As a trainer, I have worked with over 100 clients. Out of all the aches and pains that I have seen, knee pain/injuries are by far the most commonly encountered orthopedic problem with my clients. Knee problems are the most problematic and widespread out of all the joint problems. When treating knee problems, one should not examine the isolated knee joint; rather, you should examine all the muscles surrounding the knee itself as well as the ankle and hip.
There are two types of knee injuries – traumatic and chronic. A traumatic knee injury is caused by an accident or wreck. These injuries need to be diagnosed and treated by a physician or medical professional. Most of my clients have chronic knee pain, meaning they occur over time through wear and tear of the knee joint. Chronic knee pain is best described as a pain or annoyance that shows up one day and progressively gets worse through time especially during certain movements where you bend the knee. This type of knee pain should be addressed immediately, if not, you greatly increase your chance of seriously injuring your knee and taking significant time off.
First off, I should note that the best way to prevent any knee pain or knee injury is to take preventative measures. Injury prevention, also known as “pre-hab” is essentially the same as rehab strategies – stretching, decreasing muscle tone, and using proper recruitment patterns when moving. Knee pain or injuries are usually caused by poor tracking of the knee cap. Muscle length, tone, and recruitment are three factors that contribute to poor tracking of the knee cap and thus, the three areas that need to be addressed in any knee recovery plan.
Muscle Length – The most common muscles that need to be stretched/lengthened are the ones that cross the knee joint – the quadriceps and gastrocnemius. The psoas major is a hip flexor muscle that also contributes to knee pain and should be stretched. Shortened or tight muscles pull on the knee cap and affect how it tracks over the knee joint. Here are three simple stretches that you can do to effectively alleviate not only knee pain but low back pain as well.
Standing Quad Stretch – Stand and touch wall or stationary object for balance. Grasp top ankle or forefoot behind. Pull ankle or forefoot to rear end. Straighten hip by moving knee backward. Hold stretch. Repeat with opposite side.
Wall Calf Stretch – Place both hands on wall with arms extended. Lean against wall with one leg bent forward and other leg extended back with knee straight and foot positioned directly forward.
Increased muscle “tone” or tension can contribute greatly to the kneecap from properly tracking. Too much muscle tone can also prevent the muscle form optimally contracting and in some cases, may lead to muscle spasms. Increased muscle tone is also related to muscle tightness. Massage is the best way to decrease muscle tension, however, not everyone may have the monetary means to afford a massage session all the time. Therefore, the best way to resolve this issue is to perform self massage or self-myofascial release (SMR). SMR and trigger point therapy are very popular self-treatments to prevent and rehabilitate knee injuries. A trigger point is an area in the muscle with localized tension.
Fitness Town offers plenty of products that can be used effectively for SMR and trigger point therapy. A good quality foam roller is a good place to start when performing SMR. Rolling out the quadriceps, calves, and IT band can help greatly reduce tension in the muscles. The stick is another product that you can use with your hands and is easy to maneuver. It is also useful for rolling muscles that are hard to reach with a foam roller like the neck and shoulder area. There are different kinds of the stick that vary in flexibility and length. The longer and stiffer sticks are better for bigger muscle groups, and the smaller, more flexible sticks are better for smaller muscle groups. Lastly, Trigger Point has a great line of products from massage balls, rollers, and kits that can help you get rid of stubborn muscle knots and trigger points
Motor recruitment patterns are critical in order to keep the knee tracking properly during exercises that involve the knee joint. For example, when performing the squat, it is essential to keep the knees tracking right over the toes, and preventing the knees from rolling too much inside or outside (lateral) of the toes. Not only do you have to execute the movement with proper from, you should also ensure that the right muscles are being recruited for the exercise.
Control drills are exercises that isolate a muscle that will be used for a larger movement pattern. A common problem of people with knee pain is that their glutes aren’t firing properly causing other muscles like the quadriceps to compensate for the action. By performing a simple exercise, you can “wake up” a muscle to ensure proper recruitment during lower body exercises. A great control drill for the glutes is the lying hip extension also known as the “hip bridge.”
Lying Hip Extension
Lie on floor or mat. Place one leg straight and bend the other leg with foot flat on floor or mat. Place arms down on mat to each side of hips. Raise body by extended hip of bent leg, keeping extended leg and hip straight. Return to original position lowering body with extended leg and hip straight. Repeat and continue with opposite sides.
A certified personal trainer and crossfit coach with more than four years of experience, Patrick Vuong has helped countless athletes, elderly, and everyday folk improve their lives through better movement, nutrition, and body re-composition. A kinesiology graduate of UBC, Patrick continues to educate himself daily through the top health care professionals the industry and promote the benefits of regular exercise. He currently is the Assistant Manager at Fitness Town Burnaby.