Purchase some knee sleeves
. Ill make this first one easy on you. Go out, buy some knee sleeves, and wear them every time you train your legs.This could be quad-dominant day, hip-dominant day, leg day, or whatever you want to call it. Just put them on before the workout, warm-up thoroughly, and bask in the joy that healthy knees bring to you.
Dont skimp on your warm up
. This idea is beautiful in its simplicity, yet often ignored for various reasons such as Im in a hurry or I dont need to warm-up because Im 22 and therefore ten feet tall and impervious to harm. Well, Id love to see what that lack of warm-up is doing to your joints, pal Beyond improving your training performance for numerous reasons, warming up reduces the viscosity of synovial fluid (the stuff that fills your joint space), providing better lubric
Want healthy knees Focus on ankle and hip mobility
. It may sound counterintuitive, but when we have knee issues, where do we focus most of our attention? The knees, right? You know what else? Thats a big part of the problem.The fact of the matter is that knee issues are typically due to issues at other areas of the body, not the knees themselves. Lack of hip mobility in all planes can not only lead to knee pain, but back pain as well. Eric Cressey and I covered about a zillion hip mobility exercis
Get your glutes firing
. This is another area that not nearly enough of us are addressing, as most who have patello-femoral pain are only worried about isolating the vastus medialis obliquus (VMO). In research by Ireland et al. (1), they found that athletes with patello-femoral pain had significantly decreased strength in both hip abduction and hip external rotation. How much is significant? These subjects were 26% weaker in hip abduction and 36% weaker in hip external r
Forget about isolating the VMO
. A lot of athletes and lifters are interested in getting that VMO to fire, especially those with patello-femoral (PF) pain. This anterior knee pain, in many cases, is due to soft-tissue imbalances between the stronger tighter lateral knee structures and the weaker inhibited medial knee structures (the VMO). This muscle imbalance leads to a lateral (outside) pulling of the patella into the femoral condyle, resulting in knee pain.The obvious solutio
Get some balance in your training
. Im still shocked at how many people dont adhere to this rule. Theyll squat, then lunge, then do leg extensions, and then maybe get some hamstring work in if they arent totally wiped at the end of their workout.If you dont follow this rule, your knees may not hurt now, but I can guarantee they will in the future. When I say that we have to balance your training, we arent talking within the training day or even the training week. You need to addres
Stop pain provoking activities
. This is the simplest tip Ill give, but for whatever reason people still fail to listen to their body and grasp the concept If it hurts, stop doing it. This can include squatting, lunging, running, playing basketball, or any other pain-provoking activities. Your second grade PE teacher could give you the same advice. Remember that sometimes taking an extra day or two off isnt a bad thing if you can train harder (or pain-free) the next time around
Dont be afraid to isolate after traumatic injury
. Most of the time, isolation exercises totally suck, especially if strength and or performance are your primary goals. However, in a rehabilitation setting the rules can, and need, to change.Following my knee scope, I started back into training with basic proprioceptive exercises, working on regaining mobility, and then progressing back into single-leg exercises. Problem was, my quads were flat-out weak. Just like any other time one muscle is weak
Do some single leg work
. Lets focus briefly on point number four. Remember how we discussed above that those with knee issues need to improve general quadriceps strength, and also need to improve gluteal strength as well? For these reasons alone, single-leg exercises can do wonders for preventing (or rehabilitating) injuries. Beyond that, far too many of us stick solely to the big exercises in the gym. Im all for big squats, good mornings, and pulls, but single-leg exerc
Get your glutes and hamstrings stronger
. We discussed above how people with patello-femoral pain have significantly less strength in their gluteals. So whats the easiest way to rectify the situation? If you said Get their glutes stronger, you get the gold star for the day. By working to activate the gluteals pre-workout, and then working to strengthen them within your workout, youll be well on your way to healthier knees in the future. But what about the hamstrings? Have you ever seen s
Learn to absorb force
. As Im writing this, I can envision people taking it to the Nth degree and performing depth drops off a ten foot wall. Before we take it there, let me clarify my point a little bit. What Id like all trainees to have is at least a basic knowledge of how to absorb force. If you were to jump up in the air and then land with your knees straight and a loud thud, youre not allowing your muscles and tendons to absorb force. Instead, all the force is bein
Get your body in proper alignment
. Ever see a car thats out of alignment? Notice how it wears down those tires quickly? And the gas mileage you get is downright atrocious to boot. So what if your body is out of alignment?Well, just walking around could be a chore, and I can virtually guarantee one part of your knee joint is taking the brunt of the load. To make it worse, youre probably squatting, deadlifting, and lunging heavily as well, which is kind of like speeding with that sa
Learn how to lift
. This may sound really stupid, but youd be amazed at how many clients and athletes I work with who tell me, I cant do X exercise; it hurts my (insert body part here). Since this is a knee article, well assume it hurts their knees. Heres the problem though Its not the exercise thats hurting them; its their god-awful lifting technique thats the problem.Im amazed at how many people cant perform even the most basic exercises in the weightroom, yet th
Beware the irritated rectus femoris
. I used to think the psoas was the devil when it came to flawed posture and injuries, but now Im not so sure. Sure, it can be troublesome for a number of reasons, but for those with knee issues Id like to take a closer look at the rectus femoris instead.First off, Im sure youre wondering, How do I know if my rectus is a problem? Try the modified Thomas Test to find out Sit on the edge of a table or counter with your buttocks on the edge. From here
Eat an anti inflammatory diet
. A healthy diet plays a big role when it comes to maintaining healthy joints. While we dont have all the answers yet, were quickly learning that an inflammatory diet is NOT a good thing; whether youre at risk for heart disease, have asthma, or just want to keep your joints healthy. While weve known for quite some time that poor biomechanical alignment, being excessively heavy, and general wear-and-tear can wreak havoc on your joints, were also see
Take Joint Regenerating Protecting
. While the jury may be out on the ability of certain supplements to protect and or regenerate our joints, Ill be frank here Im not willing to wait around to find out. What if we found out in 15 or 20 years that glucosamine and chondroitin really do what they say? Wouldnt you be kicking yourself for not taking them sooner, when your joints were in far better shape? I know I would be. But what else is out there? I believe to keep our joints health
Get some soft tissue work done
. This is another addition to your program that can give you huge paybacks over the long-term. First, if you havent purchased a foam roller] yet, what are you waiting for? Id venture to say almost any performance coach worth his salt is using one, so why arent you? If you arent sure how to use one, check out our Feel Better for 10 Bucks article. Something we didnt discuss in the foam rolling article is changing the length of the muscle while youre
Stretch your quads and calves
. I recently came across an interesting prospective study regarding patello-femoral pain. While most studies are retrospective in nature (e.g. they examine an issue aftertheres a problem) very few look at it in the opposite fashion. This prospective study (3) examined 282 athletes enrolled in phys ed classes and took them through a battery of tests to determine baseline statistics. Two years later they followed up, and 24 of the 282 had developed p
Straight Leg Lift
. argets Quadriceps and hip flexors. Complements the walking motion by working muscles in opposition that may be underused, such as the smaller quadriceps muscles of the thigh. Cues Begin lying on back with right leg straight and extended; left knee is bent, with left foot flat on floor. Contract right thigh muscles to straighten (but not lock) the knee. Slowly raise leg until knees are parallel, then lower. Repeat 8 to 12 times, working up to 2
. Targets This multi-dimensional exercise targets the hamstrings, quadriceps, gluteal muscles, and abdominal muscles. A lower-intensity alternative to squats and lunges. Cues Stand with lower back against an exercise ball of about 25 inches that rests against a wall. Feet are shoulder-width apart and a comfortable distance from the wall. Body is erect. Slowly bend knees and lower body until thighs are parallel with the floor; keep knees above (n
. Targets Glutes, hamstrings, and trunk, including lower back and abdominal muscles. Cues Lie flat on back, with arms by sides, palms up. Both knees are bent, feet flat on the floor. Using abdominal and gluteal muscles, slowly lift trunk and hips off floor with a smooth, controlled motion. Squeeze buttocks at the top, then slowly lower. Keep pressure on the shoulders, not on the head, and do not push with the hands. If you feel cramping in the h
Single Calf Raise
. argets Ankle stability is critical to proper knee alignment. This move builds calf strength and ankle stability, as well as body coordination and balance. Cues Hold onto a chair or support yourself against a wall, and lift right leg into a hamstring curl (shin parallel to the ground); extend left ankle and lift body on the toes. Slowly lower and repeat 8 to 12 times.Finishing stretch Step forward with right leg, keeping left leg straight and l
. Targets Quadriceps, hip flexors. Cues Lying on side, with hips and shoulders stacked, pull the top foot toward the buttocks with the top hand. If you have trouble, use a towel or T-shirt to extend grip; foot does not have to reach buttocks; pull to the point of feeling a gentle stretch, not pain. Keep knees in alignment, then slowly pull top knee back behind the other knee, while maintaining stacked hip. Hold for 6 to 8 slow, deep breaths. Rep
Modified Hurdlers Stretch
. Targets Hamstrings, gluteal muscles, lower back. Cues While seated, extend one leg straight (do not lock knee) and place bottom of the other foot against that knee. Holding shoulders and hips square and back straight, slowly lower torso toward straight leg. Do not collapse through chest or round the back. Gentle pressure on the bent leg will stretch the inner thigh. Hold for 6 to 8 slow, deep breaths; repeat 2 to 3 times on each side.to keep y
On your bike
. Exercise regularly. Joints, and especially knees, dont like inactivity. Some types of exercise are particularly good for your knees for instance, cycling is better than running but the most important thing is to do something you enjoy, because thats the only way youll stick to any sort of exercise regime. So if running is the thing you love and nothing else will do, go for it. Alongside that, keep your weight under control, because the heavie
Tailor your routines
. If you get the odd twinge or niggle, look at the kind of exercise youre doing and ask yourself some questions. Is this actually the right activity for you? If youre quite sure it is, the first thing you need to check is that youre using the right equipment and doing it at the right pace, because people get more injuries from pushing themselves with the wrong equipment than from anything else. Are you perhaps doing too much
. If youre having knee problems and there isnt an obvious reason like the wrong equipment, give yourself a rest a couple of exercise-free weeks should do it. If that doesnt make any difference, its probably time to start investigating further. And if your knee stays painful or even gets worse, you definitely shouldnt just ignore it and try to run through the pain youll just get yourself into a lot more trouble.
. There are a few warning signs to look out for if your knee swells up, or keeps giving way, or gets stuck and locked in position, think about getting help. There are lots of resources, virtual and real, out there, from physiotherapists to podiatrists.
If you should fall
. Falls, especially falls where you know straightaway that youve twisted your knee, are another potentially alarming scenario. If you can manage to walk home, see if it settles down after a while. If you still cant bear weight on it at all, thats a definite sign that something is wrong and needs attention.
First try non surgical options
. When it comes to treatments, theres a range of different strategies out there. First of all, a lot can be sorted out by using the right exercises to strengthen the parts of the knee that need it so in that case, you need a proper exercise programme. Sometimes people need a bit more a short course of anti-inflammatory medication or injections to settle the wear and tear. Local anaesthetics can help too.
Seek expert opinion
. If the problem is serious, the most important thing is to get a correct diagnosis from a specialist, so that you know exactly what needs treating. The specialist will ask you questions and move your knee. From that they will usually be able to make a diagnosis, although your knee may also need a scan so the specialist can be sure of whats going on. Following this you will get a chance to discuss possible treatments.
Remember you have options
. Even with more serious problems, you always have choices and those choices dont have to involve surgery. Even if you have torn the cartilage in your knee, you may not need an operation the figures show that around one in three to one in two cases recover from damage like that without surgery. The really important thing is to know what the different approaches and options are, so that youre in the best position to choose.
And finally the surgical approach
. If you do reach the stage where you are discussing surgery, the most likely is an arthroscopy, keyhole surgery into the knee. The surgeons can do all kinds of things that way trim torn cartilage, smooth weight-bearing surfaces and even repair torn cartilage. Then there are other forms of reconstructive surgery bigger operations that can reconstruct the ligaments or even replace the whole knee. But these major operations arent without risk and
On your bike again
. Finally, if you do have surgery, youll need to do follow-up. No operation, however brilliantly successful, is going to do the job properly if you dont put the work in afterwards. You should be given exercises to follow, and its absolutely crucial that you do them to get your knee back into shape. There are no quick-fixes here were back to that first point that knees, like all your joints, need regular exercise
No more knee pain
. The number-one secret for happy knees? Stay at a healthy weight. Every extra pound you pack on puts about 4 extra pounds of pressure on your knees when you walk or take the stairs. Women often come in complaining of knee pain, and it turns out it started after they put on just 5 or 10 pounds, says Sara Edwards, MD, an orthopedic surgeon at Northwestern Memorial Hospital in Chicago. Once you shed that excess weight, though, symptoms improve and so
Dont bound up and down stairs
. Unless youre in great shape, this puts serious stress on your kneecaps If you weigh 150 pounds, that can mean as much as 600 pounds going through your knees, says Robert Gotlin, DO, director of orthopedic and sports rehabilitation at Beth Israel Medical Center in New York City. Walk, and hold onto the railing for added support.
Dont stroll on the grass
. If you have osteoarthritis or have ever had a knee injury, choose sidewalks or worn paths instead of grass or cobblestone, which put more strain on your knees and up your risk of tripping.
Work your inner thighs
. Strong hip adductor muscles (a.k.a. inner thigh muscles) are crucial for absorbing stress while you walk, so youre not straining your knee. A simple way to start Try squeezing your knees together whenever youre sitting.
Watch Your Weight
. Research shows that carrying even a little extra weight triples your chances of developing arthritis. Every pound you carry puts an average of five pounds of added stress on your knees when you move, so being just 10 pounds overweight is like having 50 extra pounds of pressure on your joints. Research also has shown, however, that for a woman of average height, losing as little as 11 pounds may cut the risk of osteo-arthritis of the knee by up to
. Motion is lotion for your knees. Strengthening the front and back muscles (quadriceps and hamstrings, respectively) of the thighs can help prevent knee trouble especially in women, who are five to seven times more likely to suffer a torn anterior cruciate ligament (ACL), which is among the most serious knee problems. One way to reduce your risk of such an injury is to practice jumping and landing on a slightly bent knee. Aim to strength-train you
. Always warm up before you exercise, and choose your workouts wisely. Know your limits. Give yourself time to get in shape, and don
Dont Wait Too Long to See a Doctor
. With new technologies like MRI scans and arthroscopy, we can diagnose and treat knee problems quicker, easier, and better, says Dr. Nicholas DiNubile, an orthopedic surgeon and a consultant to the Pennsylvania Ballet and to several pro athletes. Fortunately, many knee patients often need just physical therapy and home exercises to treat their conditions. You won
Find the Right Treatment
. New and improved physical-therapy treatments are making patients pain-free sooner. Low-level laser therapy uses certain wavelengths of light at prescribed frequencies and intensities to help relieve pain and inflammation. Many pro sports teams use the new handheld device InterX, which electrically stimulates the affected area, encouraging faster healing. With pool therapy, water