The Knee-d to run

by Shana-Lee Bownes

Lockdowns that had us all cooped up in our homes for over a month seems to have sparked a greater appreciation for exercise in us all. Who can forget how ironically crowded the Cape Town beach front walkway was on the 1st May 2020 with walking folk and runners eagerly tottering about with mask-concealed smiles.

Running is arguably one of the most accessible forms of exercise and a popular choice adopted by many trying to stay fit and get outside, especially during the hard lockdown. A survey conducted by De Jong and colleagues (2021) about running during the pandemic found a small but significant  increase in running mileage of 1,4km per week (great) but also a 1,4 times the injury risk compared to before the pandemic (not so great)(DeJong, Fish et al. 2021).

Here’s the story: We dust off out running shoes and hop on the road. The first few training sessions are rough, but then they get easier and that’s when the bug bites. Suddenly you’re up at 5am on a Saturday for your long run and posting a snap of your coffee #postrunfeels. But that little niggle in your knee that gradually builds up as you run is still there and often when niggles are ignored they have the potential to turn into more serious injuries. When looking at the studies published in running injuries van der Worp and colleagues found that injury was reported between 19,8-25% in men and 79,1-79,5% in women who run (van der Worp, ten Haaf et al. 2015).

Research on running injury prevention has unfortunately been somewhat inconclusive. Messier and colleagues have undertaken a very important step to improve research in this area by unpacking all of the different factors that contribute to developing running injuries. Over a two year period they followed 300 runners, testing running specific, physical and psychological characteristics. During the study 66% of participants sustained injuries in the two year period. Expressing more negative emotions, being a female and knee stiffness was associated with injury, this is unsurprising considering knee injuries were most commonly reported. Knee stiffness, especially in those weighing 80+ kilos, significantly increased the chances of developing one of those pesky overuse injuries (Messier, Martin et al. 2018).

So, where to from here? Hopefully with this knowledge we can focus our efforts on discovering the mechanisms by which these risk factors contribute to injury. Hopefully by addressing these risks we can come up with strong preventative measures. Measures will translate well into the running community and when implemented – will protect us against injury.

Until then in the wise words of Dean Karnazes: “Run when you can, walk if you have to, crawl if you must; just never give up.” (Meuller 2020)


DeJong, A. F., P. N. Fish and J. Hertel (2021). “Running behaviors, motivations, and injury risk during the COVID-19 pandemic: A survey of 1147 runners.” PLOS ONE 16(2): e0246300.

Messier, S. P., D. F. Martin, S. L. Mihalko, E. Ip, P. DeVita, D. W. Cannon, M. Love, D. Beringer, S. Saldana, R. E. Fellin and J. F. Seay (2018). “A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS).” Am J Sports Med 46(9): 2211-2221.

Mueller, S (2020). “60 Inspiring and Motivating Running Quotes” [online] Planet of Success. Available at: <; [Accessed 11 April 2021].

van der Worp, M. P., D. S. ten Haaf, R. van Cingel, A. de Wijer, M. W. Nijhuis-van der Sanden and J. B. Staal (2015). “Injuries in runners; a systematic review on risk factors and sex differences.” PLoS One 10(2): e0114937.

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