How to Prevent Knee Pain

Get stronger quads, for one

Let’s talk KNEES.

Every Joint and muscle on your body is “use it or lose it” in regards to function

The human body is evolved to move. There is no joint or muscle on your body that is weirdly meant to stop working as you age. The idea that aging is a process of automatic degradation is one of the most limiting beliefs common amongst the general public. While it is true that your muscle mass and strength will not be the same at 70 as it was at 30, it is also true that you can maintain mobility in all your joints, maintain muscle mass, and still be functional well into your later years.

With that prefaced, lets examine the knee joint.

The knee is a rotational hinge joint. In simple terms, your knees are able to bend. The muscles responsible for this bending are the quadriceps and the hamstrings.

If you practice “knee bending” throughout your life, and maintain strong quadriceps (especially quadriceps) and hamstrings, you will not lose the ability to knee bend, barring a serious injury.

And unless you suffer a catastrophic injury, you can still rehab your knees and restore functionality. There is ample clinical evidence that function can be restored through intelligent rehab and exercise programming.

There 2 Reasons People Experience Knee Pain

The first is you spent years doing immense amounts of knee bending, possibly very heavy, or repetitive, and you have worn out the cartilage in your knees. Or you experienced multiple injuries, and rehab wasnt sufficient. If this is your situation, I understand your pain. Overuse injuries are real. If you need a knee replacement (or two), get one.

The second reason is the opposite situation though

As we age, it’s common for recovery from exercise to slow. Its also common to experience “non specific” pain. Your knees might ache, but you cannot pinpoint exactly what made them ache, aside from possibly too much exercise.

For many people, their attitude towards pain is AVOIDANCE. As soon as a joint starts to hurt, they avoid using it.

While this attitude may seem logical, and indeed, most medical professionals will advise “rest, dont use it” for any kind of orthopedic issue, the reality is that this practice and position is NOT supported by either anecdotal or clinical evidence.

A joint that hurts will began to LOSE function when it’s not being moved. It won’t regain function.

For anyone that has ever experienced ACL surgery (or knee replacement), the most important priority in the rehab process is to restore KNEE BEND as soon as possible.

This process is painful and uncomfortable, but if you neglect this, your knee will become permanently dysfunctional and unable to bend.

Unfortunately, this fact is not applied outside of the Physical therapy world.

If your knees hurt, rather than “rest” them and avoid using them, what you need to be doing is intelligently adjusting your training to STILL train your knees and muscles, but do so in a non-aggravating function.

Managing Knee Pain is about managing the Load on the Knees, not removing it entirely

• If certain exercises bother your knees, try LIGHTENING the weight first. If they still bother your knee, modify the exercise (a reverse lunge in place of a forward lunge)

• Reduce LOAD first, then change exercises as necessary

• If heavy back squats bother your knees, try single leg squats

• If running outside bothers your knees, switch to a treadmill

• If running seems to be out, use an exercise bike

• If you think you are exercising too much, reduce your volume of exercise, don’t stop completely

• If you think you are lifting too heavy, start with pre-exhausting the quads, and reduce the weight on heavy squats and leg press

• If your knee pain is persistent, try ISOMETRIC exercises and assess if your pain improves

• If compound movements are aggravating, trying using only isolation exercise for a few weeks or months (leg extensions, leg curls, and single leg press)

This is not an exhaustive list by any means. The principle is the same; reduce load, adjust and modify exercises, do not stop training completely.

The best way to insure Knee Pain never happens is to get your knees as Strong as Possible

This means developing the thigh muscles, notably the hamstrings and quadriceps. The glutes as well, but they are not acting directly on the knee.

There are 4 exercises that I consider critical for knee health, and can be performed by any level of trainee. Be advised this is based on my professional and anecdotal experience, and contextual to clinical studies.

1. Leg Extensions

2. Leg Curls

3. Bulgarian Split Squats

4. Hindu squats

If you progressively and intelligently train those four exercises over the course of your life, building as much muscle and strength and endurance as possible, I believe your probability of experiencing knee pain will be as close to zero as possible.