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Risk Factors for Knee Pain in Distance Runners

Knee pain is the most common problem facing people who run more than 10 miles per week. Most of these problems happen in the anterior(front) part of the knee, around and under the kneecap. Each year, up to 65% of all distance runners will have to stop running or seek medical care due to anterior knee pain. Since there are about 32 million regular distance runners in North America, that translates to roughly 21 million people.

Knowing which runners are at risk for knee pain is the first step toward prevention. To help with this, the authors recruited runners at local races and in running magazines. Two groups were formed. Seventy non-injured runners were selected for the control group, and 99 injured runners were selected for the injury group. All the runners completed detailed questionnaires about their running experience, training routines, running terrain, shoes, and injury history. Researchers used medical and video technology to measure each runner's legs, feet, strength, stride, and running style.

The authors found several differences between the groups. Runners were more likely to have problems with anterior knee pain if:

• They had high arches in their feet.


• Their feet didn't begin to pronate as soon as they hit the ground.


• They had weakness in the muscles that straighten the knee.

The authors also found that runners with knee pain replaced their shoes more often. According to the authors, this probably did not actually cause the pain. It could be that having high arches caused their shoes to wear out faster, because high-arched feet generally don't absorb shock very well.

Professionals who work with runners may be able to use this new information to help their clients avoid problems with anterior knee pain.

References: Michael J. Duffey, et al. Etiology Factors Associated with Anterior Knee Pain in Distance Runners. In Medicine & Science in Sports & Exercise. November 2000. Vol. 32. No. 11. Pp. 1825-1832.

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