Fixing those achy knees
Welcome back to the Total Performance Newsletter! If you are a new subscriber and did not receive previous editions, let me know and I will send them over right away! This month, we will continue to take a look at some specific movement and injury-related issues that commonly arise and how to deal with them.
Are you someone who has "bad knees?" Maybe you have to wear a brace when playing tennis on the weekends or even to just go for a walk. Or maybe they ache, click and crack whenever you go up and down the stairs. Or maybe you've had someone tell you to avoid squatting because it "puts too much pressure" on your knees. If so, this newsletter is for you.
Knee problems can develop for several reasons, but this newsletter is going to focus on the most common cause for pain that develops over time for no obvious reason. With that being said, it is important to rule out any significant structural damage, such as a torn ligament. A qualified professional can do this.
When knee problems develop over time without an obvious cause, it is often the result of a lack of mobility at the hips and/or at the tibia (shin bone). More specifically, if these two areas lack what is called "internal rotation," the knee is often affected. To summarize briefly, internal rotation is needed at the hip every time you bend down or squat. If the hip lacks this motion, the knee will pick up the extra range of motion in order to help your body compensate. Regarding the tibia, every time the knee bends, the shin bone twists inwards slightly-you can barely see this and we cannot actively control this motion, but it is needed for proper movement to occur. If either or both of these motions are limited, this will place extra stress on the knee joint, and over time, can contribute to achy and painful knees.
In turn, the best way to begin to help achy knees is to improve these ranges of motion and build strength with proper movement mechanics. In turn, this will decrease any compensations your body has to do and therefore, take pressure off the knees. This exercise sequence is a great place to begin this process.
Hinge Squat Breathing; 4-5 sets of 5 breaths per set (video link: https://youtube.com/shorts/AT6ZQTp7PDs)
Cues to remember: goal is to stretch out the glute muscles, which will improve hip internal rotation; hinge back with knees slightly bent until you feel a gentle stretch in your glutes; then, reach your arms out in front of you and squat down just a little to increase the stretch in the glutes; take slow inhales through your nose and slow exhales through your mouth; maintain full foot pressure, with slight emphasis on inner part of foot (base of big toe and inner heel); after 5 breaths, stand up, rest briefly, and repeat for 4-5 sets
Foot on Box Knee Flexion; 3-4 sets of 10-12 reps per set (video link: https://youtube.com/shorts/B27mXMPO5C0)
Cues to remember: goal is to restore tibia (shin bone) internal rotation; knee should travel straight over the front foot-knee cap should travel between big toe and 2nd toe; as you rock forward, use your hands to twist your shin inward while keeping kneecap in alignment-also be sure to maintain full foot pressure, with slight emphasis on inner part of foot (base of big toe and inner heel); as you rock backward, let shin twist back outwards to "neutral"
2 Band TKE; 3-4 sets of 12-15 reps per set (video link: https://youtu.be/I6Hy2poZcjg)
Cues to remember: goal is to work the knee through it's range of motion and utilize the tibia internal rotation that you gained from the previous exercise; put top band just above knee and lower band just below knee; rock as far forward as you can while keeping heel down-kneecap should travel between big toe and 2nd toe; as you rock forward, maintain full foot pressure, with slight emphasis on inner part of foot (base of big toe and inner heel); to straight your knee, push into the ground through these foot contacts; should feel your quad muscle working
Hands Supported Split Squat; 2-3 sets of 8-10 reps per set (video link: https://youtube.com/shorts/ORMApgUHDDE?si=6FGlU3IW8edpIKQl)
Cues to remember: goal is to train your body to utilize the hip and tibia range of motion that you gained from previous exercises and start to build strength so that those ranges of motion can become more permanent; at the bottom, hips and knees should be at about 90 degree angles with a little more weight on the front leg compared to the back leg; on the front foot, maintain full foot pressure, with slight emphasis on inner part of foot (base of big toe and inner heel); to stand up, push into the ground through these foot contacts; as you move up/down, think about moving as vertical as possible (think "move like an elevator, not an escalator); should feel your front leg working
There are several progressions and variations for each of these exercises based on each person's individual capabilities, limitations, and needs, but this general outline is a good place to start. Give this a shot and if you have any questions, need some different variations, or are ready to progress beyond this starting point, feel free to reach out!
Stay tuned for next month’s newsletter, where will we continue to look into some common issues that arise and practical solutions to deal with them! Also, if you have any topics that you want to see covered in a future newsletter, please let me know!
Brett
