Dealing with knee pain. Knee pain is the worst. It hits when we least expect it and it can be completely debilitating. My knees lock up when I sit for too long without moving, think movie theaters. I also have problems with walking down hills and they occasionally give out when I’m doing an exercise like squats.

I’m sure most of you can relate to some of this, if not all the time then on occasion. I once went to see a doctor about my knee issues and after injecting my knee with hyaluronic acid (which was the most painful thing I ever did to myself) he informed me that I needed surgery. Luckily for me, I’m a big skeptic whenever I hear something like that and I went to see my physiotherapist who suggested that we work on strengthening my knee first. This was confirmed by a doctor-technician who did an ultrasound on my knee and thought exercise would be better.

I’m a firm believer in strengthening muscles before seeking more invasive treatments so I readily agreed with the second opinions. While my knees aren’t perfect and they do occasionally cause me pain, it’s nothing I can’t handle and I’m equipped to make them feel better. Now there’s no saying I won’t need surgery sometime in the future but for now I’d like to make that future as distant as possible.

DEALING WITH KNEE PAIN

STRETCHES & EXERCISES FOR KNEE PAIN

Going on the assumption that your knees are in good condition and you don’t have an underlying medical issue, the best way to keep them healthy is to ensure that the muscles surrounding them are doing their job.

CAUSE #1

Hips. One key to having healthy knees is to have proper mobility in your hips. The easiest way to check this is to lie on your back, arms out to the side with both legs straight on the floor. Lift your right leg up to the ceiling. If you can lift it to 90 degrees without either leg buckling or rotating or knee bending then your hips are sufficiently mobile.

SOLUTIONS

Head to knee. This one can be done standing with one foot on a chair or sitting. Stretch one leg out in front of you and bend forward until your head touches your knee. Of course, that’s just the goal but lean as far as you can trying to keep your upper body straight and relaxed. For those of you who are more advanced, stretch both your legs out at the same time. Tip: For an added calf stretch, flex your toes toward you. Breathe and hold for 20 seconds on each leg.

Straddle. This is a variant on the above stretch. Same rules apply, but your leg is now out to the side and you will lean sideways over the leg and then forward toward the floor. You can also do this with your legs open to a v- position on the floor.

Pigeon. Sitting on the floor, bend your right leg so that your foot is touching your left thigh or is in a parallel position in front of you. First, sit up straight opening your chest to the ceiling. Hold for 20 seconds. Then, slowly hinge your body forward and if you can, reach your arms out on the floor in front of you. If you are more advanced, try pulling your back leg toward your glutes. Hold for 20 seconds and switch legs.

Frog. Don’t do this if it bothers your knees or ankles. I like to place a blanket under my knees to cushion them. Supporting yourself on your hands let your knees slide out to the sides while keeping the soles of your feet together. Let your upper body lie flat while you relax into this pose. Hold for 30 seconds.

ADDITIONAL EXERCISES

Donkey kicks. Targets: hip flexors, quadriceps, gluteus maximus. Start on all fours (abdominals engaged, shoulders down) with your hands beneath your shoulders and your knees directly below your hips. Bend your right leg so that your heel is reaching for the ceiling and your thigh is parallel to the floor. Keeping your leg bent at a 90 degree angle, gently pulse your leg upward 20x. Lower your leg and repeat. You should feel a burn in your glutes. Do 10 sets on each leg.

Fire hydrant. Targets: gluteus medius. Starting in the same position as above, lift your right leg sideways but keep it bent. This exercise can be tricky because you’ll want to bend your body, so try to keep it still which will target only your glutes. When you’ve lifted your leg as high as it will go without rotating your body, do 20 small pulses at the top. Lower your leg and repeat. Do 10 sets on each leg.

Lunges. Targets:  glutes, quadriceps, calves. explosive lunges. You’ll start in a lunge position, push off your front or back foot and come into a balance, then hold it for 10 seconds and return to the start. Do 15 reps on each leg. If you need more of a challenge, try standing on an uneven surface with the working leg.

Side step squats. Targets: glutes, quadriceps, calves. Similar to explosive lunges but this time you’ll start standing with your feet hip width apart. Step out to one side with your right leg, bending your knee into a lunge position. Do 15 reps on each leg. For a greater challenge, try landing your working leg on a BOSU ball.

CAUSE #2

Ankles. Oftentimes a lack of ankle flexibility can also negatively affect your knees. I admit that if I wasn’t dancing I would probably never think of my ankles, but because they are stabilizers, they should be strengthened on a regular basis. To find out if your ankles are flexible, lie down on your back with your feet flat against the wall at 90 degrees. Now try to pull your toes back (your heels shouldn’t move). If you can’t then you definitely need to work on that. Roughly one inch is good and more is even better.

SOLUTIONS

Knee bends. Stand, on your right foot, about an inch away from a wall. Yes, you can hold the wall for support. Keeping your back straight, the goal is to try to touch the wall with your knee without letting your heel lift off the floor.  Do this slowly 10x and switch feet.

Point and flex. Channel that ballet dancer in you. This exercise is best done with a resistant band. Place the band over your foot. Gently pull on the band to create some resistance and then point and flex your foot slowly. Try spreading your toes and really focus on working through your whole foot. This exercise is great because it both stretches and strengthens your feet and ankles. Do this 15-20 times on each foot.

ADDITIONAL EXERCISES

Plie. Essentially, this is a turned out version of a squat, but it’s all about the technique. It can be done in a ballet first position with your heels together and your toes turned out, or in second position standing in a turned out position with your feet slightly wider than hip distance apart. Staying tall and keeping your abdominal muscles engaged, bend your knees ensuring that they point over your toes. Bend as far as you can without your heels leaving the ground and then straighten. As you straighten, think about squeezing those inner thighs together. Repeat 10 times in each position.

Releve (aka calf raises). See above for your positions, but now instead of bending your knees, you will engage your quads and rise up high on your toes. Repeat 15 times in each position.

RUNNING AND KNEES

I often hear people say that running is bad for your knees. It’s actually not. It might not be great if you already have bad knees but otherwise it’s exercise and if you do it properly then what it’s actually doing is helping keep your bones strong and healthy.

Osteoarthritis.  Alright, let’s go into some detail about this.  If you already have a predisposition to osteoarthritis then you can pick up the phone and thank your parents, because that’s genetics. You can, however, still run if you love it. You just need to be more aware of what your body is telling you. If you feel a lot of pain then it’s probably wise to stop and to get yourself checked out by a medical professional.

Preventing osteoarthritis. Did you know that running might actually help prevent arthritis in older age? Being healthy and active is your best defense against pain in later years.

Joint pain. There’s real joint pain and then there’s muscle soreness and discomfort. It can sometimes be tough to know which is which, but not all pain is necessarily bad (more on this in a later post). If the pain isn’t severe and goes away quickly, then you can probably continue. Sometimes all you need to do is some strengthening exercises, consistent stretching post runs or even changing your footwear for the discomfort to disappear. The key is to really listen to your body.  Is your body trying to tell you “I’m hurt, please stop,” or is it saying “meh, I don’t feel like working out now, so why don’t we just take a seat on the couch.”

Change your route. I personally find that running on asphalt for long periods of time does give me a lot of discomfort. It feels like the asphalt is entering my veins and my legs become as heavy as cement. It’s for this reason that I will opt to use a treadmill or run off the beaten path. Park trails and uneven surfaces are perfect for me.

Moderation. Like with everything, moderation is key. Going for a light jog 3-4 times a week for 30 minutes or even 45 minutes is not the same as running an ultra-marathon. Ask yourself how much more stress are you really putting on your joints with some extra activity. Realistically, it’s probably not that much.

Honestly, the best thing you can do for your knees (unless a medical professional says otherwise) is to keep moving them. You might have to modify your movements and you might need longer breaks and that’s okay but staying strong and limber is your best bet to having healthy joints.

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