We are continually bombarded about the importance of exercise to improve our appearance, reduce our risk of disease, improve our energy levels, and prolong our life. Yes, we live in a fast-paced society that often cuts into our workout time, but often the reason many of us don’t exercise is knee pain. Let’s look at some numbers.
Over 600,000 knee replacements are performed each year, and researchers estimate that number to increase to 3.48 million by 2030. Next, out of the estimated 100 million Americans experiencing chronic pain, knee pain is reported as being the second-most common complaint. Finally, an estimated one-third of all Americans will suffer knee pain at some point in their lives. Ouch!
One cause of these troubling trends is that we have an aging population. The number of Americans age 65 and older increased from 35 million in the year 2000 to 49.2 million in 2016. However, it’s not a foregone conclusion that if you live long you must suffer knee pain and perhaps undergo the knife.
The good news about knee pain is that there are many practical, self-help preventative measures you can take to help you prevent and resolve knee pain. But let’s start with the following disclaimer: “If you are currently experiencing knee pain, seek the help of the appropriate health care provider.” According to the Mayo Clinic, you should immediately contact your doctor if you experience any of the following symptoms:
Can't bear weight on your knee or feel as if your knee is unstable
Have marked knee swelling
Are unable to extend or flex your knee fully
See an obvious deformity in your leg or knee
Have a fever and redness, pain, and swelling in your knee
Have severe knee pain associated with an injury
From this starting point, here are six steps you can take to deal with knee pain:
1. Maintain a healthy bodyweight. An estimated 40 percent of men and 30 percent of women are overweight, and an estimated 35 percent of men and 37 percent of women are obese. Further, about one-third of youth ages 6-19 are considered overweight or obese. One of the major causes of knee pain is carrying excess bodyweight that places increased stress on the knee joint, so if you fall into the category of overweight or obese, take the necessary steps to reach a normal weight.
2. Get a structural balance assessment. The basic theory of corrective exercise is to stretch muscles that are tight and strengthen those that are weak. A structural balance assessment consists of a series of tests to assess deficiencies in strength and flexibility. One structural balance assessment is a single-leg jump test called the Klatt test, which helps determine weakness in the muscles that stabilize the knee. For example, if the test determines that your hamstrings are weak, a trainer could add leg curls and glute-ham raises to your program.
3. Take care of your feet. Proper knee function begins from the ground up! If your feet do not function properly, you will not be able to maintain optimal knee alignment, which will increase the stress on the knee. One of the most common foot problems that can cause knee pain is fallen arches.
The medical name for fallen arches is valgus feet. Valgus feet cause the lower limbs to internally rotate, increasing the risk of ACL injuries. If your knees buckle inward during the descent of squat, you probably have valgus feet.
Orthotics may help address the issue of fallen arches, but there are also many exercises that may help restore the structural balance of the feet.
Among the best exercises for foot problems are seated calf raises (to work the soleus) and standing calf raises (which work the gastrocnemius). Because these muscles are often tight in those with valgus feet, it’s important to work them through a full range of motion. One other important muscle is the extensor hallucis longus, which is a muscle that lifts your big toe and produces lateral tension on the foot, thus helping to create the foot arch. Performing step-ups in bare feet with your big toe up is one way to strengthen this muscle.
4. Strengthen your VMO. Often knee stability issues can be traced to weakness in a teardrop-shaped muscle on the inside of the lower leg called the vastus medialis oblique (VMO). A weak VMO will impair knee joint stability and thus the ability to stop, move laterally, and change directions. One specific exercise to strengthen the VMO is a single-leg movement called the Petersen step-up. This exercise can be used in the beginning stages of a corrective exercise program. As the VMO becomes stronger, the progression could be to split squats, lunges, and then squats.
5. Strengthen your glutes. The gluteal muscles help stabilize the pelvis as you stand, walk, and run. If these muscles are weak, especially the gluteus medius (which is located under the gluteus maximus), knee alignment can be compromised. One cause of gluteal weakness is excessive sitting. Several commonly-performed exercises that work the glutes are glute-ham raises, reverse hypers, and deadlifts. Also, it’s a good idea to invest in a stand-up desk to reduce the amount of time you spend sitting.
6. Stretch the muscles that surround the knee. Tight muscles can affect the alignment and stability of the knee. In the field of corrective exercise, one of the most popular tests to assess flexibility and muscle balance is the overhead squat. With this test, you grasp a stick with a grip slightly wider than shoulder-width, then squat down as far as possible.
During the overhead squat test, if your knees flare outward excessively (which can cause knee pain), this could suggest tightness in the piriformis (a muscle involved in hip rotation) or weakness in the thigh adductors (muscles that bring the leg towards the mid-line of the body). Using this information, it follows that you need to stretch your piriformis and strengthen your adductors.
Chronic knee pain is becoming increasing common in our modern society. To avoid becoming a negative medical statistic, follow the advice presented here and enjoy the benefits of having healthy knees that enable you to do the activities you enjoy.