04 Feb, 2013

Breathing Problems and Runner’s Knee

Breathing Problems and Runner’s Knee

Breathing Problems

I need advice on low lung capacity and running/cycling. I was diagnosed with 66% lung capacity, I am 36 years old, and though I do run and cycle, I battle the whole way with my breathing. Is there anything I can do to improve my breathing or running as I am getting very despondent? – Emma Chisholm



Unfortunately there is nothing you can do to get back to 100% of your lung capacity, but you can better utilise the 66% you do have available. You are born with a particular maximum lung capacity which is called VO2max – maximum rate of oxygen flow, also known as aerobic capacity. In your case, you only have 66% of your VO2max, hence the importance of training smart.


Lactate Testing is considered to be the most important determinant of success in endurance activities. Training at the right intensity is important to help you reach your goal. During training, your body uses glucose as energy, and the by-product of this glucose breakdown is lactate. To get rid of the lactate in your blood, you need enough oxygen to break down lactate and re-use it as energy. When you don’t have enough oxygen and produce too much carbon dioxide, lactate can’t be broken down and it accumulates in the blood, and eventually you reach exhaustion.


With VO2max and lactate tests, we can identify the most appropriate training intensity and type of training for you specifically, to build your fitness level at your own pace. However, it is easier just to start running slower and concentrate on deep belly breathing, which may aid in increasing your lung capacity and efficiency. It expands the diaphragm to its max during inhalation and uses your abdominal muscles to squeeze air out during exhalation, resulting in more oxygen reaching the muscles per breath.

Modern Athlete Expert


Biokineticist at the Technogym Wellness Centre in Fourways, Johannesburg, lecturer in exercise science and Ironman finisher. Andries specialises in sport and orthopaedic rehabilitation and sport-specific testing and conditioning. (


 Runner’s Knee

I am 37 years old and a casual runner. I have done about six 10km and 15km events. I experienced a terrible pain on my right knee during my last 15km race and I could hardly walk or climb up the stairs afterwards. I rubbed my knee and after a week the pain was gone, but it started again when I attempted exercising again. What is the cause of this and what can I do for the pain to go away permanently? – Thenji Masuku



It sounds like you have patellofemoral knee pain, also known as runner’s knee. The pain is localised around inner and outer border of the kneecap, is felt while running, and generally gets progressively worse and is aggravated by longer distances. Sitting for long periods, squatting and walking up and down stairs can also cause discomfort. This pain can result from several causes:

?         Excessive pronation of your foot. Check for abnormal wear on your shoes.

?         Weak hip muscles which result in inward rotation of the thigh, resulting in increased pressure under the kneecap.

?         Training errors which include building mileage too quickly, or excessive speed or downhill running.


Treatment should include one or several of the following:

?         Anti-pronation shoes or orthotics may be required to correct excessive pronation.

?         Strengthening of the thigh muscles (quadriceps) and hip muscles to help decrease the load and pressure on the knee.

?         Taping can help correct altered tracking of the kneecap and temporarily decrease the pain.


Modern Athlete Expert


Toni is a physiotherapist in Edenvale, Johannesburg. Has finished 21 Comrades, four Ironmans and two New York Marathons, plus various cycling and canoeing events.