Oh My Aching Knees!
As you get older, the slow march of time takes its toll. There’s no getting around it. Your body works hard all day every day. When you’re young, you work, you play, you exercise, you relax—for the most part, you go through life without thinking about your knees. But a lifetime of walking, sitting, standing, running, and jumping has a cumulative effect, and your joints—knees in particular—are often the canary in the coal mine. They start complaining before anything else. The constant weight of your body, combined with the effect of gravity, slowly breaks down the cartilage between your femur (thigh bone) and your tibia (shin bone). This means there’s less padding between to cushion the impact if simple, daily activity. In addition, the bursa—a fluid filled sack that serves as an additional shock absorber—can become impinged, which may lead to inflammation, and in some cases, pain.
This is why, as the years go by, every step you take might seem harder and harder. This is why your knees might creak and pop when you wake up in the morning, and sing you unhappy songs when you walk up and down stairs you used to skip up and down enthusiastically. However, as inevitable as knee pain may seem, due to the wear and tear of time, it’s actually completely avoidable. Like any injury or pain caused by repetitive use, there’s a way to keep it from happening if it hasn’t happened yet, and even better, there’s a way to fix it if the aching has already set in.
Three Keys to Healthy Knees
The following three factors form the fundamental components of a practical knee health check list:
- Movement: Consult an exercise physiologist, professional trainer, or kinesiologist to assess your movement. An expert can determine if your habitual movement patterns are healthy or if they’re causing you pain or might lead to pain in the future. If you have experience, you can also assess your movement yourself.
- Mobility: The same professional (or you) can determine if you have a healthy range of motion in your knees. Chronically tight thigh muscles, hip muscles, and calves can all lead to decreased mobility, and eventually—if unaddressed—to knee pain.
- Strength: The health and stability of the muscles both above and below your knees is essential to keeping them pain free as you age. These muscle groups need to be strong to ensure efficient movement patterns (1). They also need to be supple and open to ensure adequate mobility (2).
This checklist is amazing, because it works forward and backward in time. No, we’re not talking about breaking the laws of physics. What we mean is this: if your movement is fine, your mobility is good, and the muscles surrounding your knee joint are strong, you can implement a movement, mobility, and strength plan to make sure they stay that way as you move toward the future. If your knees are already hurting, you can use this trio to remediate your movement, mobility, and strength issues to turn back the clock. You can go back in time and return your knees to a state of health and sustainability.
How to Avoid Aching Knees
Focus on healthy, efficient positions and movement patterns in your daily usage. As you go through your day, pay close attention to how your knees operate. You’re going for an alignment relationship between your hips, knees, and feet known as neutral. You want to keep a straight line from your hips, through your knees, through your ankle, and out through your second toe. This means the feet should point straight ahead while you’re moving—not out or in—and your knees should also stay in a straight line: they shouldn’t move in or out in relationship to your hips and ankles. People who’ve taken dance will recognize these alignments as parallel and people who’ve taken yoga will recognize them from all the beginning standing poses, especially Tadasana.
At home, analyze your own movement habits: when you stand up from your chair, do your knees dive in? When you walk, are your feet turned out? Any misalignments compromise the health of your knees. These distinctions may seem small, but remember the effect is cumulative: we’re talking thousands of steps per day, even for people who aren’t incredibly active—on average, a forty year-old human has already taken well over 50 million steps. With that in mind, train your feet to remain neutral and parallel when you walk and keep your knees properly aligned when you stand up from a chair, walk up a flight of stairs, or lift anything heavy.
Often times the muscles above or below the knees wreak havoc on the joints themselves. If your quads (thigh muscles) are chronically tight, your knees pay the price. If your calves are all knotted up, then your knees will likewise suffer. To maintain a good range of motion, it’s crucial to keep both muscle groups long and supple. Yoga poses geared toward lengthening and opening the calves, thighs, and hips work wonders. Also, using a foam roller to smooth out the kinks in your leg muscles makes a huge difference. If you use a foam roller, make sure to roll out not only your calves and the front of your thighs, but also the outer and inner thighs as well. And if you’re courageous, use it on those glutes, too: trust us—it’s worth the short-term discomfort.
Leg strength is a prime predictor of both short term knee health and how long your knees will stay pain-free. Functional strength movements such as squats, step-ups, and single leg deadlifts are crucial exercises to include in your long-term knee health plan. Think of your body as a building: it requires a strong foundation to keep it standing firm over time. A strategic approach to leg strength, employed consistently over time, is absolutely essential for keeping your knees pain-free as you age. Training the legs with functional exercises is like shoring up the concrete pillars of your building and then reinforcing them with rebar: you can’t go wrong.
If Your Knees Are Already Aching
Cut out high impact activities such as jumping and running. If you love playing pick-up basketball, we’re sincerely sorry, but it’s time to find something easier on those knees. If you’re a long distance road runner, we’re equally sorry, but you need to think long term. Is the runner’s high worth living the rest of your life with pain? If you already have achy knees, high-impact activities like these are guaranteed to make things worse. Consider non-weight bearing activities such as cycling and swimming. Weight bearing movement such as walking is acceptable, but if your knees are aching, you must be hyper-conscious of your usage. Check your patterns: if you’re not walking neutral and parallel, now is the time to change. Years of poor mechanics are most likely what led to your knee pain, so if you want to move forward in a healthy and sustainable way, your job is to identify the exact movements behind the pain and take action to change them.
Everyone should know and perfect one or two individualized mobility techniques to address specific range of motion issues and/or the aches and pains unique to their own body, movement idiosyncrasies, and health history. If you’ve had a knee replacement or a knee surgery, or if you experience persistent knee pain, a great way to free up the joint and restore mobility is to utilize the knee 360 technique. This involves using a yoga tune up ball to massage and loosen the fascia and soft tissue above your knee joint. Spending 2 to 3 minutes per knee every day will make all the difference in the world.
The key here lies in the first two steps: unless you screen your movement and mobility habits first, any strength exercises you implement have a strong chance of backfiring and making your knee pain worse than it already is. Once you identify and apply steps to remediate any movement and mobility issues, you can then start your strength training protocol—but it will have to be very precise. Avoid doing lunges or split stance exercises at first; your body may not be ready for these quite yet. You can save them after your movement and mobility improve. Your best bet is to work with a knowledgeable fitness professional and learn the right corrective exercises under controlled conditions. Balance training and deadlift patterning (picking something up from the ground) are two beginning exercise modes a qualified trainer might prescribe to get your leg muscles strong enough to support your knees.
You Have The Power
The good news is that whether you have achy knees or just want to prevent knee pain, you’re in complete control of the situation. Get screened by a professional—or screen yourself—and carefully apply changes to your movement, mobility, and strength training. Understand that everyone is different, and your plan needs to be specific to your physical history and personal needs. If you’re unable to get formally screened by a professional, put out the word to your friends, family, and your social network. Be judicious in the advice you take, of course, but the chances are there’s a qualified person in your sphere who’s willing to give you their time and help you get on track. As always, use your instinct and apply your innate common sense. Don’t overdo it. If you keep your exercises simple and do them consistently, your knees will thank you in the years to come.
Jeff Ford is the Fitness Director at Skyterra Wellness Retreat. A lifelong athlete and a wellness industry veteran, he believes that there are two essentials for every fitness routine: proper form and personal enjoyment.