A lot of my personal training clients, myself included have had knee pain at some point and time in their life.
You might remember this nagging pain under the knee cap, maybe off to the side. Some feel it just below the knee or they have problems straightening their leg because the knee feels tight.
The knee is one of the most complex joints in the body. It has many surfaces that glide over each other. It is being held in place by strong ligaments and is stabilized and moved by the muscles of your whole leg. Yep, the whole leg. You might wonder now what your butt or your calf has to do with the knee but we will get to that in a little bit.
First I need to tell you what this article is NOT, it is not a guide how to treat acute or chronic injuries yourself. First of all, I am not a medical professional, second of all, it would go beyond the scope of this blog. What the blog will do though, is get you a little bit better at understanding your body in order to help you discuss your issue with your fitness or health care professional and understand how your training impacts your knee.
The causes for knee injuries differ widely. Some are caused by an acute injury, like you tripping, someone sliding into you during sports, etc. Others come on chronically due to biomechanical factors which could be habitual, genetic, etc. and some are a combination of the above.
Your training might be able to train up your legs, make them stronger and more injury resistant to acute injuries (see above). Now when it comes to biomechanical problems it gets a little bit more complicated. Here the goal is to correct an underlying issue. Depending on its nature that might not be possible. You might have been born with a severe leg length difference, scoliosis, etc. Factors that we as trainers or health care professional might not be able to correct at all or only minimally.
So what can training do for you?
A lot of chronic knee issues come from the joint above or below the actual knee. I always tell my clients the following analogy: “If one of two workers goes on vacation, which one is the most likely to complain about it?” The answer is obvious, the one doing all the work. Especially with chronic knee pain we often see that the hip muscles are not able to do their job for various reasons. The hip joint is not properly stabilized or mobile enough which in turn can lead to problems in knees or back.
Bad Movement – No Pain
When a personal training client comes to us, we perform a comprehensive initial consultation to check out their movement patterns, see if pain exists, etc. Occasionally we find dysfunctional movements that do not cause pain. Oftentimes using proper lateralization/regression exercises, we are capable of activating and correcting those movement patterns and prevent an injury from happening.
Pain with Movement
In case we already have an existing pain pattern, we refer the client out to a health care professional we trust, in order to work in tandem on the problem. Together we create a cohesive team dedicated to our client’s well being.
For a long time therapists were focused solely on the muscles surrounding the affected joint. In case of the knee they would work the quads and hamstrings. One of the favorite machines back in the day was the knee extension. Extensive research and a lot of ruined post-patellar cartilage later this machine finds less and less use.
Since then, things have come a long way. Good physical therapists during the rehab phase, and personal trainers and coaches during the reintegration phase, have started to look at the whole kinetic chain. We have realized that we cannot just look at the muscles surrounding an affected joint. Don’t get me wrong those have to be addressed appropriately, but we have to look at what is happening above and below. good hip stabilization, ankle stabilization and movement patterns very much influence the knees.
What does that mean in regards to your training?
Single leg deadlifts, deadlifts, bridges, chop patterns half kneeling or tall kneeling and so many more exercises can be great tools in your tool box. We have found that when you train a client who has knee pain and stay away from pain causing movements and focus on hip exercises, we often see improvements in their pain and movement patterns, and pain free range of motion.
Despite us not doing any treatment at the hurting location and instead addressing the muscles that were not working properly prior to the injury we were able to help some clients minimize their pain, or eliminate it completely.
So, just because your knee hurts does not mean you cannot train legs. You have to train smarter!
Have an awesome day,