Summary

If your knees are giving you jip don’t ignore the issue – get a diagnosis so that you know what to eat and how to look after the joint better.  Common treatment for all types of knee pain are:

  1. Below the knee; work on foot pronation which is putting unnecessary torque on your knee
  2. Above the knee: strengthen the quads and Gluteus Medius in particular and Release Piriformis and Glutes to ensure a stabilised hip joint which is causing the knees to be pulled out of alignment
  3. Lose weight!  1lb extra on your tum is 3lb extra pressure on your joint!

The Relationship of Weak Leg & Butt Muscles and or Pronated Feet with Knee Pain

You know they say now that sitting is the new smoking.  Well if you have a painful and possibly swollen knee joint (or joints) with a restricted range of movement you will know that those achy knees agree with the statement.  Sitting has caused your glutes to go to sleep and with them off the job, your knees are taking the rap. Issues with the knees needs to be tackled from both above and below the joint.  The knee is a hinge joint and although there is a small amount of rotation when the knee is bent ONLY, the key principles for having healthy knees are facilitating the joint being able to take weight, only when the above and below bones are aligned correctly, ie in a straight line, which allows a hinge joint to do it’s job efficiently.  We will see below how malalignment puts pressure on the knee and causes the pain and swelling of the joint.

What Affects Bottom Half of the Knee Joint?

FLAT FEET DRAG THE LEG BONE INWARD PUTTING TOURQUE ON THE KNEES

A quarter of the population have pronated feet (arches collapsed).  Unless we are working our feet hard in Yoga classes and wearing barefoot shoes the rest of the time, including during exercise, the problem is inevitable in our shod culture where the feet go to sleep inside shoes that are more or less an anaesthetic for the soles.  ESPECIALLY IF YOU WEAR INSOLES TO PROP UP YOUR ARCH which is making the foot lazy as it rests on the prop instead of developing muscles to pull the arch into position naturally (it’s easy to do this consciously once you know how).

The collapsed arch leads to an inward twist in the tibia which is causing a structural issue since the knee is being forced to turn in also.  The muscles outside of the lower leg then get adaptively tight. Ideally feet knees and ankles should operate in a straight line.  In this situation the line is far from straight as all the body weight is being driven down and inwards.  Although correcting pronated feet is the subject for another lesson, it’s important to note here just how much of a contribution it is on inwardly pointed knees / knock knees / knee valgus.  However, rather than stuff your shoes with arch supports and weakening the foot arch further, do the following two things. 1. Increase the strength of your arch and mobilise the ankle as per the video below and 2.  Use a calf support such as this one when exercising and you will be amazed at the effect on the Knee joint.  I am living proof of this as I use these for DanceFit and Running.   It’s certainly worth such a small investment to find out.

You can use the following video which demonstrates a pandiculation technique in order to increase the range of movement of the foot (by release of the inner and outer calf muscles) that is needed in order to be able to lift you own foot arch:

What Affects Top Half of the Knee Joint?

STRUCTURE OF HIP TO KNEE IS WORSE FOR WOMEN

Women have larger hips than their male counterparts for child bearing reasons.  Good for the kids.  But not so good for the knees which knock inward more easily.  We call this knee valgus which is not only a problem for this worn out joint by the time you get to 50’s and beyond, but it has knock on effects further down too.  From a structural point of view, we all loose elasticity in the connective tissue as we age and if we have arthritis we may end up with little or no cushioning in the joint.  One easy corrective thing you can do is to swing your legs whilst sitting on a table, preferably with weights on your ankles and this will create a gap in the joint using gravity.

WEAK QUADS RECRUIT ADDUCTORS AND PULL ON KNEES

Weak quads will require extra help from muscles that pull on the knees also to get you standing upright when getting up off your couch (without using your hands).  If you go to the doctor at a certain aids you will likely be given an exercise sheet to strengthen your quads as this is a very common cause of anterior knee pain in older adults.  Exercising in one of our jolly Dance Fitness classes designed to protect older joints would help enormously if you are local (we are on YouTube and Vimeo also for free).  In a deep squat position, particularly under load and with hip width apart feet, if the quads should do the job of pushing you up from that position to knees straight in standing.  If the front of the thigh’s are weak, the next best thing is to recruit the inner thigh muscles (adductors).  If the legs are wider, it’s even easier to recruit the adductors.  These attach to the inside of your knees and pull them inwards on the upward descent.  If you are performing a squat, do so only to the point where the adductors would start to pull the knees in and only progress once the quads are strong enough to push you up to standing without the knees caving in.

WEAK HIP STABILISERS

A common cause for Patella Tendonitis is that the Gluteus Medius has shut down and the poor old knees, never off duty, have to take over the job.  The primary function of the smaller of the two butt muscles (Gluteus Medius) is hip stabilisation and facilitating your leg to lift away from your body (abduction – like abducting a child only not as nasty).  It can become weak or tight and if it’s tight, you will almost definitely have low back pain as well as poorly knees.  If you are hyperlordotic (a big back bend in your lower spine) then you’ll have a weak gluteus medius as well as a tight Psoas.

To strengthen the glutei, here is our version of the Clamshell which I’m calling Flutter Wings.  The key thing is to keep your top foot internally rotated so that the movement is felt in the correct place, the Gluteus Medius.  To keep it in place, a strap can be used as in this hairy trousered video:

 

The following videos will show you how to release tight Gluteus Medius and Piriformis.

What about the joint itself?

LOSE WEIGHT!

It makes sense to avoid too much friction on the hinge joints of the knees to avoid more wear and tear on the joint.  if your joint has cartiledge that is degenerated, all the above exercises will help to avoid unnecessary tourque on your joints but what about the joint itself?  It’s important to get an accurate diagnosis and not just ignore knee pain.  The type of arthritis you have will involve a change in your diet but it will be a different change depending on the type.  Pseudo gout for instance is a common cause of knee pain, you can also have reactive arthritis, Rheumatoid arthritis as well as the more common Osteoarthritis which I have talked about in my blog here:How to look after your knees for the long haul. Here is a link to more fully explain the types of knee arthritis you may have.

What is common to all is that extra weight on the joint will have a devastating effect on the joint so one of the most powerful things you can do to make your knees a LOT healthier.  According to this article:

Experts estimate that for every 1 pound you weigh, your knees feel the force of 3 pounds of pressure when you take a step.34

1 lb bodyweight = 3 lb of pressure on a knee/step

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