If you run, it is very likely that you have already had pain in your knees ... or that you dread their arrival.
We therefore discuss with Jean-François Esculier, Speaker and Leader of research and development at The Runner's Clinic, knee health.
Daniel: You are considered an expert on injuries related to running, but also on those related to the knees. Can you explain us your background and your interest?
Jean-François : When I started my career as a physiotherapist in 2009, I saw a lot of runners who mostly presented to treat knee injuries. So that intrigued me and I started looking in the literature to find ways to adequately help them. Despite my research, I quickly realized that there were very few posts on this topic. This is what prompted me to get involved not only in research related to knee pain, but also in the explanation of their appearance.
Daniel: You and your research group have just published an interesting paper on cartilage and running. Can you tell us a bit about it?
Jean-François : We often hear that running is bad for the joints. We therefore wanted to explore the following question: “What are the effects of running on the joints of the lower limbs (ankle, hip, knee, feet)? ".
We searched all the articles that explored the effects of running on the joints using a magnetic resonance image (MRI). In other words, participants underwent pre- and post-running IMR.
The results are as follows: the cartilage is a little compressed after running due to the repetitive impact having the effect of pushing water out of the cartilage. On the other hand, the MRI scans carried out a few hours after the race showed that the cartilage returned to its normal state, therefore regaining the water lost previously.
The discovery for us it is therefore that the cartilage is made to tolerate the impacts of running, despite its temporary thinning.
Daniel: Have you discovered an increase in the quality of cartilage for people who train regularly?
Jean-François : There are some studies that suggest that we can actually improve the condition of our cartilage. A study in Belgium, for example, found that the content of cartilage changed in people who started running by becoming more tolerant. Little by little, we are discovering that running is good for our joints.
Daniel: Correct me if I'm wrong, but I have the impression that the impacts on the cartilage are difficult to measure… if we compare with a muscle that can double in size with training for example.
Jean-François : Absoutely! Cartilage is a practically inert tissue. On the other hand, it adapts and becomes more tolerant, without necessarily doubling in size.
Dan: Can you give us your advice number 1 for take good care of our knees?
Jean-François : One of the main points is maintaining an ideal level of stress. A classic example would be the runner who stops running in the winter to resume in the spring. If this is the case, I advise you to continue a little throughout the year, but at a minimum, to do various strengthening exercises (squat, lunges, etc.).
Otherwise, the other advice would be to be gradual in our activities. Running uphill or downhill, for example, puts a lot of load on the knees so you have to go quietly.
Daniel: Aside from progression, are there any other ways to prevent knee injuries?
Jean-François : It is certain that keeping your musculoskeletal system healthy by performing muscle building exercises helps a lot. I convey it a lot in my practice, although no research proves it.
Spreading your training over a week is also a good idea. For example, it's great if a person runs only on Saturdays and Sundays, but I highly recommend adding a very small outing on weekdays to allow the body to adapt better.
Playing with the type of surfaces, in order to avoid running 100% of the time on the road, is also appropriate. Running on trails, for example, allows the impact to be spread all over the knee due to frequent changes of direction.
Finally, there are the recovery and self-listening components which are super important.
Daniel: You and your study group did research to link running injuries to training parameters. There does not seem to be a connection as strong as it was believed in the past. Can you explain to us?
Jean-François : When I assess people injured by running, I ask a bunch of questions like "Did you increase your volume?" »,« Did you increase your running speed? "," Did you change your running club, "" Did you change your running technique or your shoes? Etc. These are important questions since they influence the risk of injury and in the vast majority of cases the injury is caused by a change.
So we wanted to know if the riders got injured because of the changes mentioned earlier. We were, in fact, surprised by the results which turned out to be quite contradictory, which did not allow us to say, beyond any doubt, whether such or such a change resulted in an injury. We quickly realized that each injury has its own personality and that we must adapt to each person.
Daniel: Is there a part of luck / bad luck in the injuries?
Jean-François : You could say that, but there are still a lot of factors that we control. It goes a lot through the education of runners as well. For example, if you follow your training program to the letter and go for a 5 km run despite certain warning signs and injure yourself, is that bad luck?
I repeat it again, but listening to yourself and progress are proof of everything. The best athletes I have dealt with in my career are individuals who have been able to adapt their program according to their feelings.
Daniel: Finally, in what ways can we follow you?
Jean-François : For research, I invite you to follow The runner's clinic. Otherwise, regarding physiotherapy consultations, I have my own clinic Movemed. Although I am currently in British Columbia, I do a lot of virtual consultations and it works really well!
Thank you very much for this interview. Very interesting and informative!
Thanks for the kind words!
Shoe companies are constantly changing their models (for marketing reasons, we all know that) so as runners we have no choice but to change shoes. My knees have been sore for a year and I greatly suspect my new shoes (Nike Turbo 2), I who previously ran with the old Nike “slippers” (Vomero 9, 10, 11, 12). Unfortunately, Nike has changed the vocation of its Vomero model for a few years and I hated the Nike Vomero 14 for its lack of comfort hence my change of shoes. Are there any shoe brands currently on the market that are known to prevent knee pain?
Goods.
Hello, unfortunately I don't believe there are specific shoes to prevent knee pain.
My suggestion would be to try some in stores, but beyond that, there isn't really much to do.