control vs 14% in the gait retraining group). (Chan 2017)

Some of the common running technique issues we see in runners with runner's knee include:

• Overstriding

• Increased vertical oscillation (up and down movement)

• Increased hip adduction & Knee valgus

• Pelvic drop

• Lack of hip extension

• Knee over toes in midstance

Gait retraining options

If there are running gait issues identified, some of the strategies that can be used include:

• Increasing cadence by 5-10% has been shown to reduce knee loads (Heiderscheit 2011, Lenhart 2013, Willson 2014). This can also help reduce overstride & vertical oscillation.

• Transitioning from rearfoot to forefoot strike: caution with this one to not overcorrect & run on the toes

• Using a slight forward trunk lean

• Cues to reduce pelvic drop, hip adduction and “knee strategy”

There are often many retraining options but it’s important to consider how changes impact other areas! It is important that you seek advice from your health professional before making changes to your running technique to ensure that any changes are right for you.

For further assistance with your knee pain please don't hesitate to contact us at www.healthhp.com.au

References

• Bonacci, J., et al. (2017). "Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial." J Sci Med Sport.

• Bramah, C., et al. (2018). "Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?" Am J Sports Med: 363546518793657.

• Chan, Z. Y. S., et al. (2017). "Gait retraining lowers injury risk in novice distance runners: a randomized controlled trial." American Journal of Sports Medicine.

• Heiderscheit, B. C., et al. (2011). "Effects of step rate manipulation on joint mechanics during running." Med Sci Sports Exerc 43(2): 296-302.

• Lenhart, R. L., et al. (2013). "Increasing Running Step Rate Reduces Patellofemoral Joint Forces." Medicine & Science in Sports & Exercise

• Neal, B. S., et al. (2016). "Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis." Gait Posture 45: 69-82.

• Noehren, B., et al. (2011). "The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome." British Journal of Sports Medicine 45(9): 691-696.

• Roper, J. L., et al. (2016). "The effects of gait retraining in runners with patellofemoral pain: A randomized trial." Clin Biomech (Bristol, Avon) 35: 14-22.

• Willson, J. D., et al. (2015). "Influence of step length and landing pattern on patellofemoral joint kinetics during running." Scand J Med Sci Sports.