Beyond the obvious like falls or impacts, knee pain can stem from a whole host of factors. This post will give you some ideas as to why your knees may be feeling a bit trashed, how your sport could be contributing and what you can do about it right now.
Note: If you’re symptoms are severe it’s best to rule out any significant trauma or degeneration by consulting with a trained therapist.
Even without significant trauma it’s not surprising a knee can get gnarly if you’re active and love playing sport considering:
- All the funky positions knees need to get into or end up in especially in sports like jiu-jitsu
- The dynamic, unpredictable forces going through them heightened in sports like skiing or snowboarding
- a lack of movement variety and repetitive stress in sports like running
That’s without mentioning overuse patterns, remnants of old injuries, overtraining or sitting for hours on end and all the great stuff that does for our bodies. So sport, exercise and training is pretty challenging for strong knees at the best of times.
Now imagine if you’re knees are a bit bunged up, feeling stiff, a bit weak and don’t move so well…
Cue ‘over-pronation patterns’.
A really common contributing factor in knee pain. Over-pronation is where the knee caves in and the foot arch collapses when we land. This overly stresses the medial knee structures. Overtime this can cause nagging aches or acute pain on the inside of the knee or around the kneecap.
Add heavy or dynamic loads and you’re likely heading for tissue damage, more pain and worst case scenario ligament tears. This is why you’ll often hear less experienced trainers or coaches getting a bit overly obsessed with everyone keeping the knees perfectly in line with the toes and heels always down.
Over-pronation patterns stems from many places. For most of us it often comes down to less than good enough mobility (bound up low backs, stiff hips and bunged up ankles) or lack of strength (distended tummies, a lazy butt and sleeping arches).
For example, your glutes are the strongest muscles of the hip as both stabilisers and powerful force generators. They extend, abduct and externally rotate the hip aka everything we need to absorb ground forces and decelerate effectively. So weak glutes, or a nervous system that doesn’t fire them up, equals a real lack of support. Our foot lands and collapses, the shin and femur twist in and the knee has nowhere else to go other than inwards. It tends to also mean overusing your quads and hammies too setting them up for ongoing muscle strains and niggles.
There’s also more complicated, deeper drivers that effect hip stabilisers and stiffness levels. Things like funky stuff going on at the neck or chaotic hormones from high stress levels or poor nutrition. If you are worried about anything like that then working with a good therapist or coach can be invaluable.
Imagine how much you could really enjoy or push on in your sport if you’re knees were pain free and felt properly strong…
At aps we regularly rehab the entire spectrum of knee issues back to complete function and truly playing fully again. From major injuries like torn ACL’s or meniscus damage to more superficial issues like muscle strains, nagging aches and referred pain.
The first part of our coaching is to take individuals through Base Conditioning. It’s a series of contract-relax stretches, self-mobilisations, infant groundwork movements and corrective exercises. This lays the foundations to take the rehab path to its full conclusion – restoring primal patterns, building strength and exploring plyometrcis. This comprehensive process ensures you’re fully prepared for the demands of your sport and minimises chances of any recurring problems.
Here’s a glimpse of some of the key exercises from our series to build strong and solid knees. These are really powerful when done well so you should feel the improvements pretty quick. We’d encourage doing them most days for the best results.
Long Lie Leg Lifting
This exercise is amazing for getting the foot arches awake and involved. Plus strengthening the deeper, smaller stabiliser dominant musculature of the hip and spine (aka the inner unit).
- Lay length ways along a foam roller with the back of your head supported one end and hips the other.
- Cross your arms over your chest and put your feet about hip width apart.
- Trying to stay on the roller and in a straight line (not twisting or falling out to the side) lift one leg putting your weight through the other foot.
- Hold for 5-10 seconds and then switch legs. Work up to alternating sides for 8-12 reps or a total time of 3-4 minutes.
Swiss Ball Hip Extension
This is a great exercise that works the squat pattern, ramps up glute recruitment and adds a touch of extra knee stability in for good measure.
- Sit on a Swiss Ball with feet hip width apart, roll back as you walk your legs forward to the point where your head, shoulders and upper back rest on the ball.
- As you inhale lift your hips by pushing your feet through the floor until your shoulders, hips and knees end in a straight line. Just like a table top. Keep your knees tracking roughly over your feet taking care to not let them cave in.
- Pause in this top position and then as you exhale slowly drop your pelvis back to the floor and repeat.
- You want to create an up down movement not letting yourself roll forwards and backwards on the ball. Imagining two puppet strings lifting your pointy hip bones on the front (ASIS) to the ceiling can help you to feel the movement and encourage glute recruitment. The balls going to move a bit but try to keep your shins vertical with knees over ankles.
- Work up to 12-20 reps at medium tempo and build up to 3 sets. There’s some great ways to progress this exercise by adding weight, mixing up tempos and eventually doing it on one leg.
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If you can’t play your sport right now because knee pain we’d guess you’re super motivated to solve it. A consultation could be a great first step. It’s a chance to tell us about your pain in more depth and it’s free! More importantly you can bounce any questions or thoughts you have helping to put your mind at ease and choose the best way forward.