Scenario
You start having some knee issues running.
You take a break from running.
Knee calms down.
You start running again.
Knee problem comes back.
Take another break.
Begin running again.
Knee starts bothering you yet again.
Stop running again.
Knee feels better.
You’re ready to start running again, but you know how it’s gone previously.
You come across the reasoning of “let me try adding squats (or some leg strengthening) to my routine, so my leg(s) / knee(s) are stronger before I start running again.”
Some problems with this approach-
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Problem 1: Range of motion differences
When squatting, people will bend their knees somewhere between 45 degrees (partial squat) to 120 degrees (full squat). More often than not, something looking like this:
Yet when we run, compared to above, our knees barely bend when they’re loaded i.e. when the foot hits the ground,
A critical aspect of exercise is the body adapts exactly to the manner in which it’s loaded. Even tiny differences -and those ROM differences above are not tiny- matter. This is why a new pair of shoes can make a run feel significantly different. That little bit of difference at the foot can make a lot of areas feel a more than tiny difference in load. (More about this in a second.)
–
Problem #2: No ankle / calf involvement
As seen above,
When you squat, the foot stays flat on the ground.
When you run, the foot lifts up, bends forward / backward / even a bit side to side
When we run, the ankle, calf, achilles, etc. helps propel the body forward. I mean, just try to run with a foot that doesn’t push off!
This also changes how the knee is loaded. More nitty gritty:
–How weak calves can cause knee issues
Perhaps the easiest way to think about it is when you run, you have momentum. When you squat, you’re constantly changing your momentum i.e. you go down, then have to change direction to go back up.
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Problem #3: Rep differences
In a typical leg or squat workout a person will at most do 20 reps per set. Maybe 5 work sets; call it 100 reps per workout.
If you run a mile, that’s going to be about 2,000 steps, so that’s about 1,000 reps each leg.
Running is just in another world repetition wise. Like, good luck doing a 1,000 rep squat workout!
Back to those new running shoes- this is a big reason why a tiny difference in load can make a big difference over the course of a run. It’s not just you’re slightly changing how you run; it’s you’re doing that over thousands and thousands of reps.
-> If this feels a little abstract, think about it in terms of blisters. What’s one of the easiest way to get a blister? Wear new shoes. Merely because a new shoe can just slightly change how the skin is rubbed.
–
Quasi caveats and a better approach
If your knee is really jacked up, I’m not saying some lower body resistance training has no value. It certainly can have some.
If you’re someone recovering from say, an ACL surgery, it’s probably best to gradually load your legs with some resistance training before ever thinking about running.
But that’s not really the scenario we’re talking about.
Instead, the issue here is the person who,
- First, needs to acknowledge they need to gradually load their knee again
- Second, have a mechanism to do that as similar as possible to running
As far as 1, here’s some more info about that, namely how people tend to jump back into exercise way too fast after a break:
–The biggest mistake recreational athletes make
For 2, again, it’s not that resistance training has no value. It’s that absent actually working on running, it’s not going to be enough, because it’s never going to be similar enough. It’s in that helpful-but-not-sufficient category.
Here’s an example of how slowly I’ve loaded a client running wise, with regular running but with intense detail over load management:
–An example of handling knee pain from running
With some more philosophy behind that,
–The power of programming exercise for the longterm
Sometimes you have to build your way back into regular running too though.
One fancier option these days is anti-gravity treadmills. The idea there is you put someone in this, legitimately space age, treadmill, where instead of running with their bodyweight, they only run with say, half their bodyweight.
Do that for a week. Then have them go to 55% of their bodyweight.
Then 60%.
And on it goes.
Because most people don’t have access to that, one of my favorite routes is using a treadmill with an incline. With an incline, the foot doesn’t fall to the ground as much, so there isn’t as much pounding, which in the scenario we’re talking about, is usually where the knee issues come from.
-> Note how we’re focusing on the knees here. If someone has an achilles issue, having them work at an incline could very well just make the achilles feel worse.
I might have someone start running at 4.0 mph, at an incline of 7.5, for 3 sets of 0.10 miles (maybe 2 minutes between sets).
Then an example of a progression (bolded is what changed from previous workout),
- Workout 2 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.5
- Distance: 0.10 miles
- Sets: 4
- Workout 3 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.5
- Distance: 0.10 miles
- Sets: 5
- Workout 4 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.5
- Distance: 0.15 miles
- Sets: 3
- Workout 5 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.5
- Distance: 0.15 miles
- Sets: 4
- Workout 6 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.5
- Distance: 0.15 miles
- Sets: 5
- Workout 7 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.0
- Distance: 0.15 miles
- Sets: 3
- Workout 8 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.0
- Distance: 0.15 miles
- Sets: 4
- Workout 9 (2-3 days later)
- Speed: 4.0 mph
- Incline: 7.0
- Distance: 0.15 miles
- Sets: 5
- Workout 10 (2-3 days later)
- Speed: 4.5 mph
- Incline: 7.0
- Distance: 0.15 miles
- Sets: 3
Notice how incremental it is.
- Add a set a workout for a couple workouts
- then, so the total volume isn’t much different, increase the distance but lower the sets
- gradually up the sets again at the higher distance
- then, so the overall intensity isn’t much different, lower the sets again keep but increase the speed a tad
You gradually increase the load on the knees one way or another, but not in all ways, and not too much from any one variable at once.
Give yourself 2-3 days to see how you feel. Feel good? Progress slightly again.
Don’t feel good? Back off and work your way back up. Maybe take more time at the last progression that felt good. Or possibly progress even more slowly.
Again, please note the above is a random example. For some, they might have to get used to walking at that steep of an incline before they can even think about running at it. For others, they can start at a lower incline. For others, the speed or distance could be way too low (though it is always better to lean towards starting too easy).
-> I started, and often do start, at 4.0 mph because that’s right around where people feel the desire to switch from a walk to a jog. One can jog more slowly, but it’s typically forced and not always the most comfortable. In other words, 4.0 mph is about as slow as one can go while comfortably jogging.
The point is the principle of very gradually adapting to extra load. It can seem mind-numbingly slow at first, but it very quickly adds up. After all, those 10 workouts above could easily be done within a month. Within a few months, that person is going to be cookin’.
When you consider you’ve likely already been bouncing back and forth between running like crazy and not running at all for more than a few months, it’s not that long at all.
Posted on January 28, 2021