Are runners' knees worse off than non-runners'?

It's a common question thrust at runners: "Don't your knees hurt?" Well, yeah, if I had a hard workout yesterday, but after an easy day or two, I'm ready to fly.

And despite running half a century with my main event the high-impact 3,000-meter steeplechase, my knees are probably in better shape than yours.

But the questioner doesn't want that answer. He wants to hear how badly runners suffer each time we run. That gives him an excuse not to exercise in any form.

"People often tell me my knees are going to be bad because of my running," sighs Lori Hauswirth of Merrill, Wisc. "I hear it most often from my mother."

Do runners suffer from knee problems as much as non-runners think? Curious, I used the InterActive Training Forum I manage online to question more than 300 runners about their knee problems.

Among those responding, more than half suggested they suffered knee pain "infrequently." Another quarter of respondents reported knee pain "occasionally," while an equal number reported no knee pain.

Only one runner, Jeff Schneller of Brookline, Mass. (who also identified himself as a downhill skier), confessed to continuous knee pain when he ran.

"My knees only seem to hurt after the mileage increases on a pair of shoes," admits Doug Richter of Vernon Hills, Ill. "I always use this as a signal to replace the shoes."

In an article in the Montreal Gazette titled "The Joints Can Take It," Jill Barker suggests that exercises such as running actually strengthen the joints.

"The stress of impact causes the joint to adapt positively, thereby improving its overall health," writes Barker. "There is, however, a threshold that if surpassed exceeds the normal wear and tear a joint can endure."

Determining a level of safe exercise, however, puzzles researchers. One study quoted by Barker suggests 55 weekly miles as the point where joint breakdown begins, but only a small percentage of runners train that much, even when getting ready for a marathon.

Reportedly, if you limit your training to 15 to 25 miles a week, you're safe. That's about my level now, but earlier in my career, I routinely pushed past 100 weekly miles.

A 1995 study at the Stanford University School of Medicine compared older runners with sedentary people and found that the runners reported less knee pain.

Increase mileage gradually, avoid gut-busting workouts, and you not only will spare your knees, but also the rest of your body. Intelligent training, not anti-inflammatories, is the best antidote for knee problems.

"My knees bothered me when I first started running high mileage a dozen years ago," says Michele Keane of Westlake, Ohio, "but once I started strength training, they have not been a problem."

Keane pushed from 25 to 75 weekly miles in a matter of months after college to score a 2:58:56 marathon, but a side effect was sore knees. Years later after the birth of a child, she went from 0 to 50 miles for another marathon, using one of my training programs, with no knee pain.

"The difference was a much gentler mileage increase," she reports.

Chip Loney of Winchester, Ind., was told never to run again after ACL reconstructive surgery to repair a basketball injury. He followed that advice for a decade, then started running again three years ago.

"This year I will run Boston as my second marathon," Loney says. "My knee actually feels better now that I am running on a consistent basis than it did when I was not very active."

What, thus, should be your response the next time a non-runner asks if your knees hurt? Smart-aleck replies won't do. Miss Manners would suggest a pleasant smile followed by, "My knees feel fine. How about you?"

Hal Higdon is the author of Marathon: The Ultimate Training Guide. For advice on running, visit his Web site:

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