Running has become more than a workout. From early-morning running groups to corporate teams signing up for city marathons, putting on a pair of shoes and chasing a personal best has become part of the fitness culture. But somewhere between the 5K, 10K and the marathon finish line, an obvious question often gets lost: what is all that running doing to your knees? The short answer is that running itself is not necessarily bad for the knees. The bigger problem can be doing too much, too soon. “Running is a great way to stay fit, but problems can occur when people begin running long distances without allowing their body enough time to adapt,” explains Dr. Sinukumar Bhaskaran, HOD - Adult Joint Replacement & Reconstruction and Robotic Arthroplasty (Hip & Knee), Manipal Hospital, Kharadi. “A marathon puts the knees through thousands of repetitive movements, so if the muscles are not strong enough or training is increased too quickly, the knees can start hurting.” Not automatically. A common fear among recreational runners is that every kilometre is gradually damaging the cartilage in their knees. But regular running, when approached sensibly, does not mean a person is destined to develop knee problems. In fact, runners who build their training gradually and allow adequate recovery can continue running for years without major joint problems. The concern is load management. Someone accustomed to running 3 or 4 kilometres cannot reasonably expect their body to handle 15 or 20 kilometres simply because they have decided to train for a marathon. The muscles, tendons, bones and joints all need time to adapt to the increased workload. “The body needs time to adapt to a greater load,” Dr. Bhaskaran says. “Sudden changes in training are often where we see problems.” Running is repetitive, and the knee does not work in isolation. The muscles around the thighs, hips and knee help control movement and absorb some of the forces generated with each stride. If those muscles are weak or fatigued, the knee may end up carrying more of the workload during longer runs. This is why a marathon training plan should not consist entirely of running. Strength exercises that target the quadriceps, hamstrings, glutes and hip muscles can complement endurance training and help improve the body's ability to handle the demands of running. Your old injuries can come back to haunt you as well. A previous knee, ankle, hip or leg injury can also influence how a runner handles increased mileage. The same applies to poor running mechanics, unsuitable footwear and insufficient recovery. Footwear, in particular, should be appropriate for the individual's running needs and comfortable enough for the distances being covered. But simply buying an expensive pair of running shoes cannot compensate for an unrealistic training schedule. Recovery matters just as much. Long runs create temporary stress on muscles and other tissues. Repeatedly training hard without allowing adequate recovery can leave the body struggling to keep up. This is where the 'no pain, no gain' mentality can become a problem. Some post-exercise muscle soreness is not unusual, but persistent or worsening knee pain should not simply be treated as proof that the training is working. “Some runners continue training despite pain because they believe they need to push through it,” mentions Dr. Bhaskaran. “I would not recommend this.” Pain accompanied by swelling, difficulty walking or symptoms that continue despite rest deserves medical evaluation. Continuing to increase mileage while an injury is developing can make recovery more difficult. So, can you train for a marathon without ruining your knees? Yes, but the marathon should be treated as a long-term training project rather than a sudden fitness challenge. Increase distance progressively. Include strength training. Pay attention to running technique and footwear. Build recovery days into the schedule, and don't ignore persistent pain. “The act of running isn't the enemy,” explains Dr. Bhaskaran. “The key is to train correctly, increase the distance gradually, strengthen the supporting muscles and give the body enough recovery time.” The finish line, after all, should not be the point where your knees tell you the training went too far. A good running plan is one that helps you reach the finish line, and keeps you healthy enough to want to run again. Simran covers books that start conversations, beauty insights, fashion moods, and stories that make people feel something. Off duty? You’ll find her c... View More