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Knee pain after activity

This week's question -

Whenever I do too much of an activity, my knee hurts, is it just an overuse injury that will never go away?

My answer -

While I do believe there are such things as overuse injuries, I think they are FAR less common than what I refer to as "over mis-use" injuries. Our bodies are very resilient and capable of a lot. When you look at ultra-runners and our military members and powerlifters, they are able to participate in extreme activities without their bodies breaking down. So why is it that some people can run over 100 miles per week, but when you go over 4 your knee hurts (despite no structural damage). Is it because you are just not destined to be active? No. I think there are 2 reasons for this.

1- you did not progress your activity correctly. If you go from running 0 miles or lifting 0 pounds to running 10 miles or lifting 100 lbs, you will likely get injured/have pain because your body is not correctly adapted to it. Therefore, you are at higher risk than someone who goes from running 19 miles to 20 miles or from lifting 490lbs to 500lbs. Even though the load is a lot higher, the progression is slower. Similarly, if you go from training 2-3 hours per week to 10 hours per week, there will be a toll, even if your body could structurally handle the higher load.

2. You have a faulty movement pattern either with the activity causing you pain or in other areas of lift that is exacerbated with this activity. For example, if you have a very stiff ankle, it would be no surprise to me that your knee hurts when you run. Does this mean you are running too much? Well only for the way your body is working right now. If you can mobilize that ankle, you may be able to run 4x as much as you currently are without knee pain. So was that overuse of your knee? Not necessarily, but rather over mis-use. If you never ran or called on your ankle to move, you may never have known that your stiff ankle leads to a painful knee, but just because you didn't know it doesn't mean it wasn't there.

So what does this mean? If you have been told you have an "overuse injury" yet no structural damage (aside from some inflammations etc.) it is likely due to one of the factors above. Take a look at your training and see if you had a significant activity change around when the pain started. If not, move on to reason 2 and get someone to evaluate your joints/movement patterns to find the link that is faulty and may be leading to your pain!

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