Runner's Knee Not Improving? Here's Why

Summary

Jae Gruenke from The Balanced Runner explains that runner's knee, a common front knee pain, is often misdiagnosed as a muscle imbalance issue. The real cause, he argues, is poor running form, particularly having your weight too far back during mid-stance. Gruenke suggests that correcting your core action, allowing natural torso rotation, can balance your gait and alleviate the pain without needing to stretch or strengthen specific muscles.

Takeaways

• 🏃‍♂️ **Runner's Knee Identification**: It's a dull ache around the kneecap that occurs during running or when standing up from a seated position.
• 🔍 **Understanding the Issue**: The pain is in the patellar tendon, not the sides or deep inside the knee, indicating a specific area of concern.
• 💡 **Common Misdiagnosis**: The belief that tight quadriceps are the sole cause of runner's knee is challenged.
• 🤔 **Questioning Conventional Treatment**: The script questions why quads are overused and why glutes and hamstrings are underused, suggesting a deeper issue.
• 🏋️‍♂️ **Stretching and Strengthening Limitations**: While stretching quads and strengthening glutes and hamstrings may provide temporary relief, they don't address the root cause.
• 👟 **Running Form Analysis**: The way one runs, particularly having weight too far back in mid-stance, is identified as a primary cause of runner's knee.
• 🧍‍♂️ **Mid-Stance Weight Distribution**: Correct weight distribution over the foot is crucial for preventing excessive quad strain.
• 🙅‍♂️ **Myths Debunked**: Overstriding and increasing cadence are common recommendations that don't effectively solve the problem.
• 🔄 **Core Movement Importance**: Engaging the core and allowing natural torso movement is key to balanced weight distribution and preventing runner's knee.
• 🛑 **Exercises to Avoid**: Overemphasis on core stability exercises that restrict natural movement can exacerbate runner's knee issues.
• 🆓 **Resource Recommendation**: A free mini course, 'Runner's Knee Solution', is offered to help runners feel and implement the core action correctly.

Q & A

What is runner's knee?

Runner's knee is a condition characterized by a dull ache or pain at the front of the knee, specifically in the patellar tendon which connects the quadriceps muscle to the lower leg.

Who is Jae Gruenke?

Jae Gruenke is the founder of The Balanced Runner, a specialist who has been assisting runners and triathletes improve their form and performance since 2003.

What is the common misconception about treating runner's knee?

The common misconception is that runner's knee is caused by overworked and tight quadriceps muscles, and that stretching or strengthening the quadriceps, glutes, and hamstrings will solve the issue.

Why do stretches and exercises not always fix runner's knee?

Stretches and exercises may provide temporary relief, but they do not address the root cause of runner's knee, which is often an incorrect running form that leads to overuse of the quadriceps.

What is the fundamental cause of runner's knee according to Jae Gruenke?

The fundamental cause of runner's knee is the way a person runs, which overuses the quadriceps and underuses the glutes and hamstrings.

What is mid-stance and how does it relate to runner's knee?

Mid-stance is the moment in the running gait when one foot is on the ground and the body is bearing 2.7 times its weight. If the body weight is too far back during mid-stance, it can cause the quadriceps to overwork and lead to runner's knee.

What are the three main ways a runner's weight can be too far back in mid-stance?

The three main ways are: 1) Leaning forward with the butt too far behind the foot, 2) Being excessively flexed at the hips, and 3) Arching the back excessively which pushes the weight back.

Why might increasing cadence not solve runner's knee?

Increasing cadence, or taking shorter, more frequent steps, might reduce the stress on the knee but does not address the fundamental issue of the runner's form and weight distribution during mid-stance.

What is the core action and how does it help prevent runner's knee?

The core action involves the twisting of the pelvis and upper body in opposite directions, which helps balance the runner over their feet and prevent the weight from being too far back in mid-stance.

What is the Runner's Knee Solution mini course mentioned in the script?

The Runner's Knee Solution mini course is a free resource that teaches runners how to feel and utilize the core action in their running to prevent overuse of the quadriceps and alleviate runner's knee.

What advice does Jae Gruenke give regarding exercises that train a still core?

Jae Gruenke advises against exercises that train the core to be still, such as planks or Pilates, as they may contribute to the problem of runner's knee by not allowing the natural core action needed for proper running form.

Outlines

00:00

🏃‍♂️ Understanding Runner's Knee

Jae Gruenke, founder of The Balanced Runner, introduces the issue of runner's knee, a common front-of-knee pain experienced by runners. He explains that it's not just about stretching or strengthening muscles but understanding the root cause. The pain is located in the patellar tendon, not on the side or deep inside the knee. The conventional wisdom suggests that overworked quadriceps are the culprit, but Gruenke points out that the real issue is the running form that causes an imbalance in muscle usage. He emphasizes the importance of using glutes and hamstrings more effectively during running to prevent overuse of the quadriceps.

05:07

🔍 Fixing Runner's Knee by Improving Running Form

The paragraph discusses the common misconceptions about treating runner's knee, such as stopping overstriding and increasing cadence, which may provide temporary relief but do not address the core issue. Gruenke explains that the real problem lies in the runner's form, particularly the positioning of the body weight during mid-stance. He suggests that the weight should be directly over the foot, engaging the glutes rather than the quadriceps. The paragraph identifies three common ways runners may be incorrectly positioning their weight: leaning too far forward with the butt behind the foot, being overly flexed, or having an overly arched back. Gruenke advises against overworking the core to fix the issue and instead recommends allowing the body's natural core action to balance the weight over the feet.

10:09

🛑 Core Movement and Runner's Knee Solution

In this paragraph, Gruenke emphasizes the importance of the core muscles in regulating gait and preventing runner's knee. He advises against exercises that train the core to be static and instead promotes the natural twisting motion of the core that balances the body over the feet. Gruenke offers a free mini course called the Runner's Knee Solution to help runners understand and implement this core action in their running. He explains that engaging the core correctly can lead to a more balanced muscle usage, reducing the strain on the quadriceps and alleviating knee pain. The paragraph concludes with advice for runners with severe knee pain and a reminder to subscribe for more videos on running form and injury prevention.

Keywords

💡Runner's Knee

Runner's Knee refers to a common overuse injury characterized by pain around the kneecap, especially during running activities. It is typically caused by an imbalance in muscle usage, where the quadriceps are overworked while the glutes and hamstrings are underutilized. In the script, it is discussed as a prevalent issue among runners that the speaker, Jae Gruenke, has experience in addressing. The video aims to provide insights into why traditional treatments like stretching and strengthening exercises may not resolve the issue if the root cause related to running form is not addressed.

💡Quadriceps

The quadriceps are a group of four muscles at the front of the thigh responsible for knee extension. In the context of the video, an overuse or overworking of the quadriceps is identified as a contributing factor to runner's knee. The script suggests that the pain is not due to the quadriceps being too tight, but rather due to their overuse caused by an incorrect running form that doesn't engage the glutes and hamstrings effectively.

💡Glutes

The glutes, or gluteal muscles, are a group of muscles responsible for hip extension and abduction. The video emphasizes the importance of gluteal muscle engagement in running to prevent runner's knee. It is suggested that strengthening the glutes can help distribute the load more evenly across the leg muscles, reducing the strain on the quadriceps and alleviating runner's knee pain.

💡Hamstrings

The hamstrings are a group of muscles at the back of the thigh that help in knee flexion and hip extension. The script points out that these muscles are often weak in runners with knee issues, which leads to an imbalance where the quadriceps bear too much of the load during running. Strengthening the hamstrings is proposed as part of a solution to redistribute the effort and reduce knee pain.

💡Patellar Tendon

The patellar tendon connects the quadriceps muscles to the shin bone via the patella (kneecap). The script explains that runner's knee pain is often felt in this tendon due to the overuse and strain caused by incorrect running form. It is not the direct cause of the problem but is where the symptoms manifest.

💡Mid Stance

Mid stance is a phase in the gait cycle when the body's weight is fully on one foot, just before taking off. The video explains that in runner's knee, the weight is often too far back in mid stance, causing the quadriceps to work harder to prevent the body from falling backward. Correcting this posture is key to alleviating runner's knee pain.

💡Overstride

Overstriding is a running technique where the foot lands too far in front of the body's center of mass. While associated with runner's knee, the video clarifies that simply fixing the foot strike does not address the fundamental issue of weight distribution in mid stance, which is crucial for preventing the condition.

💡Cadence

Cadence in running refers to the number of steps taken per minute. The script mentions increasing cadence as a common recommendation to reduce the impact on the knee, but it is noted that this does not address the core issue of running form and can feel unnatural or lead to other problems.

💡Core Action

Core action in the context of running involves the coordinated movement of the torso and pelvis to maintain balance over the feet. The video suggests that engaging the core correctly can help align the body's weight over the foot in mid stance, reducing the strain on the quadriceps and preventing runner's knee. Allowing natural core movement is proposed as a solution rather than刻意 holding the core still.

💡Runner's Knee Solution

The 'Runner's Knee Solution' is a free mini course mentioned in the script, designed to help runners understand and implement the core action to correct their running form and alleviate knee pain. It is presented as a practical tool for runners to feel and apply the concepts discussed in the video to their running practice.

Highlights

Jae Gruenke, founder of The Balanced Runner, helps runners improve form and performance.

Runner's knee is a common front of knee pain that occurs during running.

The pain is located in the patellar tendon, not the sides or deep inside the knee.

Traditionally, runner's knee is attributed to overworked quadriceps muscles.

Stretching and strengthening glutes and hamstrings are common treatments.

The root cause of runner's knee is often not addressed by traditional treatments.

The fundamental cause is an inefficient running form that overuses quads.

Movement patterns should precede strength and flexibility training.

Running form that causes runner's knee involves weight too far back in mid-stance.

Mid-stance is when the runner supports 2.7 times their body weight on one foot.

Weight should be over the foot to engage glutes instead of quads.

Three common ways to have weight too far back include leaning forward, being too flexed, or arching the back.

Runner's knee can occur on one side due to asymmetrical body mechanics.

Overstriding and increasing cadence are common but ineffective recommendations.

The core muscles regulate gait and balance, which can prevent runner's knee.

Allowing the core to move naturally can alleviate runner's knee pain.

The Runner's Knee Solution mini-course helps runners feel and use core action effectively.

Engaging the core correctly can lead to spontaneous use of glutes and hamstrings.

Quads will be less overused, reducing knee pain and improving running form.

Recovery time varies, and walking should be comfortable before running again.

Additional help is available in the form of a video on the right way to engage the core.

Transcripts

Do you have pain around your kneecap when you run or have you been diagnosed with runner's

knee?

Here's why that happens, why stretches and exercises don't always fix it, and what to

do instead.

I'm Jae Gruenke, founder of The Balanced Runner, and I've been helping runners and triathletes

from beginner to Olympian improve their form and performance since 2003.

And since the very beginning, runner's knee has been one of the easiest problems for me

to solve with the understanding and the tools that I have.

And so now I'm going to bring some of that magic to you in this video.

If you haven't subscribed yet, please subscribe and hit the bell icon so that you'll be notified

every time I upload a new video on running form, running injuries and how to get back

that fun free flying feeling you had when you were a kid.

Runner's knee is that classic front of knee pain that comes on as a dull ache when you're

running.

You can also feel it when you're standing up from sitting down.

It's in your patellar tendon, that's the tendon that attaches your quadriceps through your

patella or kneecap to your lower leg.

It's not on the side of your knee or deep inside your knee.

Those would be other problems, and it's not behind your knee either.

And so people will tell you that what causes this is your quadriceps muscles, the front

of your thigh being overworked too tight, and that this pulls on and irritates your

patellar tendon.

And then as a result, the cure for this is first to release the tension on the quadriceps

muscles.

So that would be to stretch and or to foam roll or do some sort of other manual release.

And then also to try and strengthen your glutes and hamstrings, which are almost always too

weak if you've got runner's knee, so that your glutes and hamstrings would be able to

share the load with your quads and you wouldn't have this extra tension.

And so take a moment in the comments and let me know what stretches and strengthening exercises

you've been doing to try and help with your runner's knee.

So the problem with this whole stretch and strengthen paradigm is that it begs the question,

why are your quads getting overused and why are your glutes and hamstrings not getting

used enough?

You can spend a lot of time stretching your quads, rolling them out.

It probably temporarily makes your knee feel better.

You can rest and let that irritation and inflammation subside, but when you go back to running,

it'll come back.

You can strengthen your glutes and hamstrings and maybe you get a little improvement, but

you're still not addressing the fundamental cause.

And the fundamental cause is that the way that you are running uses the quads and doesn't

use or not sufficiently uses your glutes and your hamstrings.

Movement comes before strength and produces strength and flexibility.

So if you knew how to run in a way that used primarily your glutes and hamstrings and didn't

overwork your quads, then your glutes and hamstrings would already be strong and you

wouldn't need any special exercises for them, and your quads would not be overstressed and

causing this problem.

So let's look at how your running form is causing you to overuse your quads and underuse

your glutes and hamstrings.

So the way your running form causes runner's knee is by having your weight too far back

in mid stance.

Now, mid stance is this moment in your running gait when you're on one foot, you finish landing,

you haven't started taking off yet, and this is that the moment when you're bearing 2.7

times your body weight.

So it's not when your foot hits the ground, it's when you're supporting yourself here.

And so if your weight is in the wrong place, if you're a little too far back, your quads

will immediately start to work.

And in fact, they'll be the only thing fighting 2.7 times your body weight to keep you from

sitting down on the ground.

And so it's no wonder they get tight and sore.

Instead, your weight should be over your foot so that it's your glutes keeping your head

from going down and not your quads keeping your butt from going down.

And that's how you use your glutes instead of your quads or in balance with your quads

in running.

So there are three main ways that you could be keeping your weight too far back behind

your foot in mid-stance.

And one is if you're leaning forward but your butt is just too far behind your foot.

The second, probably the most common is that you're just really flexed like this.

And the third is for people who've really been working on their running form too hard

.

You lift the chest and almost arch your back so that it's actually your upper body that's

putting weight back when you run.

Now, of course you can have runners knee on just one side if one side of your body is

working differently from the other, which is true for practically anybody.

So in fact it's more often the right knee than the left that has runners knee if it's

gonna be just one.

And that's because it's easier to be sitting back on the right foot to put the right foot

too far down in front of you.

And so you're still behind it in mid stance.

So now the question is how do you fix it?

Right?

So there are two common recommendations that don't really work that well, and one of them

is to stop overstriding to fix your foot strike.

So a lot of people say that runner's knee is associated with overstriding, which is

landing with your foot too far in front of your body.

And that's true, but that's not necessarily when the stress happens.

Runners who overstride tend also to sit back behind their foot in midstance.

The feet are just, the legs are just working too much in front of you rather than underneath

you throughout your whole gait cycle.

And so focusing on fixing your footstrike doesn't normally change things enough to keep

you from sitting back at mid stance.

And so that can be kind of a frustrating thing to be working on and unsatisfactory.

Another thing that you'll often hear is that you should increase your cadence--how often

your feet hit the ground.

You should take shorter, more frequent steps.

Your feet should hit the ground more often, and that also doesn't solve the problem.

, it just reduces the stresses because it reduces everything.

So your strides are shorter, and so you're not as far behind your foot in mid stance

because everything's smaller.

And that can to some extent improve your runner's knee without really being the change you need.

It can feel very choppy and unnatural, and I've even seen it cause other problems.

But most importantly, it just doesn't get to the real problem.

So how do you fix it for real?

Like really from the source so that you're not sitting back at midstance, but you're

right over your foot where you need to be.

The way to fix this for real is to tap into your body's mechanism for balancing you over

your feet, which is the core action or the muscles of your torso that regulate your gait.

So that is your pelvis turning one direction while your upper body turns the opposite direction

so that you have a twist around your lower ribs.

And because that uses your flexor muscles and your extensor muscles at the same time,

it keeps either one from overpowering the other so that you're not too flexed, too flexed

at the hips or too arched, but you're nice and balanced over your foot.

So now if you have been deliberately trying to hold your core still, you've been doing

lots of exercises that train you to hold your core still, like lots of planks for instance,

or a ton of Pilates-type exercise, STOP.

That alone might solve your problem.

And this is where I've gotten so many emails from people over the years where they just

read my blog posts about this (where I give the same explanation) and began to allow their

core to move and their knee pain went away.

If you haven't been doing those things or you have and you stop, but that's still not

enough of a solution for you and your knees are still bothering you, then I don't recommend

you try doing the core action on purpose.

That's not really how it works.

First, it's very confusing.

Second physics and your nervous system will simply supply this movement and in the right

amounts once you know how to let that happen.

And so I have a free mini course called the Runner's Knee Solution.

The link to sign up is in the description below and that will give you an opportunity

to really feel how the core action works and you'll begin to use it in your running.

And when you do, you'll find that you are spontaneously using your glutes and hamstrings

more for running.

You can feel them working in a nice way.

They may even be tired for a little while, but they'll quickly get stronger.

And at the same time, you'll find that your quads are not getting so overused, so fatigued,

so sore and your knee will start feeling better.

And for everybody, the timeframe for that is different.

I don't know how bad your runner's knee is.

If you can't currently walk comfortably, then do the lessons but wait until walking is comfortable

before you try running.

If you can run but it just bothers you, then you may find that very rapidly your knees

stop bothering you and you feel a lot better for additional help.

Be sure to watch this next video on the right way to engage your core.

Again, please subscribe, like, and leave a comment.

Thank you so much for watching.

And may all your running dreams come true.