No body part is more vulnerable to exercise-related injuries than the knee joint. But exercising regularly doesn’t have to lead to painful knees. In fact, Stanford’s Arthritis Center compared the knee problems of runners and non-exercisers ages 50 years and older over an eight-year period and found that the exercisers experienced 60 percent fewer knee problems than their sedentary counterparts. In another study, researchers at the Boston University Medical School tracked the development of knee arthritis in older adults for nine years and found that exercisers had no greater or lower risk for developing osteoarthritis of the knees. So while exercising may not delay the progression of osteoarthritis of the knees, it doesn’t appear to accelerate it either.
Other Origins of Knee Pain
Like your shoulder and your hip, your knee is a ball-and-socket joint. It is the largest and most complex joint in your body, held together by strong tendons and ligaments which act like stays and pulleys, allowing the joint to twist, bend, push and withstand the stress of hiking, dancing, playing tennis or just climbing stairs.
In addition to osteoarthritis, knee pain is often a symptom of a biomechanical problem or muscular imbalance in another part of the body. Weak quadriceps muscles combined with tight hamstrings can, for example, lead to an improper tracking of the knee and can even pull the knee cap out of its groove. Knee pain can also be caused by excessive foot pronation (when the arch collapses and the foot rolls too far inward) or tightness in the muscles surrounding the hip joints. Worn or improperly fitting athletic and everyday shoes can further exacerbate a knee problem.
Replacing Worn Out Knee Joints
Severe degeneration of the knee joint usually results from osteoarthritis or repetitive knee trauma/injuries. In either situation, the protective cushioning of cartilage wears away resulting in the painful rubbing of bone against bone. Knee replacement surgery is usually a last resort when pain becomes constant and the ability to function normally is impaired. Exercising both before and after surgery is critical: “ pre -habilitating” your knee prior to surgery makes the post-surgery rehabilitation faster and easier. In both cases, aquatic exercise is particularly beneficial in developing the leg muscles without loading the knee joint.
“Tom” came to me three months prior to his scheduled knee replacement. We worked hard in the pool to prepare him for the surgery, specifically focusing on building the strength and increasing the flexibility of his quadriceps and hamstring muscles. Because of the aquatic “prehab” he did prior to surgery, Tom breezed through the knee replacement and was the star of his post-surgery physical therapy class with his very impressive range of motion. For more information on aquatic prehab and rehab, please visit the aquatic therapy/training page on my website at www.bewellcoaching.com.
Strengthen Those Leg Muscles!
Speaking of exercise - “weak in the knees” is more than just an expression. Rehabilitating sore knees and preventing future problems requires strengthening and stretching the muscles and tendons surrounding the knees. When the quadriceps, hamstrings and gastrocnemius muscles are weak and/or tight, the knee joint receives the brunt of the force with weight-bearing exercise or activity. Exercises such as wall or chair squats, seated leg lifts and even stair climbing strengthen the leg muscles so they can provide shock absorption for the knee joint.
Note that knee pain can result from a sudden increase in exercise. Give your knees time to adjust to a new activity level by gradually increasing the duration and intensity of your workouts and by scheduling rest days in between. Also, make sure you have the proper adjustments when using exercise equipment. For example, a bicycle seat that’s positioned too high or low or too far forward or backward puts additional stress on the knee joint. Bottom line: exercising intelligently doesn’t increase your risk for knee problems, but being sedentary does.