Why do we have clicking knees?

I decided to write this blog post when I read a letter from one of Runners World’s readers.

For quite a long time, he has been experiencing clicking knees.
Owing to lockdown, he has been running outside, and after about a month, his knees stopped clicking.
Before the lockdown, He has been running on the treadmill, so he asked why is running outside better for his knee than on the treadmill?

During my career, I have gotten many cases like that one, with an easy fix of the problem with a sports therapy treatment such as a Sports Massage.

Very often clicking knees and knees pain are diagnosed with arthritis or Joint Hypermobility Syndrome.

But most of the time they are caused by more common conditions such as:

  1. Excessive tension between bones, tendons, and related capsules for muscle stiffness.
  2. Scarcity of Synovial Fluid ( inside the capsule knee joint ).
  3. Poor range of motion of the knee joint.
  4. Poor muscle flexibility.

More important causes of “clicking Knee” are:

  1. Arthrosis.
  2. Arthritis.
  3. Degenerative Meniscus.
  4. Meniscus Tears.
  5. Ligamentous laxity ( weak Ligaments ).

To understand the difference between outdoor and indoor running, we need to analyze the biomechanics of running on the treadmill:

  1. Since running is a forward motion of the entire body, the horizontal component of the momentum (mass x velocity) is much more important than the vertical component, but on the treadmill, the horizontal component is reduced a lot ( the mat automatically slips under the runner ).
  2. On the treadmill, there are fewer lateral and speed variations than on the street.
  3. On the treadmill, the impact surface has a higher shock absorber function than Tarmac (asphalt).
  4. There is less energy expenditure on the treadmill.

So even if at first glance outdoor running might seem more traumatic, it has many advantages:

  1. There is greater use of the knee and hip muscles for the complete biomechanics of running.
  2. Greater excursion of the hip and knee joints ( wider range of motion than on treadmill ).
  3. Greater lubrication of the knee joint for a greater range of motion.
  4. There are more variations in the terrains (Tarmac, gravel, etc. ) that result in better adaptability of the joints to different situations, with an improvement in the flexibility of muscles, tendons, ligaments, and related joints.
  5. Greater energy expenditure.

Outdoor running, for the reasons listed above, results in more effective running training.

Improve the health of your knees with these 5 Tips:

  1. Focus your training on the flexibility of your muscles, not just their strength ( yoga, bodyweight exercises ).
  2. Exercises with a wide range of motion of your joints and muscles.
  3. Exercise with less weight on your knees but with a wide joint excursion (e.i Cycling, Rowing ).
  4. Increase the amount of stretching by dedicating an entire workout section ( 30-45 minutes ).
  5. Use meat bones ( chicken, beef, etc.) to make a stock, because It contains glycosaminoglycans that help to lubricate your joints, and increases your daily amount of water.


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