Weak Muscles Can Lead to Runner’s Knee. That, And Really Bad Luck.
I covet athletes’ bulging thighs. That’s right. You heard me. I don’t dream of having Gwen Stefani’s abs or Madonna’s biceps. OK, maybe a little. But what I really want is strong, muscular thighs. (Though I hope mine are a little less masculine than the ones in the photo above.)
A new study confirms something my doctor told me more than a year ago: Weak leg muscles contribute to Runner’s Knee, a layman’s term for the oh-so-fun cartilage condition I have.
If I didn’t hate my knees so much, I’d call them something like remarkable or incredible. If I were to call them that, I’d do it because these tiny disk-like bones are what allow you to walk, bend your legs, and lift heavy objects. See, without them your thighs would fall onto your shins, making it really hard to do things like sit. And making you look really, really, ridiculously funny.
So about those knees … They’re connected to your upper and lower legs by tendons and ligaments. I imagine them like rubber bands, connecting the whole shebang. You can think of them however you like.
The knee moves mainly thanks to the quadriceps muscle (front of your thigh) and hamstrings (back of your thigh). Here’s where problems happen. If your hamstrings or quads are imbalanced—or if you’re weak in both spots—your knees can take a beating. I know, it’s not very fair that weak muscles can cause your knee to scrap the femur (thigh bone), wear down cartilage, cause massive pain, and make it so you’re unable to walk more than a block without excruciating pain. I know!
But, alas, it happens. According to the study’s author, people with weak quads and hamstrings don’t bend their knees enough when running or jumping. “That means the contact area between the kneecap and the femur is smaller, so pressure is focused and pinpointed on a smaller area.”
My doctor says that an overly ambitious lateral retinaculum (a tendon that attaches to the outside of the kneecap) pulls my knee too far outward, causing the bone to slip out of the groove it follows when bending and ultimately leading to cartilage damage. Strengthening my quads—especially the vastus medialis obliquus (VMO), a bulge of muscles just above the knee—can help pull the kneecap back in the right direction.
I have a handful of leg-strengthening exercises I use, but I’d like to hear from you. Do you focus on your legs when strength training? What exercises do you find the most helpful?
12 comments
hi tracey! i just found your blog by way of facebook! can’t wait to read more of your writing! i have a running blog that i’ll link to here… also another (anonymous, mostly) blog that isn’t associated with fb.
hope you’re doing well!
meg
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Tracey Reply:
December 3rd, 2009 at 10:40 pm
Hi Meg! So good to hear from you–I’m glad you found my blog. I’ll definitely check yours out, too!
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Are there any exercises one should avoid if they have knee pain? It sounds like strengthening that muscle above your knee would make things worse, not better.
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Tracey Reply:
December 4th, 2009 at 11:15 am
There are a couple exercises I stay away from: squats and lunges. Both hurt my knees. I do modified squats, though, by placing an exercise ball between my back and a wall. It takes some of the pressure off of the kneecap. And, of course, when doing any exercise, you shouldn’t let your knee move over the toe line (they should be in line if you were to, say, hold a ruler up to your foot).
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I actually tend to stay away from strengthening my legs…simply because I run so much that when I hit the weight, I feel like I should devote the time to my arms since they’re not getting as good of a workout during my runs. I do occasionally do some lunges because they are great preparation for when I play tennis. I always feel them in my legs and butt the next day!
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Tracey Reply:
December 6th, 2009 at 8:25 pm
I’ve stopped doing lunges since I injured my knees, but when I do these walking squats my hips and butt are sore, sore sore then next day.
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I thnk this theory is bogus. If weak muscles lead to cartilage damage, why is my left knee sore, and my right not. The muscles are pretty close in size. And, I have extremely well developed muscles on both legs. I believe the problem is a slight misalignment of the knee that causes cartilage damage. When the cartilage then tears, the misalignment is exaggerated and arthritis results.
I was going to get a replacement knee until I found a device that subtly twists my knee one way and the calf the other. This reduced the load on my medial area and I was not only able to avoid surgery, but I started running and playing rugby again.
check this alignment system out at http://www.inthegroovebrace.com
Despite the name, it really isn’t a brace, but an alignment system. This works only for active people.
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Tracey Reply:
December 9th, 2009 at 3:58 pm
I agree that there are many factors that come into play, specifically misalignment. But I do think building up strong leg muscles helps pull the knee into better alignment and reducing some of the wear-and-tear on the cartilage. In my case, I have misalignment in both knees but more in my left, which hurts more and has worse damage. (In fact, for years my right knee was fine. It was only until my left got so bad that it started to hurt, too.) With less muscle mass in my leg, my knee’s tracking is even more out of whack, especially during exercise. But, as they say, your mileage may vary. My doctor said people with Runner’s Knee typically don’t feel pain while walking and I do. So go figure.
Glad you found something that works for you. I’m definitely going to look into the “brace.” What was your diagnosis? That is, did you injure your knee first … or did you have cartilage damage from overuse? And how long did it take for this “brace” to start helping? I’m open to trying pretty much anything!!
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Tracey, how much have you focused on flexibility as well as strength? About 6 years after first being told I had the knees of someone 30 years older (lifetime recreational soccer player), I had pain so bad in my normally less painful knee I was convinced I had injured it. Went to a sports medicine orthopedist who said nope, no injury, just that same arthritis, and suggested a course of physical therapy. I was surprised after the initial evaluation that she said it was flexibility, not strength, I needed to work on. (Tight muscles, as well as weak muscles, can pull the kneecap out of alignment) After 6 weeks of daily stretches not only was the severe pain gone, but I was rid of aches and pains that had been pretty much constant for the previous 6 years. I am now an avid stretcher (IT band and hamstrings seem to be the most important to keep long and loose) and have not had any increase in knee pain in 3 years.
Sorry for the long post but I see a lot of talk about strengthening which is definitely important but I’m telling you, spending time working on leg flexibility has reduced my knee pain exponentially. So I’m kind of a zealot about it now
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Tracey Reply:
December 9th, 2009 at 4:06 pm
Hi Cat, thanks for stopping by the blog. Sorry you can relate—but I’m happy to hear you’ve gotten past the pain. Every time someone shares their story, it gives me hope, so thanks for that. Before my knees started hurting, I rarely stretched. I was super tight. I also had my physical therapist sold me for having such tight muscles…and I learned to stretch my hamstrings and IT band. I do notice that when my hamstrings in particular are tight, my knee hurts. I got a foam roller to stretch the IT band and—yowzers—does that hurt but makes my knees feel so much better.
Thanks for spreading the word about the importance of stretching. I’ll have to post about that in the near future!
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Hi, just found you and your knees! I’m in a similar position – I had reached 18 miles in my (first) marathon training before my right knee started screaming at me. Now it’s looking unlikely I’ll be able to do the race, in March.
Tony makes a good point about weak muscles and only one knee suffering – I hadn’t thought of that. However, I think running on a one-way camber triggered my Runners Knee; I’ve assumed that’s why I’m feeling it on one side and not the other.
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Tracey Reply:
December 18th, 2009 at 3:55 pm
Sorry to hear you’ve been having knee pain. I feel for you. I do hope your pain resolves quickly and doesn’t become chronic. I’m not sure if you’ve already done it, but I’d urge you to get to a doctor pronto so you can figure out the cause of your pain. If it’s from overuse then the question is whether your knee tracks improperly. If so, strengthening the muscles in the leg and using orthotics for flat feet can help.
As for one knee feeling it and not the other: My knee pain started in my left knee only and stayed that way for a couple years. My right knee pain only started a year ago and was partially caused by relying on it too heavily and a change in my gait. My left knee just happens to track worse than my right thanks to more bowing of the leg, a lower arch in my foot, and a too-tight ligament on the outside of my kneecap. So, don’t discount maltracking. (Though I hope it’s not the case.) Get it checked out by a doctor who can check your knee’s tracking and–if it does track improperly–advise you how to compensate and prevent further damage.
The biggest advice I can give you (without knowing specifics, of course) is to take it easy.
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