Knees, We Need 'Em

Knees. We all have them. Some are in better condition than others. There are a multitude of reasons why knees hurt. ACL injury, meniscus tear or strain, ITBS, bursitis, or something else. The point is you are either in pain or you want to not be in pain. Therefore, you are researching what you can do to protect your knees or help them feel better.

This is an incredible joint with an unbelievable range and amount of motion. Such a burden to be

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taken by a relatively small joint. It’s not that any joint has an abundance of muscles covering it for support or protection.

This complex joint is a hinge joint. It only moves along one plane. Looking at the anatomy of the leg, one can easily see and understand how the muscles of the upper and lower leg attach around the knee. Taking a quick look at the image to the left, you can get a clear picture of how the muscles and tendons are connected around this joint.

Both in front and behind the knee, there are several muscle sections that do overlap the joint. This is a structural feature that imbues the knee with its great lateral strength and flexibility. Conversely, the this joint is also left unprotected to the sides and, after a specific range, to the front. The knee is vulnerable to hyperextension. Many runners, martial artists, and football kickers have experienced the embarrassing and painful event of over-extending one’s knee. Like a minor sprain, hyperextensions are easily recovered from with a little time, ice packs, and ibuprofen.

There are several more injuries that are far more damaging and have far more extensive recovery protocols. The therapies for each of the types of injuries and recovery times are better suited for chapters in medical books than articles. What we will do instead is go over how to keep your knees healthy and strong thereby preventing injuries. Prevention being preferable to recovery.

So long as you and your doctor are both clear on what you are doing, there should be no issue with these exercises. This is not a good time, for us middle-age athlete/weekend warriors, to follow our old coaches’ mantras. We are no longer in position to “play through the pain.” This can be catastrophic, my man. Catastrophic. This is easily more debilitating injuries, early onset of degenerative diseases, or both. According to specialists, knee injuries and surgeries are increasing. That includes repair for over-use and under-use of our knees. So, talk with your doctor and work with said medical professional in putting together your knee care plan. Using this piece will give you a starting point.

Warmup

The beginning is always the best place to start. For exercising the beginning is a warmup. Using a stationary bicycle is a solid choice. If you are coming back from an injury or from a physician’s care, follow your doctor’s recommendation. As a general guide, using the bicycle is a safe choice as it will engage all the musculature that supports your knees. The pumping action is also going to cycle synovial fluid, the lubricant that keeps joints slick and moist, through joints at am increased rate. Incidentally, the practice of tai chi chuan is also known to increase the pumping action through the legs, hips, and spine. In this way, the ancient art of tai chi has been proven to reverse joint and related tissue damage.

Form

One of the major contributors to knee injuries in training that I have seen is alignment. Whether you are doing one of the numerous variations of lunges, doing squats, deadlifts, any keg exercise or movement the alignment of your leg joints is paramount. Even without weight doing lunges on one leg when the joints are misaligned can end in severe knee pain.

I mention lunges as several physical therapists use lunges as part of the rehabilitation process after surgery or severe injury. Common mistakes on the side lunge include:

·         Knee past toes

·         Knee direction not aligning with your foot direction

·         Going too fast through the lunge before establishing solid form

These mistakes on the side lunge are a sure way to injure your knees. Pay close attention to:

·         Starting with your feet at shoulder width

·         Stepping with one leg to the side

·         Lowering your body to the desired depth

·         Keeping your hip joint aligned over your ankle

These guidelines and pointers apply to all variations of the lunge. Proper technique in the squat will also fully strengthen and support all the muscles and tendons surrounding the knees. You can read about the squat here.

Machines have come a long way in the decades since they were first introduced into the world of weight training. For combating imbalance between the quadriceps and hamstrings the leg extension and leg curl machines are fantastic. These two machines come with instructions and are easily used. The one caveat that must be mentioned here is joint and cam alignment.

There is a pivot point on the machine, that is the cam. That cam must be as closely aligned to your knee joint as possible. If this alignment is not kept, over time, there will be an increase in the amount of damage from imbalance in your knees.

Finishing out the balance equation involves the calves. These muscles are among the most frequently used in our body. We use them to balance, stand, and walk. This makes training the calves harder to train. There is an upshot to training the calves. Stretching and training calves can be done on any stair step.

Stretches

The stretches here are common and, I will wager, that you already know what they are. You just need to put foot to butt and do the stretches.

As above, where we discussed muscular balance regarding strength, balance in flexibility is no less important.

Quad Stretch – Stand on one foot, reach back, take hold of the other foot, pull up and back, press against the pull with your thigh gently and you should feel the stretch

Hamstring – feet together with your legs straight (NOTE: Do Not lock your knees, rather keep your knees slightly flexed), bend at the hips, reach for your toes, allow gravity to do most of the work

Hamstring – put your heel up on an elevated support, keep your knee slightly flexed, bend at the hip

Calves – stand with the balls of your feet on the edge of a step or a tall block of wood, lower your heels far enough to feel stretching in your calves

For each of the stretches lean into the stretch and hold it for 10 to 15 seconds. Stretch each muscle or muscle group for three sets of 10 to 15 seconds.

Pain

Anyone who has a history with physical movement and exercise knows that exercise will hurt. Whether it hurts that moment or the next day, exercise is going cause discomfort. What I mean by pain is that sense of something being very not-right. That sensation screaming, “Motrin of any military size is NOT going to cut it this time, pal.” That kind of pain tells us we need to go back to square one … back to the doctor.

You know what your body feels like when it is broken or injured. Listen to that sensation. Our knees support our weight. We need them for all we do. One day, carrying a grandchild up the stairs is going to be of paramount importance. Do not trash that.

Stay strong.

Train smart.