Breaking the Knee Pain & Inactivity Cycle
Courtney here, sharing some insight on one of the most common things I see clinically.
“My knee pain is preventing me from exercising”
For one reason or another, someone presents to the clinic with knee pain. This knee pain may be a chronic issue that has been going on for years, or may be an acute injury.
I commonly hear that people are eager to start an exercise program, however, their knee pain is preventing them from starting. They’re afraid that exercising will make it worse and they simply don’t want to subject themselves to more pain than they are currently experiencing, therefore they avoid exercise all together.
I also hear people say that they would like to lose a couple pounds to take some pressure off the knees however, they feel stuck in a vicious cycle. They want to lose weight because it’s causing more unnecessary pressure on their knees, but exercising just hurts the knees even more. These people would be correct in the sense that if you do have some weight to lose, this is a good place to start to improve your knee pain. Every pound of extra weight exerts about 4 pounds of added pressure on the knees. For example, if you could lose 10 lbs, this would eliminate 40 lbs of pressure through the knees. When we start to think about how many steps we take in a day and multiple that by 40 lbs of pressure, we start talking about significant forces that are being put through the knee.
Some people tell me that they understand the importance of exercise and strengthening so they push through the pain. They try to exercise but perhaps they didn’t find an exercise that works for them, and then they hurt more afterwards. They also feel stuck in the cycle. These individuals, however, are correct in thinking strengthening is important. Strong muscles can act as shock absorbers of the knee. If the muscles can take more of the load, the bones won’t be required to take as much load, which will decreased the unwanted stresses through the joint.
Along with strengthening, stretching is also important. If the muscles surrounding the knee aren’t strong enough to provide the joint with stability, the muscles will tighten up to try to find that stability. This could results in a loss of range of motion in the joint which could lead to even bigger issues. These tight muscles will also cause unwanted compressive forces through the knee, causing more pressure and pain than is necessary.
It is essential to find stretching and strengthening exercises that are appropriate for your level!
Start with the basics and work your way up. Everyone loves the squat for strength gains (myself included) however it may not be an appropriate place to start for everyone. (continue reading for tips on troubleshooting your painful squat).
Stretches that target the muscles that cross the knee are a good place to start. Keep in mind, the more you start to strengthen, the more important it is to stretch, as you don’t want those muscles to tighten up even more.
Here are a couple examples of some stretches.
Once you’ve started on a good stretching routine, you can add in some strengthening exercises. Let’s start with some basic exercises. These exercises would be appropriate for someone with moderate to severe knee pain that are unable to complete the more challenging strengthening exercises without pain.
From here you can progress to slightly more challenging exercises.
The above exercises are a good place to start to build some basic leg strength. Ideally, once we have the pain under control and enough strength, we would like to progress to more difficult exercises. This is where the squat comes in!
I often hear people say that squatting hurts their knees. Typically with a few cues about their form, I can get them squatting without pain, even if it is just a mini squat to begin.
The following video breaks down a few things that you can do to try to troubleshoot your own squat if you’re having knee pain.
Option 1: Mini squat with hip hinge: Your first movement will be the hips moving back, FOLLOWED BY the knees then bending. Everyone wants to start a squat by bending their knees, but by moving your hips back first, this will engage more of your glute muscles and place less strain on the knees.
Option 2: Placing a chair being you: You will take what you learned with option 1 and start moving to a deeper depth. I love placing a chair behind because it’s a really good cue to get your hips back. You’re going to bring your bum all the way to the chair, gently touch and move back up.
Option 3: Mini band around your knees: This will ensure that your knees don’t fall in towards each other when you’re squatting. Often people have weakness through their glutes which leads to the knees falling in. This messes up the alignment of the knee, causing rubbing in certain areas of the knee that aren’t supposed to rub. By using the band, your glutes will be more engaged and you knees will stay in a better place while you squat.
Feel free to combine Option 2 & 3 (Chair and Band) for added help.
As mentioned, the squat is not appropriate for everyone with knee pain, however it’s a good goal to work towards.
IT IS SO IMPORTANT TO FIND STRETCHES AND STRENGTHENING EXERCISES THAT ARE APPROPRIATE FOR YOU BECAUSE IT IS THE MOST EFFECTIVE WAY TO DECREASE KNEE PAIN.
Start with the basics and work up. Breaking the cycle can be difficult, however we are here to help you and support you on your road to a pain free life!