Knee injuries plague almost 40 percent of runners and are inevitable when you are running regularly. A painful knee is not only annoying but in many cases it can be debilitating. It’s down to a lot of factors – some that you can control, while others that are really down to your biomechanical structure. For example, you can perfect your running technique over a few months, but just one erroneous step can lead to an injury.

The Runner’s Knee or Patellofemoral Pain Syndrome (PFPS) is the most common type of knee-related running injuries. It is the wearing down of the back of the kneecap due to weak middle quad, glute and hips muscles and natural overpronation (i.e when your foot rolls inwards after landing) causing the kneecap to move offline, which results in pain on the inside or outside of the knee. If you wake up a painful knee and it refuses to go away through the day, then you are the unfortunate victim of a Runner’s Knee.

While running barefoot or with minimalist running shoes has had a positive feedback, it might not be necessarily a thrilling accessory for people with runner’s knee. Since this injury is caused due to overpronation, minimalist shoes don’t have the necessary structure or orthotics required to control overpronation. While many runners who suffer from runner’s knee are opting for minimalist shoes as a last resort for this troublesome ailment, Dr. Andrew Pritikin, Doctor of Physical Therapy and Clinical Director of the Bauerfeind Performance Center, told Competitor Running that theoretically the minimalist footwear concept sounds great but practically however, these shoes are designed for a very small percentage of runners who use them.

In fact, many runners who do try out minimalist style shoes experience a series of injuries due to the fast transition from full-soled running shoes to barefoot or minimalist running. He elaborates further by saying that our heel contains a fat pad whose key function is shock absorption when the heel strikes the ground. Normally a cushioned shoe will absorb this shock, which is then transferred to the ankle, knee, hip and lastly the back. If you are wearing minimalist shoes, then there’s no cushioning pad to absorb the stress from the initial strike and it gets transferred with the same intensity to the knees, causing more stress.

The renowned Vibram Five Fingers minimalist running shoe
The main drawback of minimalist shoes is that they do not help in shock absorption caused by foot strike

The most common muscle ailment according to Dr. Andrew is in relation to the knee and the calf muscles. The the gastrocnemius and the soleus are the two major muscles of the calf; where the gastrocnemius is the superficial muscle the lower leg uses when the knee is extended or straight and the soleus is the muscle used when the knee is flexed or bent.

The soleus being the larger muscle bears the brunt of the force and is involved more intensely since the mid foot strike requires the knees to be flexed to absorb the shock of body weight and gravity. The pain one experiences is deep and close to the bone and is difficult to get rid off with adequate stretching. Many runners have remarked that the pain is so intense that were unable to walk for three days after the run given the tightness of the muscles.

But in the end, one cannot entirely put the blame on the shoes alone. A runner’s knee needs careful attention and can be managed by practicing good technique with forefoot or midfoot strike, proper stride and steady training to handle new loads. Additional to this, a proper warm up prior to your run and a strengthening session after to work on the glutes is also proven to be beneficial in improving the functioning of the knee.

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