Running is one of the world’s most popular forms of exercise – most likely because it is cheap to do, you don’t need much equipment and you can run anywhere! As long as your legs can carry you – running is a great exercise for your cardio vascular health, lower limb strength and helps to keep your weight controlled as it burns a lot of calories.
But what happens when your legs, or more specifically your knees cannot carry you anymore? A common site if you see anyone running is a knee brace which runners use to support their knees. If you run a lot of miles it means your knees are absorbing a lot of load and sometimes they can become a bit sore, aching or injured from the amount of running you perform.
This article is going to explain the knee is further detail to make you understand the anatomy and which parts could be causing you a problem while running and then look at the different types of braces which can he you to remain active. We will also include some handy tips for rehab and prevention of knee pain that you can add to your maintenance routine.
The knee’s anatomy when broken down is easy to understand and gaining further knowledge of this can help you to understand the reasons for which type of brace you would need for running. An appreciation of how braces and supports affect the knee’s anatomy are beneficial and can help you to remain healthy and independent with your exercise.
The knee joint is formed of 3 bones including the thigh bone, the shin and the kneecap. He knee fits together to make a hinge joint – which is a type of joint that only moves 2 ways – just like a door hinge. There is a small amount of medial and lateral rotation that your knee allows for and it is about 15 degrees, the shin rotates medially and laterally but no more than that. If the knee ever twists outside of this 15 degree range then there is the chance of injuring structures and soft tissues within the middle of the knee. There is also a 4th bone that forms part of the lower leg and it is the fibula and acts as more of a support for the knee rather than main weight bearing bone – it also acts as an attachment point for other soft tissues which link in to the knee.
The shock absorbers of the knee are called the cartilage and this is specifically referring to the cartilage that is found within the knee. There is cartilage that lines the head of the femur and there is cartilage discs that sit on top of the shin. When we run and the femur impacts on to the top of the shin bone the 2 smooth, firm but slightly cartilage surfaces help to act as suspension and absorb the impact of force that we generate and also when we land. Cartilage is necessary for your knee to function correctly and maintaining its smooth surface is what helps to keep your knee heathy. When your knee becomes sore due to the cartilage it is because there could be a tear in it or inflamed from it being overloaded. Any cartilage issues can affect how you bear weight and also can make the knee produce swelling.
The bones of the knee are held together by a network of soft tissue called ligaments. Ligaments are the connective tissue which join bone to bone. Ligaments are very strong in nature as they need to keep structures together and also if a joint is moved to the end of its range – for example if a knee gets twister or hyper extended and the muscles cannot correct movement then ligaments will stop the joint from moving any further – unless the force is too much and this can result in sprain r rupture of ligaments. During running there should not be too much strain on the ligaments and the muscles should control the movements. The only time ligaments may be placed under strain during running is if a fall happens or a quick change if direction is needed.
So if the bones are held together by ligaments – then what attaches muscles to the bone, the answer is tendons of course. Tendons are the connective tissue that merge from the muscle in to a tendon then attach on to a bone. Their job is to generate force and transfer it to the muscle to help us move and also to absorb some shock on landing. During running the patella tendons and quadriceps tendons will do a lot of work helping us to generate and absorb force in the knee.
The muscles of the knee help to move the knee when it bends and straightens. The quadriceps help to straighten the knee, secure it and make it secure when it is straight. The quads are the most important muscle for running for injury prevention due to a lot of injuries occurring with a flexed knee – if the knee can be extended and straightened then this can help to reduce the chances of an injury. The hamstrings help to bend the knee, extend the hip but also they help to secure the shin by pulling it back and preventing injury and they have a huge role in preventing pain at the front of the knee due to their anchoring effect on the shin bone. The muscles around the glute area also have an effect on the knee as they help to rotate the femur and this controls knee rotation. Other muscles that assist us while we run are the calf muscles which act as a secondary knee flexor – they attach in to the back of the knee and are key during running for force generation at the foot and ankle but also helping the running motion.
Causes / Symptoms
Patella Tendon Pain – the patella tendon can be a common injury with runners and it elicits pain from the tendon at the front of the knee.
Knee Cap Pain – the patella itself can give off pain for many reasons including arthritis which means the underside if the kneecap has worn down and the surface gets irritated. The patella may have mal-tracking which causes it to not run it its groove properly causing pain and occasionally a clicking sound.
Knee Joint Pain / Meniscus – aggravated knee joints are common in runners – especially the ones who are doing a lot of miles or if you have suffered an injury and continue to run on the kne. The meniscus and joint are designed to help absorb force –so if the joint is aggravated then it may cause pain.
Lateral/Medial Pain – pain on the inner and outer parts of the knee can emanate from the knee joint and meniscus as previously mentioned or it can be from the ligaments at the side if they have been overstrained or injured. Another common form of lateral knee pain is caused by IT band syndrome and this is due to the IT band connecting at the side of the knee on the outer point – it becomes incredibly tight and causes the knee to hurt when running.
Swollen Knee – swelling inside of a knee or around any of its structures shows that the knee is not quite happy with something. The job of the swelling it to protect the knee and provide the structure with the right protection and ingredients to heal. When the knee joint is swollen then it may not be ready to run on as it is trying to fix itself. There is the possibility arthritis can be the cause of a swollen knee is some people, due to its nature of flaring and settling down and exercise being the best proven treatment, knee supports and walking/running are a great combination for treatment.
There are many variations of knee braces which we will not detail – all of them have their own individual function and problem that they can be used for.
Patella Band or Strap
This is commonly used with patella tendon pain or runners knee which prevents people from running properly due to pain experienced in the front of the knee. The strap helps to offload the painful tendon or anterior aspect of the knee and allow reduced discomfort while running by offloading the tendon and providing compression and ultimately comfort.
Knee Compression Sleeve with Patella Hole
A compressive knee sleeve may be the most common form of knee brace that you will see with runners. They have many benefits and are quite versatile. Typically made out of a soft comfortable elastic material, they fit over your knee and provide a tight supportive pressure which can make the knee more comfortable to run on. The hole in the middle for the kneecap allows the knee cap to be mobile but for it also to be guided in to its correct position if you have any kneecap issues. If you have any mild swelling then this can help to compress and reduce the swelling you have – it can be used at rest as well as running.
Resistive Knee Sleeve
One of the best ways to improve your running and remain injury free is to have stronger knees. So why not use a support that strengthens the knee even more as you run! There are now braces on the market that act as support for the knee but have a built in plastic spring which provides resistance to your knee whilst you run and this improves knee strength. The stronger your knee the less pain you will have.
Hinged Support Braces
These types of knee supports are perfect for someone returning from injury who needs more support on the inner or outer side of the knee. Let say for example you have suffered a knee injury which has damaged ligaments or the control of your knee. If you are able t return to running during your rehab and you need a bit of stability and reassurance from a brace then this is the one for you. The metal hinges that sit either side of the knee play a similar role to your medial and lateral ligaments and help to stabilise the knee and prevent further injury. If your knee has poor control and needs t be stabilised to remain in a good running style then this brace will work for you.
Prevention / Treatment / Rehab
If wearing a knee brace improves your confidence with your knee while running then it would be a sensible suggestion to keep using a support for as long as possible. If you don’t have an issue and simply wear one for comfort due to a demanding training regime then again this is fine.
If you have returned from an injury recently then the end goal should maybe be to run without a knee brace as your end goal as running with one can sometimes stop you from using the muscles around the knee as effectively as you would like.
Think about partaking in the right rehabilitation and gradual return to running to get your knee right – the brace should be used as an assistance to it. Management of training load is another important factor to ensure good knee health with running and avoid long term knee brace use.
In summary – there are many reasons in which you could wear a knee brace for whilst running. Gaining an understanding of the knees anatomy and any problems you may have might help you to understand what brace is right for you.
The position of any pain, the type of pain, dysfunction and also swelling amount can dictate as to what support you choose.
The end goal would be to run without a knee brace however if this is not possible and a knee support allows you to be able to run and not cause further problems, pick the most appropriate and happy running!