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Eight Strategies for Reducing Knee Pain

Posted August 9, 2007 at 02:00 PM by Julie R. Keen

Section: In The News, His Fitness, Injuries & Rehab

You’re sitting in a dark theater watching the latest Bourne movie.  You get up to use the bathroom and suddenly find that you can’t put any weight on your knee.  It feels like you’ve traded knees with your 85-year-old grandfather.  You go to the gym regularly, and you can’t remember doing anything to it, so what the heck? Knee injuries are common for the weekend warrior and athlete alike.  The best way to handle knee injuries is by prevention.  Once they start, they can be tough to treat, depending upon the structure injured.

When we look at the anatomy of the knee, there are some major structural elements that can be injured, usually from traumatic events.  By this I mean an improper tackle playing football, or landing wrong from a lay-up, or missing the landing on the jump when skiing.  If you have injured one of these structures, and didn’t notice, you have a bigger problem than just some knee stiffness!  If your knee is really swollen, painful, and feels unstable, go see a good orthopedic surgeon immediately. If your knees give you occasional trouble during your workouts, or you find that you can’t do certain exercises because of your knees, then these tips might help.

Don’t skimp on the warm-up.  Every workout, whether it is a “cardio” workout or a resistance-training workout, should begin with a proper warm-up.  The goal is to get the blood flowing, stretch some tight structures, and active the muscles that might not be firing properly.  A good warm-up might take you 10-15 minutes and will get your heart rate up and your muscles primed for the upcoming workout.  Here is a sample warm-up.

• Jumping Jacks x 10
• Neck Circles x 10
• Arm Circles x 10 each forward and backward
• Split Squats/Static Lunges x 6 each side
• Wide Static Side Lunges x 6 each side
• Bodyweight Squat x 10
• Toy Soldier walking x 10 each leg
• Gluteal Bridging x 10
• Side-lying Clamshell x 10 each side
• Push Up Plus x 10
• Spiderman x 10

Get the immobile parts of the lower body kinetic chain mobile.  So, stretch the tight muscles, and work on getting your ankles and hips more mobile.  A chain is only as strong as its weakest link (“You ARE the weakest link!”).  This might be a cliché, but it is certainly true.  So if your ankles are stiff, you knee will try to make up the movement during your squats and lunges.  If your hips are tight, your knees (and lower back) will take up the slack.  This increased strain can lead to injury, overuse, or degenerative changes over time.  Stretch your quads and calves.  Sounds simple, but tight quads and calves put more stress on the entire kinetic chain.  The simple pull-your-heel-to-your-butt stretch works just fine for the quads, and hanging your heels off a step works great for the calves.  Hold each stretch for a minimum of 30 seconds on each side.  Do the joint mobility work and dynamic stretching before your workout as part of your warm-up and save the static stretching for after.

Work on getting all of the muscles firing properly.  Most people have issues with getting their gluteals to fire (can you say flat butt syndrome?!).  Good exercises to include in your warm-up to get the gluteals working properly include bridging, side-lying clamshells, donkey kicks, hip airplanes, and band-resisted sidestepping.

Do regular soft-tissue work.  See a good massage therapist or ART practitioner if you have lots of knots and can spare the expense.  If not, invest in a good quality foam roller and spend 15-20 minutes most days doing some deep tissue torture, I mean rolling.  Working out all those painful knots in your hamstrings, quads, calves, ITB, glutes, and TFL will go a long way toward improving your mobility and decreasing your knee pain/stiffness.

Focus on getting the posterior chain strong.  Many people have a significant imbalance between quadriceps and hamstring strength.  Ideally, they should be about equal.  Be sure that your workouts are balanced in quad-dominant and hamstring-dominant exercises, and if your posterior chain is weak, increase the amount of hamstring and gluteal exercises, like good mornings, deadlifts, Romanian deadlifts, glute-ham raises, pull-throughs, and high step-ups.

Incorporate some single-leg balance work.  Get off the Smith machine, and away from machines in general.  When you use a machine as the basis for exercise, you take away the body’s ability to use its natural stabilizers.  To really activate those stabilizers try doing exercises that force you to balance.  So instead of doing prone hamstring curls on a machine, grab a pair of dumbbells and try a single leg Romanian deadlift.  Try Bulgarian Split Squats instead of using the leg press machine.  If you think those are easy, instead of knee extensions on a machine, try the Pistol (a single leg squat).

Focus on form.  Reading fitness magazines and pulling the exercises from them can be a great way to gain more fitness exposure.  But if you are using improper form, you can be hurting yourself rather than helping.  Have a friend videotape you doing the exercise.  Watch the video and notice where your form is deteriorating.  If you find that you consistently have pain during a particular exercise and you can’t see where your form is bad, it might be time to have a professional evaluate your form.  Make an appointment with a qualified personal trainer.

Keep any inflammation down.  After your workout and static stretching, put ice on your knee for a good 20 minutes.  If you are short on funds and don’t want to spring for a nice ice pack, and don’t want ice-water leaking all over the place, invest in a few family-size bags of frozen peas.  Write “ICE” on them in permanent marker, and stick them in your freezer (DO NOT UNDER ANY CIRCUMSTANCES EAT THE PEAS!!!). When ready to use them, wrap in a pillowcase or T-shirt and put on your knee for 20 minutes.  Take a good fish-oil supplement, which has been shown in studies to reduce inflammation.  If you have known joint degeneration, take glucosamine.

Give yourself a month or two of implementing these strategies.  If you notice no difference in that time, then it is time to see an orthopedic doctor and/or physical therapist.  But, give these strategies a shot first, your knees will thank you.

For resources and more information: [picture1]; [picture2]; [Keen Fitness]

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Tags: arm circles, art, bodyweight squat, calves, chronic knee pain, glucosamine, gluteal bridging, glutes, hamstrings, ice, injury prevention, it band, jumping jacks, knee injury prevention, knee pain, lower body kinetic chain, massage therapist, neck circles, posterior chain, prevention, push up plus, quads, side-lying clamshell, single-elog balance, smith machine, spiderman, split squats, tfl, toy soldier walking

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