Knee Health: Staying Fit For The Long Run

As a registered massage therapist and a long distance runner I’m often asked about knee injury prevention and treatment. There’s always someone who knows someone who used to run all the time until his/her knees gave out. While it is true that running can take its toll on your knees there are ways to prevent this and keep you in running shape for the rest of your life. In this manner, massage therapy and cross training can be a runner’s greatest allies.

Much of my lower body workouts are geared toward preventing injury. As with any sport, running helps us to develop certain muscles very well while leaving other muscles relatively untouched. What this leads to is a muscular imbalance that puts stress on the joints that those muscles cross. For runners this usually means bad knees — a condition referred to as Patellofemoral Syndrome (PFS).

Let me illustrate. Let’s take 2 kids who are the same age, height, and weight and have them play a game of tug-o-war. Because the kids are evenly matched there is going to be an even distribution of pull and the ball in the middle of the rope is pretty much going to stay where it is. But let’s say one of those kids is working out and getting stronger and stronger so that in the coming years she is still the same height as her friend but is now 25 pounds heavier. What do you think will happen in that same game of tug-o-war now?

In runners, it is very common for the outer thigh muscles, in particular the vastus lateralis to be that stronger kid who’s been working out.


The inner thigh muscles in runners are the weaker child in my tug-o-war analogy. In particular these inner thigh muscles of concern are the musculotendons of the Vastus Medialis as it inserts into the patella or knee cap. These musculotendons are called the Vastus Medialis Obliquus or VMO.


Also on the outer thigh, there is a connective tissue band that runs from your hip to just below your knee called the Iliotibial Band or ITB. And in runners, it too becomes very tight.


So going back to my tug-o-war analogy, in runners, not only do we have a big kid (the outer thigh muscles) taking on a little kid (the inner thigh muscles), but the big kid has one of his big kid friends (the ITB) also ganging up with him. In this case, how can a runner’s knees NOT have problems?

So what to do? You counter the pull of the outer thigh muscles and ITB by stretching out these areas and you strengthen your inner thigh muscles, most notably the VMO.

The most effective stretch for the outer thigh and ITB is to stand with one foot crossed behind the other:


In this case, my left foot is crossed behind my right foot. Keeping my legs straight and bending to touch my toes will allow me to stretch out the outer thigh muscles and ITB on my left leg. Switch feet and cross your right foot behind your left to stretch out your right thigh. Hold each stretch for 30 seconds.

Now to bolster your inner thigh muscles! I like to do an exercise that I call the mini-squat. In traditional squats you are bending your knees to a 90 degree angle and then straightening back up. But to isolate your inner thigh muscles, bend your knees to about 15 degrees and then straighten. I like to do this exercise while holding dumb bells in each hand to further strengthen my VMO’S.

Together, stretching the outer thigh muscles and ITB and strengthening your inner thigh muscles will help even the tug-o-war on your knee and keep you in full running health. And of course, contact me if you’re in Toronto and book your massage treatment at least once a month to prevent injury and help keep you fit for the long run!



  1. […] Knee Health: Staying Fit For The Long Run […]

  2. shawnasob · · Reply

    Reblogged this on Lace by lace and commented:
    Great post by one of my favorite bloggers and runners runrodrun

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