Running isn't bad for knees. Bad knees are bad for running.

I think one of the toughest parts of my job is unraveling the knots of fear that naturally occurs after an injury. Elderly people that fall are forever in belief that the next step they take will be a tumble. Golfers that injure their back put down their clubs thinking that next swing will throw out their back. Runners that develop knee pain believe that if they run another mile, they will have to trade in their knee for a new one at the local surgery store (I wish orthopedic medicine was that easy). Sometimes the fear is substantiated. The balance is off, their spine is out of alignment and every stride with poor mechanics wears down the cartilage of the knee down to the bone. Would we still have that feeling of dread if balance was retrained, the spine was aligned and knee mechanics restored?

 To understand pain and injury, we can break the causes into two simple categories: 1) a stressor is compressing or grinding on other tissue 2) something is being overstretched and thereby strained. To simplify it even further, let us discuss cause #1 which is the reason we get degeneration of the knee joint and arthritis. If structures such as the meniscus or cartilage  get rubbed on and wear down because of an unstable knee or pathological mechanics of the joint, bone can be uncovered. Bone is full of nerves and can be very painful when scraped, impinged, or compressed. "Bone-on-bone", like Rome, wasn't built in a day and this process comes from a lifetime of poor running mechanics. 

But what if we made the knee more stable or fixed the faulty mechanics of the joint? What if we addressed the indirect cause of faulty mechanics of the knee by treating neighboring joints such as the ankle or hip? Does it not make sense that further damage will ebb and healthiness will flow? The motion of running is something we are meant to do. Our knee joints are created to handle shock with the patellar tendon-quadriceps complex.  Assuming good strength and flexibility as well as proper mechanics, we can feel confident that the only damage we are doing is in the mileage department. Many painful ailments are due to injuries, but even more can be attributed to something more sinister: inactivity.  This state of being makes us tight, weakens our muscles and wreaks havoc on our bodies. 

Not sure your knee is run-ready? Here are a few quick questions to ask yourself before you lace up:

1) Do you have poor hip flexibility?

2) Do you have flat feet? 

3) Do you have a tight IT Band?

4) Do you have weak glutes?

5) Do you feel your knees are unstable?

If you answered yes to any of those questions, put running on hold temporarily (maybe start cross training into another exercise while you address the problem so you don't lose your muscular endurance as well), but don't be afraid to get back out there when everything is back in order.