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Learn to land well before you return to running following knee injury

Updated: Apr 16, 2020

Tessa Hinds is a Clinical Director at The Physio @ Sandringham Clinic in Sandringham, Melbourne. She has a 15+ year history of clinical interest in knees and sports injuries.

So many people return to running following injury without looking at how they land. An important aim of gait and running re-training for those with knee pain is to reduce the load at the knee. There is usually a need to work on improving impact through the whole kinetic chain of the legs and spine.

Here are some tips that may help you to get back to healthy running and activity:

Landing with a bent knee is optimal– Learning to shock absorb with the muscles around the knee rather than the knee joint itself is ideal.

Landing under the hips– Reduce striding too far. Landing with the foot under the hip stops the knee extending and keeps the pelvis in its optimal stable position.

Quick feet- Increasing your cadence (how quickly your feet step one after the other) will help with shortening your stride. This helps lessen the impact. A long bounding stride will cause an increase in load and potentially switch off core activation.

Relaxed landing– Easier said than done but tension in musculature will increase forces through the joints.

Good posture– Being in good alignment allows you to take advantage of all the above. Run tall.

Keep your gaze straight ahead- Your lean should come from the foot and ankle.

Strength and Conditioning– When you are running, it's not only body weight going through the legs and feet but also gravity. Gravitational force can increase with quicker running speeds. This is one of the reasons that strength and conditioning is essential. Gluteal strengthening of both the gluteus maximus (low buttock) and gluteus medius (high and deep to the gluteus maximus) along with traditional squats and lunges will help greatly. There is also evidence to support the requirement of calf strength to help with propulsion forwards which may also take stress away from the knee. Advancing these simple exercises to single leg and weighted exercises will help. Eventually, exercises involving more complex chain movements at higher load will help to progress to further controlling degrees of impact.

As physiotherapists, we work to ensure people understand their correct posture and movement patterns first. Flexibility and strength techniques follow before educating improved running techniques.

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