Knee Pain From Jogging

IT Band and Knee Pain:

If your pain is in the lateral or outer part of the knee (not the front nor within the joint) and feels muscular, then it may be coming from your IT Band. In this case, here are your guidelines for jogging.

1. Warm up for 5 minutes (fast walk, bike, etc).

2. Stretch for 5 minutes, including a lot of IT Band stretches. Hold each stretch for 20-30 seconds and repeat 3-4x for each leg.

3. Start jogging on a flat surface and at a slow-moderate pace. 

4. If you feel IT Band pain while jogging, you may need to stop and stretch.

5. Do not increase your pace, distance or frequency until you can do so without increased pain.
6. Stretch the IT Band after workouts and throughout each day.

For example, you may be able to jog 20 minutes, 3x/week without increased pain. Try to increase by 3-5 minute increments to see if you can tolerate more. Do not push through pain in order to maintain a certain pace or distance. In that case, you would continue to worsen the problem instead of giving it a chance to heal completely. The goal with jogging is to slowly progress in order to do so without pain. 

Pain in Knee Joint: Book for Self-Treatment:

If your pain is within the knee joint, I recommend a book called Treat Your Own Knee by Robin McKenzie. It will teach you which knee movements may treat your pain and which movements to avoid.

Knee Strengthening to Prevent Knee Pain:

Joggers need to do leg strengthening in addition to jogging. You should spend at least 1-2x/week doing strength training for the lower body including all major muscle groups. One of the single best exercises to stabilize the muscles surrounding the knee is Straight Leg Raise. Lie on your back with unaffected knee bent. Straighten your knee (of painful leg) and slowly lift the entire leg ~10 inches and slowly lower (keep knee straight the whole time). Repeat 3 sets of 8-15 reps. Once you can do 3 sets of 15 easily without weight, increase resistance by using an ankle weight. Progress slowly in 1-lb. increments.

Photo: celiajohnsononline.com

Cross Training To Prevent Knee Pain:

Frequently, knee pain can be prevented by cross training. If your goal is cardio exercise, replace 1-2 jogs per week with another form of cardio. I highly recommend biking, swimming, or cardio workout machines. Of course, there are various other forms of cross training such as strength training, plyometrics, flexibility, interval training or various sports.

Jogging Modifications To Decrease Knee Pain:

1. Jog on grass instead of roads/sidewalks.

2. Decrease distance. For example, instead of 3-4 miles each on 2 consecutive days, do 2 miles every other day.

3. Modify shoes using inserts, orthotics or a new type of shoe.

4. Decrease speed. Lower your pace and see if it changes your pain.

5. Try interval training in order to increase your power without having to do as long distances in order to achieve an excellent cardio workout.

Postpartum Jogging and Knee Pain:

After pregnancy, it may be challenging to get back into jogging, especially if you are having knee pain. Your knees may not be ready yet to return to 3-4 miles, as the ligaments are still lax from pregnancy/childbirth. Progress very slowly as your body tolerates. If you are first returning to jog since having a baby, try 1/2 or 1 mile of walking/jogging. Jog for a bit but stop and walk as needed (keep a moderate to fast walking pace). Once you work up to jogging for a mile with no walking needed, increase to 1.5 or 2 miles of walking/jogging. If it is painful, decrease your jogging intervals. Slowly, as your knees tolerate, you should be able to jog more and walk less. But do not push through moderate or severe pain in order to jog a certain distance or speed. 

Always consider why you are jogging. If for weight loss, there are alternate exercises that you can do, so find one that is not painful. If for exercise outdoors, try biking instead. If for alone time/mom's sanity, join a gym with good childcare. If for specific race preparations, take a longer time to train. If you continue to injure your knee, you may have to stop jogging completely, so it is better to treat and prevent the pain than to jog through it.

SHIN SPLINTS: Can They Be Prevented?

Photo: by jpo.ct (Creative Commons)

If you are a runner and have experienced SHIN SPLINTS, you know how painful they can be and how much they can inhibit your running. The good news is that they can be prevented, and it is actually much easier than treating them once they occur.

How To Prevent Shin Splints:

1. Warm up well before running. This may include walking, stretching, and/or slow jogging.

2. Stretch your lower legs well before running. Stretch your calf muscle, soleus muscle (lower part of calf), and the front of your ankle (by pointing your toes downward/inward and downward/outward). Hold each stretch longer (30 seconds) if prior stretching routines have not been effective.

3. Avoid running on hard surfaces. Find trails, sand, grass, or a padded track to run on.

4. Be sure to wear proper shoes. Replace running shoes every 300 miles.

5. Consider using orthotics (over-the-counter or custom-made).

6. Slowly increase your training schedule, especially if you are new to running or returning after an extended time away.

7. Slowly progress to running on hills.

8. Do not run through shin splint pain!  

9. Do regular ankle Range of Motion and ankle strengthening exercises.

10. Cross train from the beginning of your jogging or running program.

Source: Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation, 2nd ed. 2003: Mosby. "Shin Splints in Runners" (Casillas MA, Jacobs M), pages 522-526.

The time I needed PT

I knew I wanted to be a PT since high school. But in college I actually needed Physical Therapy for knee pain. Every time I ran, the back of my knees would hurt during the run and afterward. I actually had to stop running because the knee pain made it hard for me to climb stairs. I lived on campus at King College (a small school in Bristol, TN), where I had to walk and climb stairs a lot.

So I saw a PT here in Columbia on one of my breaks from school. He showed me several exercises, and as I did them for the next weeks-months, my pain progressively decreased. However, I was afraid of the pain returning, so I stopped running completely. At the gym I did the elliptical machine instead, which did not bother my knees.

I went through the rest of college and grad school without returning to running. I did other forms of cardio but stayed off the treadmill. Several years later, I finally decided to try jogging again. Everything I learned in PT school kept me from having knee pain. I learned how to warm up, do the right stretches and avoid hurting my knees again. So now I can jog regularly without pain! I actually do the treadmill now much more than the elliptical.

All this is to say that PT works! If you have an injury or frequently painful area, find a good PT near you! But ideally, you can learn how to think like a PT now to prevent future pain.