Running is a form of exercise that some love, and others hate. For those of you who loathe lacing up sneakers, but keep at it, all too often its knee pain that makes you stop. Rest usually ends the discomfort, but once running is re-initiated, the pain returns. This cycle is very common, and the reason for its occurrence has more to do with muscle imbalance and less to do with the type of shoe you use, or the number of miles conquered.
Walking produces forces on our feet that are 1-2 times the weight of your body. Running on the other hand will drive approximately 2-4 times your body weight into your feet, and then to your knees. Here is research that discusses this for those reading who like detail: https://pubmed.ncbi.nlm.nih.gov/2782094/
There is one major group of muscles that are commonly imbalanced/weak that cause knee/thigh pain—which are the glutes. Yes, it’s true—are your surprised? The gluteal/buttocks muscles have an extremely important function while running to buffer forces as each foot strikes the ground. But all too often we work our glutes only while running or walking forward—not moving side to side.
Weakness in the glute muscles develops over time, and to compensate the thigh muscles and tendons start activating more to cushion each step. This creates irritation to large tendons that connect the thigh muscle into the kneecap—which is why (front), or anterior knee pain often starts above the kneecap and moves down. Each stride creates sharp pain upon landing each foot.
Rest reduces pain but doesn’t solve the problem. There are other factors that can cause this issue, but the one mentioned above is huge.
To solve this problem, proper stretching and gluteal muscle activation is needed, along with rest and a slow re-start of running mileage back up to prior levels to avoid re-injury.
Clam shell exercises and many others work great if performed consistently at resolving this issue. Also, while the body is healing, avoid running up hills and on banked surfaces, as this puts more pressure on the thigh muscles.
Imbalance of the glute muscles is routinely assessed during initial exams at our office and addressed, helping achieve better outcomes consistently for the patients we serve.