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Hey everyone, welcome to the Stay Healthy El Paso Podcast. I'm your host Dr. David Middaugh, specialist physical therapist from El Paso Manual Physical Therapy. Today we are going to talk about the top four reasons for knee pain from walking and running.

The reason why we made this set of tips and advice for knee pain from walking and running is because, since all the shutdowns everyone stayed at home and had to miss going out to the gym, had to miss accessing their treadmills, and all the normal workout equipment they might have at the gym if they were going to the gym.

There has been an obvious increase in people out in the streets, out in the sidewalks, running and walking for exercise. And as a result of that, we've seen more patients in the clinic here with knee problems, hip problems and foot problems but the big one has definitely been knee pain. So, I'm going to cover with you today the top four reasons for knee pain from walking and running.

Reason number one, bad form

A lot of people don't realize how terrible their running form, or even their walking form is. And every time we get somebody with a knee problem here in the clinic, that's one of the first things we cover. You probably have been walking for years and years of your life if you have been lucky enough to have functioning legs. You have been walking and probably even running, and you wouldn't think twice about how you did it, the way that you stepped, which muscles you used, how much you raise your knees, how hard you step.

There are all these different factors that we go into depth, when it comes to walking form and running form. And then it changes at different speeds. There is likely a huge chance that the way that you are running, the way that you are walking even, is affecting your knee problem. If you take thousands of steps, even just hundreds of steps, it can put some bad forces through tissues that aren't designed to take those forces.

Because you have a running form issue, or a walking form issue, it just overloads that tissue. It might be a ligament, a meniscus, it could be a muscle or tendon as well. If that tissue gets overloaded, then it's easy to just irritate the tissue, eventually possibly tear the tissue. Definitely get some swelling in the area. But at the lowest level, your body lets you know, by just reporting pain, you just feel some pain in the area, sometimes the joint, the knee will get hot as well. And sometimes it just gets achy.

There are times when the knee won't hurt during running or walking, it actually might feel better. But then later in the day, the knee starts to ache, maybe even at night. That is a sign that there's some knee problem going on when you are running. It typically is a sign that it's a cartilage problem or a ligament problem as well. Versus if you get pain during running, it's more likely going to be a tendon or muscle problem.

That's not a hard and fast rule. Those are just likely reasons for the problem that you are facing. But if you are having any sort of pain around the time that you are running, whether it's during running, right after, or later on in the day, then there's likely going to be some running form problem or walking form problem. The best thing to do to fix your running form, or your walking form is definitely to talk to an expert, especially an expert Physical Therapist, we deal with movement.

With running and walking, there are lots of moving parts that we can address for you. And it's not a big fix, most of the time, it's just tiny tweaks that you can make instantly and begin to reduce that pain problem that you are facing in your knee.

Reason number two, too much too soon or overloading

Let's assume that you have great running form and great walking form. If all that's fine, it may be that you are doing too much too soon. In other words, you weren't walking as much as you started to walk recently. And you feel good, you felt fantastic. You enjoy the fresh air, you enjoyed the sun and everything around you. If you are on a hike, you are enjoying your hike, and you just overdid it, that can definitely cause pain in your knee.

What you have to look at is giving yourself smaller amounts of walking or running. And then gradually building it up over time to the distance, or the time that you desire to do so its going to sustain for the long term. If you are going to begin a running program or a walking program for exercise, and you want to work up to three miles for instance, you won't be able to cover three miles. I wouldn't go into doing three miles the first time you go run or walk. That's going to likely overload your tissues, and you are going to do too much too soon, and you are going to have some knee problem very likely.

You got to start out with maybe a half mile to a mile at the beginning. Do that for a week or two. It just depends on how out of shape you are. Then work your way up to a mile and a half to two miles, and then work your way up to two and a half to three miles over time. This might take you a month or two months or three months. It just depends on your specific situation.

But you need to consult an expert on this. If you are confused about how to do it. There is a lot of information online that is very helpful. You might start there too. And if you have a running friend that's gone through marathon training successfully, or half marathon training, or even ten-k training, they might be able to help you quite a bit, based on how much to walk or run at the beginning, and then how to work into as you get better and stronger.

Reason number three for any pain from running and walking is your footwear

Your shoes, especially for walkers, because people that walk may not always wear the right shoes. You definitely want to have some sort of athletic shoes or running shoes is ideal. But if you are wearing your casual shoes that don't have a whole lot of support, you might switch those out for some more athletic shoes that offer you plenty of support.

Here's why it's important. You are running, you are on your feet, you are walking, you are on your feet, there are muscles in your feet and there are muscles up into the leg that just get tired as you do more. And what those athletic shoes do for you is, they help support the position of your foot, which affects the position that your knee and hip and all the way to your low back. And if your muscles get way too tired because you are pushing yourself, then they won't support you the way that they are supposed to, because they are just not strong enough yet. But that shoe can give you that that little boost that you can last as long as you need to.

Another common mistake, related to shoes is, people just wear their shoes out. If your shoes are pretty old, or you just put a lot of mileage on them, you have walked around on them quite a bit, then it's time to get new shoes. And, there is all kinds of debates about every six months or every 12 months, or even if you didn't use them for six months, the I've heard that the materials kind of wear out. There is all kinds of debate. What I would go by, for you specifically is what feels best for you.

I can tell you from experience, I've been an avid runner myself, and I tried switching it out every six months and I tried other times as well. I couldn't find something specific. I just went by the feel I had. Some shoes I used for over a year. Currently I have some shoes that are probably two or three years old, that I still use to exercise in, and they still give me good support. They give me what I need, and they are in decent shape. I don't find a reason to get new shoes at this point me personally. But as soon as I feel like those shoes aren't supporting me, you bet I'm going to go get some brand-new shoes. And I'll be just assessing as I go on.

That's what I encourage you to do. If you are walking out there, and you are thinking to yourself, oh, gosh, these shoes that I'm about to put on are five years old. But then you might rationalize yourself and say, Well, I haven't been on a running program or walking program in five years, so maybe they are going to be okay. I'd say give it a shot.

But if you got knee pain, and you can't quite solve it, definitely go get some new shoes, it's not going to hurt, it's only going to help and that might be the fix that allows you to continue your walking routine and your running routine without having to go visit a doctor get medications or injections or anything like that. Running shoes is always a good, easy fix for you.

Reason number four old unaddressed injuries

Many people had knee problems back when they were in high school, when they played sports, and they played volleyball or football, or they were running before. They may have suffered injuries back in the day, but they never really fully got them addressed. They just laid off of them. And then now they are picking up a walking routine or running routine. They are kind of coming back but were never fully addressed.

Typically, what we find in physical therapy is that there's some muscle imbalance or some improper joint movement that is hard to feel or find out. Or it doesn't really come on unless you stress the joint like when you go on a walking program or running. But in normal everyday activities, it just wasn't enough to bother you. Those old unaddressed injuries now get magnified for you, especially if you are going to be more intense with your walking or running routine.

What I would strongly urge you to do is talk to an expert about this. Because if you can address subtle injury at the beginning of your new walking or running routine, it's going to go a lot smoother for you than if you keep running through it or walking through it, and it festers into an arthritis problem or some tear in some tissue that isn't ready to take what you are going to put it through. I strongly encourage you to talk to some experts like myself about this knee problem, so that it's not going to stop you from reaching your goals from being able to run as much as you want or walk as much as you want.

If you are unable to get to an expert, there's nobody in your area, or you just want to stay at home, make sure that you are safe at home, then I strongly urge you to consider checking out our 28-day Knee Health And Wellness Boost Program. This 28-day structured program will show you how to get stronger in your knees, strong in your hips, even your feet. It's a structured program to make sure to boost the health of your knees and make sure that you know how to address your knees strength moving forward, and how to maintain it so that you are not having recurring knee problems. Check out more about that program by visiting the link in the description here.

Thanks so much for listening to our podcast. I hope that you learned a lot about all these reasons for knee pain from walking and running. If you have more questions or you just have some specific questions about your specific problem, if you are dealing with a knee pain problem, you can reach out to us. Our phone number is 915-503-1314.

Of course, if you are in the El Paso area, we can help you directly. Now if you are looking to find us online, you can find us at www.EPmanualPT.com and you could see our website there, find all our free resources right on the homepage. You can go into our blog and find more tips and helpful advice for knee problems. I hope that this podcast was helpful for you, and we'll talk again soon. Bye

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