How to Prevent Knee Injury and Pain

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By far the biggest complaint I get from runners about running is that it's so hard on their knees. Secretly, inside of me, I have my own complaint. It's that running is blamed for all the knee problems when in actuality it's not running that is causing the injuries—it's the way people run.

Every time someone's knee goes out and their friends ask them how it happened, they're quick to respond, "it happened the other day while I was running." The truth is that if you can work on your running technique so that there is minimal impact or undue stress to your knees, you'll never have knee problems. It's as simple as that.

Protect Those Precious Knees

  • Avoid a heel strike. Don't over-stride and let your feet get ahead of you. Always make it a point to stay ahead of your feet and let your legs swing to the rear, not forward.  If you reach with your legs as you swing them forward, your feet will land in front of you and you'll be putting on the brakes with every foot strike. Then all the shock of hitting the road goes right up your legs to your knees, which were never designed to act as shock absorbers.

Eventually your knees will get tired of taking all that abuse and begin to complain. If they do, I suggest you listen to what your body is trying to tell you and change your stride mechanics, or you could end up on the bench.

  • Don't pick up your knees when you run. That's right. Pay no attention to the advice of all those running magazines that tell you to pick up your knees and reach forward for a longer stride. When you pick up your knees, your lower leg will swing forward and your heel will come down in front of your body and, as I just said previously, you'll be putting on the brakes every time your foot hits the ground.

What to Do

Keep your knees swinging low. At the back end of each stride, bend your knees and let your heels float up behind you. You should always be thinking, "knees down ... heels up."


  • Lean forward from your ankles and land on your midfoot. Remember, anytime your foot comes down in front of your body, the shock of that deceleration is going straight into your knees.
  • Keep your knees soft and bent during the landing and support phases of your stride. I see many runners over-stride and then straighten their knees when they land. This creates an incredible amount of impact to the heel and the knee.
  • Keep your feet pointed in the direction you are running. If your feet splay out to the side as you run, it could create knee pain while running any distance because you're torquing your knee with every foot strike. This will eventually over-stretch the medial ligaments and tendons of the knee and lead to pain or injury (medial meniscus tendonitis). You'll feel it as a sharp pain on the inside (medial side) of your knee.

Wandering Feet

Here's what happens when your feet splay out: You land on the outside edge of your heel and your ankle collapses inward. This causes over-pronation and creates a torque in your lower leg that is equivalent to someone grabbing your ankle and twisting it to the outside almost 1,200 times every 10 minutes (that's about the number of strides you'll take with each leg if you run a 10-minute mile).