Knee pain makes exercise, and everything else, more challenging! The number of people suffering from knee pain is rapidly rising as the population ages and rates of obesity continue to climb. Being overweight or obese magnifies the force you place on your knee joints and that force is amplified further when you walk or climb stairs. When walking on flat ground, the force on your knees is around 1.5 times your body weight, but when you climb stairs, it rises to 4 times your weight! No wonder osteoarthritis of the knees is so common.
Some people with knee pain retire to the couch, believing that exercise will only worsen their knee discomfort. If you have an acute knee injury, you shouldn’t exercise without getting clearance from your doctor. The same is true if you have severe knee arthritis. However, research shows that staying physically active can help people with arthritis of the knee.
How does exercise help knee arthritis? When you move, it boosts blood flow to the joints. With this blood comes vital nutrients that joints need for health. Plus, movement boosts joint lubrication. Strength training is beneficial because it strengthens the muscles that support the knee joint. Strong quadriceps is the key to giving knee joints the support they need. Plus, hypertrophying the quadriceps helps stabilize the knee joint and absorb shock. In addition, research shows that moderate exercise may reduce joint inflammation due to its anti-inflammatory effects.
Still, it’s important to exercise in a way that doesn’t worsen the pain. It’s counterproductive if you do a workout and end up with painful or stiff knees for days afterward. Keep your body moving but do it safely and with the least amount of pain possible.
Few exercises are as effective at strengthening the quadriceps than squats and strong quads give your knee joint more support. But careless squatting using poor form can worsen knee pain short-term. It’s not that squats themselves are hard on the knees, it’s the way you do them. For example, letting your knees drift too far forward causes unnecessary stress on the knees. You can shift some stress off the knees and transfer it to the hips by doing box squats. Begin by using no weight until you’ve mastered the form.
How do you do a box squat?
· Choose a box height of around 13 to 14 inches.
· Stand in front of the box with your feet a bit wider than hip-width apart
· Turn your toes slightly outward.
· Sit back into the squat as you push your knees outward and descend
· Descend until your buttocks just barely touch the box.
· Come back up to the starting position.
Since shearing forces on the knees is greatest at parallel with a squat, you can substitute partial squats for full squats. There are some benefits to doing partial squats, irrespective of whether you have knee pain. Full squats hit the quadriceps harder than the hamstring, but with partial squats, the force exerted on the quads in the front of the thighs and the hamstrings, the muscles in the back of the thighs, is more evenly distributed. In fact, the biceps femoris, a hamstring muscle and the gluteus maximus, the largest glute muscle, are activated more with partial squats than full squats.
You can also reduce the stress on your knees by alternating doing walls squats. This isometric move removes much of the force on the knees, making it a knee-friendly exercise.
Lunges, too, can be hard on your knees, especially if you use bad form. If you have knee pain, one approach is to reduce the depth of your descent. In other words, do a more shallow lunge. Also, use a shorter stride length by not stepping out as far when you lunge. Another option is to do backward lunges where you extend your leg behind you. This variation places less stress on the knee joints.
Dynamic exercises that get your heart rate up are, for your cardiovascular system but, depending upon the type, high-impact movement places a lot of stress on the knees. Avoid high-impact exercises like running and jumping if you have significant knee arthritis. The types of cardio most physical therapists and sports medicine doctors recommend to patients with arthritis is swimming or biking since they’re lower impact.
Low impact doesn’t have to mean low intensity. For example, a spin class is high intensity but places less stress on the knees than running. If you cycle, pick up the intensity to a near all-out effort for short intervals to boost your heart rate even more. You can even modify high-intensity, high-impact moves like jump squats when doing interval training. For example, rather than do a jump squat where your feet leave the ground, lift up off the balls of your feet explosively where you would normally jump but don’t let your feet leave the ground. The key is the effort you put into the movement.
The Bottom Line
A low-impact exercise that uses good form is good for your knees, even if you have knee arthritis. But check with your physician before tackling these moves. Be sure to do a dynamic warm-up before and stretch afterward. It’s important for everyone, but especially important if you have a history of knee pain. Vary your workouts as much as possible so that you aren’t repeatedly stressing the same joints in the same manner.
Also, listen to your body. If a move hurts, don’t do it. If your knees ache the next day, modify your workout. It helps to keep a training journal and record your degree of discomfort during and after a workout and the next day. You can refer back to the exercises you did and see if certain ones exacerbated your symptoms.
· Science Daily. “Exercise helps prevent cartilage damage caused by arthritis.”
· “Training Clients with Arthritis” Johndavid Maes, M.S. and Len Kravitz, Ph.D.
· NASM.org. “Research in Review: Full or Partial Back Squat – Which Activates the Muscles More?”