Q+A: How can I stop my knees hurting after running sessions?


Posted: 12 April 2011

Q. After running sessions I often have sore knees. Are there exercises I can do to improve knee strength?

A. This is a frequent complaint from runners and triathletes. The most common problem is called runner's knee. This is a pain just below and to the outside of the knee. It's caused by a tight iliotibial band (ITB), a band of connective tissue that runs down the outside of your thigh to the top of the tibia bone on the lower leg.

Pain comes on after a certain distance, on downhill sections or if you're running on cambered roads. It tends to afflict triathletes who pronate (the foot rolls inwards when it contacts the ground) and when you increase distance.

To find out if you pronate, stand barefoot and see if you have an arch on the inside of your foot. If you have a very low arch the chances are that you will pronate. You can limit this inward rolling by using orthotics and by doing calf stretches and calf raises.

Key stretches

Generally speaking, the best way to strengthen your knees is by improving the strength and flexibility of your quad muscles (the muscles at the front of the thigh), in particular the vastus medialis oblique muscle, the small teardrop-shaped muscle just above the knee on the inside of the thigh.

Strengthening this muscle will take the stress off the knee and transfer it to the muscle. The best exercise for building this muscle is leg extensions. Sitting down, with your feet hanging towards the floor, extend your legs until they are straight. This can be done with no weight at all or with a light weight resting on top of your feet.

It is best to start with both legs and as you become stronger you can progress to single-leg extensions, using heavier weights. A more intense variation is to angle your knee outwards when doing the leg extension and just concentrate on the final phase of the lift until the leg is straight.  

Other useful exercises are squats and lunges, but take care not to extend the knee in front of the ankle. This means that you have to sit back when doing a squat, as if you were sitting on the toilet, so that the knee joint is in line with the ankle. When doing lunges you need to do an exaggerated stride as you bend into the lunge, keeping your body upright. You don't need to go far, a 45-degree angle is sufficient.

The easiest way to prevent sore knees in the first place is to stretch properly before and after sessions. Tight quad muscles can pull on the knee and cause pain. My DVD Flexibility for Triathletes and Runners outlines simple quad stretches, as well as glute and ITB stretches that will improve your flexibility and help prevent juries, or improve the condition of any that you have.

Ralph Hydes

Ralph Hydes is a running, duathlon and triathlon coach. He has helped many athletes reach international-level competition and has been the trainer to corporate teams for the London Triathlon since 2001. Ralph is a freelance coach, designing individual triathlon training programmes, providing one-to-one coaching and offering nutrition advice. His new DVD is Flexibility for Triathletes and Runners. Visit ralph-hydes.com.


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