“Bad” knees are common complaint we hear in the gym. When hearing this, our first questions are, “How did you do it?” “Did you have an accident, or did they just start to hurt?” Depending on your answer, it gives us a very different story as to the potential cause, and, a much larger understanding as how we can help. Here’s why, and also two ways to decrease “bad” knees.
An impact injury is something such as a ski accident, car crash or back rugby tackle. This has nothing to do with your day to day movement, you were just unfortunate enough to have this experience. A non-impact injury on the other hand, would be experiencing “bad” knees in movements such as lunges, squats or climbing up or down stairs. This actually indicates that you are not moving as well as you could be, and, it will be something to do with how you transfer movement through your body.
Your “bad” knee (or knees) are not the problem. Pain is a warning sign that something isn’t working as well as it could be. The area of the pain just gives us an idea where your weight or movement is being incorrectly diverted to when you exercise or move in general. Your knee is simply a facilitator of movement between the hip and the ankle, so, if there is stiffness or an issue at either of these points, it is either the knee or lower back that will take the brunt of the force. The pain you are feeling is not the issue, it is simply due to increased pressure, strain or overuse of that area.
Next time you squat, lunge or move, change these two things and see if your knee pain decreases.
Check whether you supinate (roll onto the outside of your feet) when you move. Your foot needs to plantarflex (press down) and pronate (allow the arch of your foot to collapse slightly) in order to facilitate a sequence of muscle activations up the chain through your shin, knee and up to your hips. The foot needs to roll slightly inwards and allow the arch to drop slightly to allow the shin and thigh bone to move in a way that will switch on your VMO (a muscle by your knee) and Glutes (butt muscle) both of which are knee stabilisers. If you roll onto the outside of your foot, and your big toe comes up, you are in effect, switching these off, leaving the knee to take the brunt of the movement. So, think:
Big toe down, press through the inside of the foot, focus all your attention on where you are pressing from, not the exercise. Listen to your feet more.
Do you find whenever you lunge or squat you look like your trying to head-butt someone in front of you? Does your torso shoot forward, and you can’t seem to get your pelvis lower? It is most probable that your ankle has limited dorsiflexion; meaning the angle that you can drive your shin over your foot, whilst your foot is stationary on the floor is minimal. You need dorsiflexion to be able to squat and lunge effectively. If this is you, then use a block to elevate your heels a little in a squat to decrease the amount you are asking your ankle to move in this way. You’ll find squatting an entirely different experience. We have these blocks that our clients can grab if they know they need to elevate their heels.
The take-home from this should be that if you have “bad” knees, the problem may be completely unrelated to your knee, but that you need to alter the way you move to stop the excessive overuse of them.
If you are ‘self-diagnosing’ yourself with a knee injury and avoiding specific movements, our advice…don’t do either, go and see a physiotherapist or osteopath, get a deeper understanding of the situation. If there is a tear or genuine injury then you’ve stopped it from getting worse, if it is simply due to inefficient movement, then you can work from there.