Wellness & Prevention

Joint health series: Do's and don'ts for exercising with knee pain

This article is the fourth in a 5-part series focusing on bone and joint health, pain prevention and treatments.

The members at Galter LifeCenter are a tight-knit group. They share fitness equipment, time in group classes and lots of encouragement. However, many also share a nagging ailment: knee pain.

Laura Olsen, a personal trainer and certified health-fitness specialist at Galter LifeCenter, explained that knee arthritis is one of the most common conditions experienced by active adults, particularly those age 50 and older, and the pain tends to be moderate and chronic, allowing sufferers to remain active but with a steady level of discomfort. 

For those who choose to exercise through or despite knee pain, or hope to relieve symptoms of chronic joint conditions, Olsen recommends creating a fitness plan that holds your interest, is challenging, and specifically focuses on knee flexibility and strength.

To get started, she refers to her list of “dos” and “don’ts” for knee exercises:

DO

Stay active
Olsen explained that everyone has different interests and strengths when it comes to fitness, so no exercise should be “off-limits.”

That said, some stretches, training programs and cardio activities (described below) may be more helpful and less painful than others if you are concerned about your knees.

Stretch often
Stretching is important to maintain flexibility, loosen and lengthen tight muscles and relieve pain.

Hamstrings: Lie on your back, put a towel under the arch of one foot and use the towel to raise the leg straight up in the air (slight bend to knee) until you feel hamstring stretch. Repeat with the other leg.

Calf: Stand on a stair and let one heel hang down until you feel a calf stretch. switch feet.

Glutes: Lie down on your back and gently pull both knees up toward chest until you feel a stretch in the glutes.
Quads: One popular stretch is to stand and grasp the ankle of one leg and pull up to the buttocks. If your knee can’t tolerate this, instead grasp something in front of you for balance, bring foot back and place on chair behind you. Tighten through glutes and push the hips forward to feel stretch.

Strength train
Strong muscles help carry weight and relieve stress on the knee. When you do strength training, start with squats and straight leg extensions to help the quads stay strong and open up the joint.

Squats: With your back against a wall, slide down, keeping your knees over ankles. Don’t let knees go forward of the  toes. Hold for 10 to 60 seconds.

Straight leg extension: Lie down on back with one leg out straight and one leg bent. Lift straight leg a few inches off the floor and hold up to strengthen the quad.

Later add inner and outer thigh strengthening moves and abdominal exercises to strengthen the core and improve posture. Pilates may also be beneficial, as it strengthens core muscles and increases range of motion with minimal impact.

And remember, the straighter we stand, the better off our joints will be.

Stretch your hips:
Many of the ligaments, tendons and muscles around your knees are influenced by the tissues around your hips.

Hips and low back: Lie down with arms straight out from shoulders, in a t-shape. Bring both knees to chest and rotate hips to one side, keeping the opposite shoulder down. 

Hip flexors: Stand in a long lunge position, then gently push hips forward.

Hips, glutes and hamstrings: If this puts too much pressure on your knees to the point of pain, skip it. Lie on your back with feet flat on the floor hip-width apart and knees bent. Lift your hips and tighten your glutes.

Use a foam roller 
This can relieve tension in the IT band (the thick band that runs from knee to hip). Acupuncture and massage therapy can also help.  

Incorporate cardio into your workout
Aquatic exercise (like water aerobics) is a good alternative if higher-impact cardio like running causes too much discomfort. If your pain increases after exercise, you’re doing too much.

Mix it up
Try new activities to distribute stress over all your joints and muscles, not just your legs. .

DON’T

Overdo it
Never exercise or stretch to the point of pain. This can be tempting with your favorite activities, but it’s important to know your body’s limits, and when your knees have had enough.

Push through an acute injury
If you have an acute injury (a one-time incident like a fall), stop exercising, let the injury heal and consider seeing a doctor before you head back to the gym.

Bounce when you stretch
Ballistic stretching can cause muscles to tighten instead of relax and can overstretch your ligaments and tendons.

Rush in to a new workout
Start new activities gradually. If you hurt the next day, you’ve probably done too much. It’s all about trial and error

Skip rest days
Rest days allow your body to recover and grow stronger. Seven days a week is too much. Five or six is the absolute maximum number of days you should work out. A full week is no longer beneficial, as your body needs to recover.

Skip stretching 
For all the reasons we listed above, stretching is critical to keeping joints loose and comfortable.

Wear wornout shoes
Imbalanced footwear can affect your gait and balance, which can contribute to knee and hip pain. Go to a shoe store where someone can assess your gait to get the best shoes for your workout. You should never have to ‘break in’ shoes; if you put them on and exercise and they hurt, they’re not the right shoes.
 

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