Knee pain is a common issue that affects people of all ages. Whether it is a sudden, sharp pain or a dull, persistent ache, it can not only limit our progress in the gym but also negatively affect our quality of life, preventing us from doing things we enjoy.
It’s always hard to talk about our poor knees. So many things can harm them: Chronic meniscus tears, osteoarthritis (deterioration of cartilage), Q-angle (Alignment between thigh and shin bones), among others. The matter of fact is that they definitely suffer wear and tear as we age.
Some of those changes are outside our control, but that doesn’t mean there aren’t things we can do to improve our knee health. Before digging into that, it’s important to understand that the knees are primarily stability joints and are heavily influenced by the joints above and below (hips and ankles), which are mainly mobility joints (1). When hip and ankle mobility is adequate, we can better distribute the forces applied to the body, sparring the knees (2).
So this is the first tip if you’re dealing with knee pain: make sure your flexibility is on point at both the hips and the ankles. If there’s a deficit in any of them, we need to address it with proper flexibility training.
That being said, it’s important to remember that mobility is a bit different than flexibility. The former is about passive actions (being flexible, being able to be bent) while the latter also involves strength (being able to bend ourselves).
And that’s where strengthening exercises come. Resistance training is not just about building bigger muscles, it’s also about teaching them how to work better (increasing synergy between different muscles, increasing speed of contraction, recruiting more muscle fibers, etc).
So here is the second tip: if your knees hurt, you have to strengthen the muscles around them, and also the muscles around the joints above and below. It’s important to add exercises in the three planes of movement, to make sure we don’t leave any muscle untrained.
In a nutshell, to deal with achy knees you may need flexibility work (foam rolling, stretching, etc) and you definitely need strength work. The NASM Corrective Exercise Continuum is definitely a good approach to be followed (3).
For strength and conditioning exercises, it’s important to consider the type and the amount. For example, biking or skiing are less impactful for the knees than running. Regarding the amount, the number of sets, reps and load of the lower body exercises need to be adjusted carefully.
I like to start with the minimum effective dose (minimum amount of exercise necessary to build strength) and slowly increase as needed. Quality is more important than quantity, and performing the strengthening exercises correctly is key.
Pain is our best guide! A good dose of exercise won’t cause knee pain either during or after training. Being sore on the muscles is totally fine and can be good for us, but an achy joint is a sign from our body that we need to adjust our training.
Will
Movement - Functional Movement Systems
ACSM resources for the Personal Trainer
NASM Essentials of Corrective Exercise Training
Comments