Knee Pain? Start Running

I've never understood or agreed with people who don't run because it "hurts the knees." Or worse, they don't run anymore because being a runner in high school and college "ruined their knees." If running hurts your knees, it's likely you're just doing it wrong. And, if a person has bad knees, which like resulted from running incorrectly for most of their life, then the best thing they can do for their knees might be to start running.

The "heel strike" is the primary cause of pain for people whose knees hurt while running. When people run, their heels should not really hit the ground at all, except as a secondary impact. Runners, true runners, run on the balls of their feet, and it's the quads, hamstrings, and calf muscles that absorb the shock. Thus, the knee is not the target of force in running. Knees have very little to do with running form – or, at least knees should have very little to do with it. And, these days there is an ever-growing body of research that supports the idea that running is actually good for your knees.

Gretchen Reynolds, a health columnist for the New York Times and Washington Post, has spotlighted the research that speculates running not only won't ruin your knees but is actually good for them. In fact, results even propose the idea that running may prompt cartilage self repair. In reviewing several studies of the impact running has on knees, she writes “running likely also fortifies and bulks up the cartilage, the rubbery tissue that cushions the ends of bones. The findings raise the beguiling possibility that, instead of harming knees, running might fortify them and help to stave off knee arthritis.”

When I was shoe shopping recently, I noticed the common trend in shoe design that features thick cushioned soles in shoes. In recent years, however, elite running has steered away from that trend, and pure runners have gravitated toward shoes with less obvious structure and a style that mimics the foot in its natural form. With that shift toward minimalism came the rise of the barefoot running craze. This movement was greatly influenced by Chris McDougal's excellent sociological work Born to Run, which spotlights the emergence of barefoot-running "shoes" like the Vibram Five Fingers.

While running barefoot seems counterintuitive on concrete roads or rocky trails, it’s actually better form. The key is to run, as if sprinting – or as McDougal says, "like you would if you had to chase a toddler into the street while in bare feet." Basically, natural runners land on the balls of their feet, not the heels. The heel strike – and the potential damage from wear and tear of impact – results from the more padded shoes of the past thirty years that allowed runners to land on their heels. That's not what a runner should do. And, in fact, for many years the running shoe companies contributed to the problem.

Nike is undoubtedly the running shoe behemoth, and it has been since the 1970s when Phil Knight hooked up with the running coaches at the University of Oregon and Stanford and began peddling more structurally padded shoes. The effect was the launch of a new industry and fitness craze, as jogging entered the lexicon. As the shoe industry developed, the style became focused on bigger shoes with more cushion and added support.

In fact, that extra support is unnatural and might have actually weakened knees and ankles, contributing to injuries rather than preventing them. While many running shoes feature thick soles to allegedly absorb impact, Nike saw the trend toward barefoot running ten years ago, and in 2013 came out with the Nike Flyknit, a “barefoot-style” shoe made of a single piece of fabric. Nike was actually late to the game with their shoes. Companies like Merrel, Newton, and Adidas have offered shoes with minimal cushion for years.

Certainly, there is no specific shoe for someone who wants to revert to less structure and more natural barefoot-style running. In fact, anyone in nearly any shoe can "run barefoot while wearing shoes." In reality, barefoot running is all about the gait and not really at all about the shoes. So, for people with New Year’s resolutions to get healthier, there’s no reason bad knees should keep them out of the running game.

But run a 5K instead of a marathon. And that’s a whole other story.