Knee pain from running down hill, can it be stopped?

If your knees hurt from running, you are definitely NOT alone! Four million Canadian runners who suffer from knee pain every year.

Last month, a team of researchers at the University of Calgary (from the lab where I had my 3D gait analysis done), published a study in the Journal of Athletic Training showing how runners with knee pain can benefit from an intensive hip-strengthening program.

The hip muscles are some of the largest muscles in the body(and therefore technically the strongest too, by design anyhow). They have roles in keep the pelvic level and the knee aligned underneath us. But, I have seen time and time again, runners who have very weak hip muscles. They may not currently be in pain but if they increase their intensity or increase the loads (ie. by running downhill when the body is not used to lots of downhill running), breakdowns can occur.

Downhill running can feel jarring and anything but smooth. It may seem like that’s just a fact of life- we are subject to gravity…however, I believe our muscles act like springs. To dampen the forces of running downhill, I believe you should stiffen up the springs a little. How that translates in the body is to build muscular strength. Since hip muscles are large and support the proper stacking of the knee joint, seems like a good place to focus our energies. Targeting the hip external rotators, in particular, for runners whose thighs have a tendency to roll inwards would be important. Glute medius (posterior fibers particularly), sandwiched between glute minimus underneath and glute maximus above is one of those target muscles. There are many great exercises for this muscle group. The important thing is the technique with which these exercises get performed, because it is easy to substitute with other “keener muscles”. Check out this video example of a Glute medius strength exercise called the “clamshell”– the presenter covers all the important tips for ideal alignment. This is used in training someone who has limited endurance, too much discomfort or inadequate strength for standing exercises. Afterwards, standing exercises should be learnt.

So in answer to the initial question, I would say, yes, quite likely with 3-12 weeks of diligent hip strengthening exercises (depending how weak you are at the start), hill running could become a breeze, especially if combined with good technique. For tips on running up and down hills check out this post.


About Sue Shalanski

Sue Shalanski
Sue has been practicing physiotherapy for 15 years and has lived in Squamish for almost as long. She is the owner of Reach Physio and when she's not working, she can be found trail running, mountain biking or walking her dog Sammy. View all posts by Sue Shalanski

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