Knee Pain
Knee pain is characterized by pain around or behind the kneecap (patella), or on the inner or outer knee. Symptoms can be triggered by repetitive motions such as running, walking, climbing stairs, squatting, or with static positioning such as kneeling/prolonged sitting. Your knee might also make a popping or grinding sound when bending. In pregnancy, dramatic shifts in posture often leads to more knee hyperextension and adverse changes in weight distribution. In the postpartum women, weakness due to relative inactivity can lead to more joint irritation due to the lack of the muscular support and strength that was there previously.
“Knee pain” is a broad term that encompasses many structures and symptoms and is often is a result of repetitive irritation. Certain alignment issues can predispose you to knee pain. A history of hip abnormalities, foot deformities (including excessively high arches or flat feet), or anatomical variance in where your knee cap likes to sit on your thigh bone can all contribute to increased friction. Knee pain is usually driven by hips or ankles (unless you have had a recent direct blow to the knee). We often like to say that the knee is a “dumb” joint. It is caught between the hip and ankle, and thus can only do what the joints on either side will allow.
Sorting out your hip and ankle issues is often the path to happiness in your knees. For most people with knee pain, fixing hip and ankle issues will lead to the ability to exercise without knee pain.
Weakness in the hips is often a huge contributing factor to knee pain. If your knee pain is being driven from hip weakness, one of the most common patterns you will see is a collapsing of the knee(s) inward and/or forward during movements such as squats, lunges, and stair ascent/descent.
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Some beginning hip strengthening exercises that are especially kind to the knees are:
side lying leg lifts
side lying forward leg lifts
standing at counter kick leg back
If your pain seems to be coming from the front of your knee, or anywhere in/around your knee cap, you are likely dealing some aspect of patellofemoral pain syndrome (PFPS). PFPS is knee pain caused by overuse of the knee joint, specifically the pain-sensitive surface on the backside or your knee cap. Quadriceps (the muscles in the front of the knee) that are overly strong in comparison to their hamstring counterparts (that live in the back of the leg) can cause undo kneecap compression. For a variety of reasons, women tend to be more prone to this condition and thus have more PFPS than our male counterparts.
Strengthening the muscles that live in the back of your leg (hamstrings and glutes) can help a lot:
Romanian dead lifts (RDLs)
Suitcase deadlifts
Lateral walks with band (sit back into your hips, you should not feel any knee pain!)
If your knee pain is caused by ankle problem, most typically you will see a restriction in the ability to flex your ankle. An immediate compensation is to wear your tennis shoes with the highest amount of foam heel that you own, and/or squat with heels elevated. It is of the utmost importance that you get your calves loosened up to free up your ankle mobility. You’ll experience large differences in your overall ability to move and exercise if your calves are strong and mobile:
Standing 3 direction calf stretch
3 direction calf raise
A good tip is to try and think about the muscles you are working. For “glute” exercises—- you need to be feeling them in your butt muscles! If you are having trouble feeling your gluteal muscles activate, please watch our videos as we give ample instructing as to correct technique for all exercises outlined in the guides.
Still struggling with knee pain? Reach out and contact us! We’ll talk you through it!
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