Knee Pain & Downhill Running

Sports Science Basics for Runners

By Dr. David Cosman in Hong Kong

Running Downhill: Patello-Femoral Knee Pain

Knee pain while descending can be from overloading the quadricep muscles that pass over the front of the knee. This pain can often be prevented and overcome quickly by implementing efficient running technique such as the GMax technique. This is where the gluteals become the primary muscle instead of the quads. Quickly contracting to the gluteal simultaneously as the foot contacts the ground will control deceleration without overloading the knee.

The gluteal contraction contributes to stabilizing ability of thigh and knee fascia; reducing stress to quadriceps muscle and the patellar tendon at the knee, and to the ITB insertion at the outside of the knee.

If fascial adhesions are inhibiting this coordinated activity, it would require Fascial Manipulation therapy. Rolling the ITB is popular, and sometimes it helps, but the ITB has low elasticity, making rolling ineffective for this problem. If you roll the ITB, also roll the gluteals for possible a better outcome.

In review, on a steep or technical descent, take short steps and consciously contract or squeeze each glut with each foot contact. This will allow you to smoothly control a technical descent like a ninja or a cat who has that soft-touch landing.

With any knee pain, foot biomechanics must be examined. Foot orthotics with corrective forefoot postings are commonly part of the treatment plan. If the foot and ankle overpronates enough to contribute to knee torque, then foot orthotics might be part of the solution.