Transcript

Hello and welcome to episode two of the Beyond FEAR podcast. I’m Jen Coppock, and today I’ll be looking at naggy knees, focusing on the biomechanical and structural issues that affect the knee. If that’s gone in one ear and out the other, don’t worry—it’ll all be explained. This episode is aimed at runners who are experiencing knee pain while running, after running, or before running. It’s also aimed at anyone who is a bit heavier than they want to be and might be experiencing knee pain, possibly on a weight loss journey. We’ll look at what the causes of the knee pain are and what to do about it—how to improve the situation and your knee.

If you’re listening on Spotify, this might be a little bit difficult since there are no visuals. Basically, there are three bones in your knee joint: your femur, which is the big bone at the top of your thigh (your thigh bone), your tibia, which is the shin bone at the bottom, and your patella, which is a little tiny bone connected with ligaments and is essentially your kneecap. You’ve got these two bones where they meet, and the patella sits on top. So that’s it, three bones. You do have ligaments, which attach bone to bone and keep the bone structure where it’s supposed to be.

Then you have your muscles. The main muscles that control the knee are above and below it—typically, your quads (there are four muscles, hence ‘quad’), your hamstrings at the back, and your calf muscles underneath (the soleus and gastrocnemius). You’ve also got muscles at the front, but they aren’t generally the ones that cause problems. Muscles join the knee with tendons, as a muscle can’t attach directly to bone. A tendon attaches the muscle to the bone, acting like special glue.

Other important structures in the knee include cartilage, which covers the ends of the bones to help them move smoothly and prevent friction, and the meniscus, a C-shaped shock absorber that prevents the bones from bashing together. Damage to the meniscus can also cause issues.

Knee pain affects your quality of life significantly. If you’re experiencing knee pain or have in the past, you know life becomes very difficult very quickly. I’ve had knee pain myself—I severed my ACL back in 2015, and it took four months to diagnose and get an MRI. I did have reconstruction surgery, but you don’t always have to. I went to Lithuania for mine because it was too expensive in the UK. Flights, hotel, and surgery cost two grand, and you can claim a lot of that back.

When I had my knee injury, people kept saying, “Don’t worry, you’ll be back skating soon,” but all I wanted was to roll over in bed without being in agony. Simple things like climbing stairs or stepping over a child’s toy became a challenge. Knee pain can affect your movement long-term because if you don’t use your knee correctly, you start compensating with the other knee or your hip. Your body cheats to avoid the pain, but unless you address the underlying issue, you can’t correct it.

Looking at knee pain in runners, it’s normally caused by overuse unless you’ve had a moment of impact—like landing awkwardly with a sharp pain in your knee. That would be a structural issue, potentially involving broken bones, damaged ligaments, or tendons. If this happens, see your GP. Ligaments and tendons take a while to heal due to limited blood flow—typically months.

If your pain sets in gradually, worsens over time, or only happens during specific activities (like going uphill or downhill), it tends to be biomechanical. Biomechanics refers to issues caused by the body as a whole, not just the knee. Muscle imbalances, such as stronger quads compared to hamstrings, can pull the patella out of alignment, causing pain.

If you’re heavier than you’d like, losing weight can reduce the load on your knees and improve biomechanics. Adding strength training is essential. I’ve got 10-minute videos on YouTube for beginners that avoid overloading the knees and help you get started.

When addressing biomechanical issues, warm-ups, proper movement correction, and a balance between strength and flexibility are crucial. Stretching after each run is important, ideally holding each stretch for 30 to 60 seconds.

If you’re taking weight loss medications like Mounjaro or Ozempic, reducing weight will lessen the pressure on your knees. These medications have shown anti-inflammatory effects and may protect cartilage, offering further benefits for knee health.

For structural issues like arthritis, meniscus tears, or ligament injuries, seek medical advice. Persistent or severe pain, swelling, and limited range of motion are signs that need professional evaluation and potentially intervention.

Finally, focus on sustainable, long-term strategies for improving knee health. Whether through strength and flexibility exercises, weight loss, or medical intervention, consistency and dedication will lead to the best outcomes.

Thank you for tuning in to this episode of Beyond FEAR. In our next episode, I’ll be sharing my personal journey and experiences, especially with my upcoming full-distance triathlon. Stay tuned for insights and tips from my story. Until then, keep moving and take care of those knees! Crack on!

NERD ALERT Study Information; https://ard.bmj.com/content/82/9/1218