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Can Running Shoes Cause Knee Pain?

I am Angelica, a young Italian who decided to start traveling in her late teens. While traveling, I ended up in England, where I decided to stop for a while and to undertake an undergraduate degree in Food Science and Nutrition. During these years, I also developed a passion for weight lifting, so I decided to take up a course to become a Level 2 Gym Instructor, which then later developed into a L3 Personal Training course. 

Fast forward three years, I then enrolled in a Master in Food Science and Biotechnology. During this year, I made a decision to open my own sports supplement company and to formulate my own products, which was a lot of fun until Covid hit, and with great sadness, I had to close down the company. But as the very positive individual I am, I thought that it was because the world had reserved better things for me! 

At the end of my studies, I then applied to become an accredited nutritionist within the UK, of which I currently hold the title, and I decided to follow my passion and start working in the fitness industry. 

I also gained a Level 3 Diploma in Sports Massage Therapy, so I could take care of my clients in all aspects of their journey, from their nutrition and fitness all the way to their recovery. 

Between a client and a training session, I also write scientific articles on fitness and nutrition to try and share my passion and my knowledge with those who want to improve the quality of their life.  

Sometimes, even if you are a very diligent runner, you can get crippling hip and knee pain that slowly takes over and becomes too unbearable to even walk on. You may have tried all the stretches, put ice on the sore knee joint, or even rested for weeks, and yet the knee pain always comes back as soon as you wear your running shoes and go for a jog.

Knee pain is a very common issue among runners. 

If this has happened to you, or are worried it might happen, then this article is just what you need to pamper your knees with appropriate tender loving care and understand more about the root causes of this pain so that you can overcome knee pain.

knee, taping, massage

Running and Knee Pain

Runner’s knee, or patellofemoral pain in more technical words, is actually a fairly common discomfort suffered by regular runners, and if overlooked, it may lead to more severe injuries and health issues.

But in order to take care of it appropriately, it is important to first discuss what could be the cause of such pain. 

Knee Pain-Related Causes in Runners

Many factors can contribute to knee pain in runners.  The most common factors that can come into play include:

  • Sprains and strains 

  • Tendonitis

  • Damage to cartilage

  • Kneecap dislocation

  • Inflammation from overuse

These usually result in swelling, increased warmth and redness, bruising, general pain, and stiffness in the knee area, and are generally caused by tight muscles around the joint, overtraining, or even wearing the wrong running shoes. 

If you suffer from chronic knee pain or your knee pain persists, you should get in touch with a specialist that can advise you on the next steps to take. 

Don’t simply assume that knee pain is a symptom of a tough workout. Left unchecked, knee injuries can become very serious and lead to a long recovery time if treatment or surgery is required.

bandage, knee problems, football player

How Can Running Shoes Cause It?

There has been substantial research demonstrating that wearing running shoes with the wrong cushioning support can cause knee pain if the use is protracted over time.

We all land and position our feet differently from each other when we walk, jump or run due to anatomical and biomechanical differences. 

These differences in structural and mechanical dynamics make it crucial to buy running shoes that provide support in the same area where you have a deficiency or imbalance, so to counterbalance it and provide an ergonomic fit.

Likewise, even when a running shoe fits your feet perfectly, wear and tear can also be a risk to your knees, as worn-out running shoes tend to provide less cushioning after repeated use. It is, therefore, essential to keep replacing your running shoes once they become less supportive to your feet.

It is also very important to consider the level of heel inclination in your running shoes, as a lack of heel drop can increase the likelihood of developing tight muscles that can negatively affect the knee joint. 

running shoes, sneakers, sports shoes

Tips to Improve Knee Pain Caused by Running Shoes

Now that we discussed what could cause pain in your knees and how shoes can be the root cause of such discomfort, in this section, we will talk about a few details that you should look into when picking your running shoes and how to take care of the tight muscles that result from this activity. 

Tips to Get the Most Out of Your Running Shoes 

First of all, to prevent knee pain, you need to ensure you are picking the correct running shoe type for the sport you are going to practice and for your individual needs. Below is a list of the main things to keep in consideration when picking your running shoes.

Cushioning

The cushioning is probably one of the first things you should look into when picking your running shoes. Cushioning is what enables higher impact absorption when landing on the ground, which could otherwise affect your knees.

A higher level of cushioning in your running shoes can usually provide more support and protect your joints much better. 

Orthotic Insoles

Feet can physiologically lean outwards or inwards, hence why some people may get pain from some pairs of shoes and others don’t. In these cases, you can resort to orthotics insoles to compensate for imbalances in your feet structure and promote better biomechanics.

A good way to choose the right orthotics for you is to get assessed by a physiotherapist or a podiatrist, and in some cases, you may even be able to get custom-made ones based on your needs. 

shoes, woman, girl

Heel-to-Toe Drop

Heel-to-toe drop refers to the difference in sole cushioning between the toe and the heel, and it is a detrimental factor when picking a good quality running shoe.

Soles with no drop can, in fact, represent a risk to your knees, so aim to look for running shoes that offer some level of drop between the rear of your foot and the front. The ideal level of heel drop, however, differs among individuals, so you may need to try out a few running shoes or ask a specialist before finding the right running shoe. 

Feet Stabilization

Make sure the running shoe stabilizes your foot. This means that it should not be too loose-fitting but rather should support the feet in a way that prevents them from moving freely within the shoe.

Using unstable running shoes was, in fact, linked to runner’s knee syndrome, as a lack of stability in the foot can lead to less stable knee movements and landings. 

Lighter May Not be Better

Although lighter running shoes are the best option for running faster, it is also important to note that shoes that feel light on the feet usually lack some cushioning. This means that if you run long distances, you may want to look into shoes that are somewhat heavier but that provide the correct level of cushioning to support and protect your knees and prevent knee pain.

dumbbells, shoes, sneakers

Replace Your Shoes

Lastly, don’t forget that even the most perfect running shoes and orthotics can, with overuse, start to lose stability, cushioning, and structure, meaning that despite being amazing when you first buy them, wear and tear can eventually ruin them and lower their ability to protect your knees.

It is, therefore, important to replace your running shoes and insoles as soon as you start noticing a reduction in cushioning or a significant heel drop. 

Work on your Tight Muscles

Muscular tightness can be caused by muscular imbalances (weak muscles being pulled by stronger ones) or muscle overuse. Particularly for the knee joint, quadriceps that present tightness and/or muscular imbalance can cause inflammation and discomfort in the patellofemoral area.

If this is the case, you may require to work on these imbalances to prevent pain and injuries. It is detrimental that the physical and biomechanical assessment is performed by an expert so that the right intervention is applied.

Based on each individual case, rebalancing muscles may require weight lifting, functional training, mobility exercises, or stretches. 

Rest

Even if you found the perfect shoes with impeccable cushioning, and started weightlifting and mobility training specifically to avoid patellofemoral pain, don’t forget that resting is essential to preserve your knees’ health and prevent overtraining and related injuries. 

knee, old, care

References

  • Bonacci, J., Hall, M., Fox, A., Saunders, N., Shipsides, T. and Vicenzino, B., 2018. The influence of cadence and shoes on patellofemoral joint kinetics in runners with patellofemoral pain. Journal of science and medicine in sport21(6), pp.574-578.

  • Dos Santos, A.F., Nakagawa, T.H., Serrão, F.V. and Ferber, R., 2019. Patellofemoral joint stress measured across three different running techniques. Gait & posture68, pp.37-43.

  • LaBella, C., 2004. Patellofemoral pain syndrome: evaluation and treatment. Primary Care: Clinics in office practice31(4), pp.977-1003.

  • Nigg, B., Hintzen, S. and Ferber, R., 2006. Effect of an unstable shoe construction on lower extremity gait characteristics. Clinical Biomechanics21(1), pp.82-88.

  • Tumia, N. and Maffulli, N., 2002. Patellofemoral pain in female athletes. Sports Medicine and Arthroscopy Review, 10(1), pp.69-75.

  • Zhang, M., Zhou, X., Zhang, L., Liu, H. and Yu, B., 2022. The effect of heel-to-toe drop of running shoes on patellofemoral joint stress during running. Gait & Posture93, pp.230-234.

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