Developing Knee Health and Ability
The knee can often have a wide range of diagnosable issues. The best way to address the knee is not by labeling a particular injury but instead addressing function and ability. What can your knee do? What can it not do? What hurts?
Ultimately, healing an injury is about knowing what and how to challenge a knee enough to adapt it and improve performance, without overreaching into a place of reinjury or accidently magnifying imbalances.
There are two areas to assess when determining the course of training.
Alignment. The knee functions as a hinge joint primarily. While it does have minor rotational mobility, ultimately the better lined up the less strain is placed on the joint mechanics. Creating the correct alignment for your knee requires proper foot mechanics and proper hip mechanics.
Internal rotation is a frequent misalignment in the hip. The upper leg is internally rotated due to poor abduction mobility. This can contribute to anterior, medial knee pain. This is often due to tight weak adductors or underactive abductors. This often causes an inward movement of the knees during.
Tight IT bands may cause an issue at the knee for similar reasons, pulling on the lateral section of the knee cap.
Tight and inflexible hamstrings can also place strain on the back of the knee contributing to posterior knee pain.
And these are all above the knee.
Below the knee inflexibility in the ankle can cause strain at the knee as well. Stability at the foot, mobility at the ankle, all help to hold the lower section of the knee stable and aligned.
Regardless of the issue, mobility at the hip and stability in the lower leg are a phenomenal place to start for aligned knees.
4 basic mobility and stability movements for the knees:
Quad, hip flexor stretches.
An inflexible quad and hip flexor can cause strain on the knees especially in a deep bend.
2. Elevated pigeon stretch.
Improves abduction, stretches the IT band origin.
3. Bent leg calf stretch.
Improves ankle dorsi flection, essential for full range squats.
4. Clamshells or monster walks.
Helps provide stability to the glute, abductor complex. This is essential to preventing shear forces at the knee due to excessive valgus knee movement (knees caving internally).
2. Load Tolerance. Knees are adaptable tissue and chances are that if you have sat most of your life or have in some way suffered from modern life hampering your movement, your knee joint has almost no load adaptation, why would it?
Patellar tendonitis (jumper’s knee) and hamstring strains are common indications of a lack of knee durability. The solution to this issue is always to regress the knee movement to a pain free level and slowly build knee ability.
Understanding the different positions of the knee and how to challenge those areas is often when a trainer or in a more acute situation a physical therapist can provide massive value to recovery.
General mobility will always help reduce damaging strain and ensure that the stimulus causes a beneficial adaptation.
Recently training knee durability has become much more popular, resulting in many success stories for long term pain.
4 basic knee strengthening exercises that can help create resilient knees
1. The reverse walk, sled.
One movement that undoubtedly has a history of helping knee health is the reverse sled pull, or in acute pain cases, just walking backwards. This easy reverse movement places a safe load on the front of the knee joint supporting adaptation.
2. The hamstring curl, Nordic curl.
Likewise, loaded knee flexion like a hamstring curl or a Nordic curl can help create adaptation at the back on the knee. Another variation could be a hamstring bridge.
3. Deep knee bend.
The ATG split squat or the ATG squat can both provide a full knee bend. Bending the knee fully is essential to help provide blood flow to the knee mechanics. This full bend is also a great way to build durability in the joint.
4. Poliquin step-down.
Like the reverse sled, this exercise helps to target the quad muscles and the front of the knee joint. If progressively loaded, never through pain, this exercise can be a game changer for everyday knee issues, like descending a hill or stairs.
Knee pain can seem like a life sentence to many people, and if not addressed can be a chronic issue. The good news is that knee issues are almost always improvable, like everything in the body our physical actions and habits can trigger improvements, adaptations, and healing.
If you want help understanding where to start and how to incorporate, program, and execute these exercises and many more, you can schedule an online or in person free consultation to address your specific issues.
Stay resilient!
Chris P
