Archives for posts with tag: knee pain

In Part I of this series, I talked about how poor ankle mobility can cause knee pain, and what to do to fix it. Today, I’m going to talk about the hip and how this complex joint might also be the culprit.  

Here’s today’s self test

1. Take your shoes off and stand in front of a mirror.

2. Squat

3. What does it look like? How does it feel? Does it look like this?

What I want you to pay most attention to is if your knees naturally collapse inward. Without getting to geeky on you, just know that this squat pattern puts a lot of stress on your hips and knees, and could indicate poor hip stability. Even if you don’t squat per se in the gym, this kind of dysfunctional movement pattern can show through even in your walking stride. Chances are you walk. Chances are you also perform some kind of squat in your daily life too.. cough cough …

That’s a lie… Nobody poops but you

Here’s what to do

If you’re part of the general population, you most likely sit for most of the day. This leads to tight hip flexors and weak glutes, which translates to poor hip stability. Here’s a proper progression for you. Always start from the ground up. Master all the “1” exercises before moving on to the “2’s” and “2’s” before the “3’s” etc.

1A. Supine Hip Bridges

Do this with your feet together and your knees pointed slightly outward. This puts your femurs into external rotation and creates a little more glute activation. Really try to use your butt muscles and pinch. If you feel this more in your hamstrings, try a tip I learned from Eric Cressey: Place your hands on your quads. Doing this should activate your quads and shut off your hamstrings.

1B. Side lying clams

When doing clams, make sure to not let your hips open; this should be a small range of motion. The outside of your hips should feel the burn after about 10-15 reps.

1C. Monster walks

Wrap a mini band around your ankles and walk laterally 8 steps each direction. Avoid what I call the ‘weeble wable’: Sticking your leg our first and then moving your upper body. Keep your upper and lower body as one unit.

2A. 10+2 Forward Lunges

Stand with you feet together and your torso tall. If lunging straight forward was 12 oclock you’re going to lunge slightly off to the side at 10 oclock and then 2 oclock. Lunging can put alot of sheer stress on the knees, so if this bothers you, stay away from this one for now. This movement actually works adductors more (the muscles located medially to the knee), which are also vital for knee and hip stability.

2B. Knee Banded Box Squat

Place a mini band around your knees and find a box or a bench. Stand with your feet wide and toes slightly pointed out. Repeat this mantra in your head: “Knees out, butt back, chest tall. Knees out, butt back, chest tall.” It’s as simple as that.  The band around your knees will help reinforce pushing out because you’ll be working against it.

See a video here

3A. TRX Pistol Squat

This is a 1 leg squat variation that requires alot of strength and stability. When doing it with the TRX, just use the handles for balance; try not to pull yourself up with your arms. If you can’t get your butt to your heel (as shown), keep your squat a little more shallow until you build up strength.

3B. The Bowler Squat

The bowler squat is the money move. Here’s a video because pictures don’t give it justice. If you can perform 8 reps without touching your other foot down, you’re awesome. If this is challanging for you, start with 3 reps and build up.

Bulletproof Knees

Like I said in Part 1, the pain you may be experiencing in one part of your body is usually the effect of a dysfunction in another part. Mobile ankles and stabile hips should go a long way for the longevity of your knee health. Obviously, this will not fix everybody’s knee pain. If you have an old injury, like ligament or tendon tear, it may not have healed properly or you may have scar tissue etc. It probably won’t hurt to do some mobility and stretching for your hips as well, but that will be another article for another day 😉

Until next time!

-L

Recently, a client of mine complained that he couldn’t run farther than 3 miles without getting knee pain. He expressed his frustration because he felt he was doing everything right. He stretches and foam rolls daily, as well as strength trains with me weekly.

We ended up finding a simple solution to his problem, and it inspired me to write this blog post so that maybe his answer can be your answer.

Keep it Simple

My grandfather taught me that when faced with a problem, always look at the simplest solutions first. An anti-example: When the TV’s not working and you play with the remote for 10 minutes, call your dad to ask him what to do, then hit it a few times only to discover that it wasn’t plugged in.

The same concept can be used when fixing nagging aches and pains. What a lot of people don’t realize, is that when you get pain somewhere (re: the knees) it’s usually because of an imbalance or compensation of somewhere else (re: the ankles or hips). So in my client’s case, we looked from the ground up starting with his ankles.

I want you to do this is self test:

1. Stand up and find a sturdy chair or short table. Place your right foot on top of the chair.

2. Lean forward to see how far you can get your knee over your toes without lifting your right heel off of the surface.  Here’s what you might see:

If you can’t tell, have a friend look for you or do it in front of a mirror.

Good

Bad

3. If you can get pretty far over your toes, congratulations! you have good mobility; keep it up. If you feel as though your pretty stiff and get a pretty stellar calf stretch when you do this, you have some work to do.

4. Repeat with the left foot

In my clients case, his ankle mobility was lacking, and this ended up being the key to his pain.

Here’s what to do about it:

You’re in luck! I’m about to tell you how to fix your ankle mobility.

1. Foam roll and fascial release.

Start with foam rolling. If you don’t do it already, start doing it. Start with rolling both legs at the same time. If that feels comfortable, cross one ankle over the other to get some more pressure. This should be a “hurt so good” feeling. Play with the angles of your feet to get the inside and outside of your calf muscles too.

That’s not me by the way

The next step is to get even deeper in your achilles tendon. Find a barbell or a dumbbell with a small diameter handle. Have a seat, cross your ankles, and let all hell loose. This is not going to feel good… but I promise it will help.

Neither is that

If you still feel like you have a lot of tightness after doing this exercises consistently for a week or two, see a licensed manual therapist.

2. Active ankle mobility drills

There are a lot to choose from. Here are a few of my favorites, my all time favorite being the knee-to-wall drill, because your improvement is visible and obvious.

Knee-to-wall: Stand facing a wall, putting your right toes up against it. Lean to touch your knee to the wall. This should be fairly easy; repeat 5 times. Inch your toes back and repeat the knee to wall movement another 5 times. Continue to inch back your toes until you can just barely touch the wall WITHOUT lifting your right heel off the floor. Repeat with the left foot. If you want to track your improvement, leave a mark with a piece of tape or chalk, and compare from week 1 to week 3.

Here’s a video of knee to wall ankle mobility

Rocking ankle mobility: Get in a downward dog position. Cross one ankle over the other and lift and lower your heel. Switch and repeat 5x per side.

Calf raises: Place one foot on the edge of a step. Let your heel drop so you get a nice stretch in your calf, then raise your heel and come up on your tippy-toes. Repeat 5x per side.

Side Note

You might feel as though one side is tighter than the other. Take note of this and perform more mobility work on the side that is tighter.

The End of Part I!

I hope you found this information helpful. Give this stuff a try and let me know how it goes. My client emailed me a week after our discovery saying that he ran 6 miles over the weekend completely pain free! Even if you don’t have any pain, this is great for pre-hab. Part II will have some more simple solutions for you to try.

Until next time!

-L