Common Mistakes That Cause Knee Pain

 

In basic terms, exercise is simply movement that places physical stress on our body, in a good way, that provides a positive outcome when completed. Unlike cars, we are thermodynamic engines that actually improve after stress and challenge. The not-so attractive side of exercise though, is that sometimes all of this rigorous movement, frequent and over a long time, can create aches and pains in certain areas. Pain is a signal, and much like cars in this regard, eventually we can’t ignore the dummy light on the dashboard.

 

One common area that avid exercisers feel discomfort in, is the knee region. Not shocking, as this joint experiences a hinging motion with any leg exercise.  Every time you’ve ever squatted, lunged, jumped, pedaled, crawled or swam, the knee gets attention. Most times it receives lots of love and cooperation from the it’s teammates above and below, the hip and ankle, respectively. Yet other times it becomes the victim or “monkey in the middle” of those other regions, and the result can be pain or dysfunction. To discuss why knee pain happens, let’s discuss its anatomy.

 

The knee can be easily divided into two main sections:

 

The Tibio-femoral joint: Our classic idea of the knee, where the knee simply hinges. It is encapsulated by tissue, and inside of it are ligaments and cartilage (meniscus)

 

The Patello-femoral joint: Where the knee cap, or patella, glides along the grooves of your thigh bone, the femur.

 

Sometimes people complain of discomfort “inside” their knee, while others feel irritation around their knee cap. These types of symptoms are actually very helpful in distinguishing the type of tissue involved, or even perhaps the origins of how we created the pain itself. A high percentage of knee pain during exercise comes from one of two reasons:

 

1) Collapsing too far inward or outward during load and movement

2) Knee cap translating forward too far beyond the toe line during load and movement

 

Earlier in this article, we mentioned the variety of movements the knee experiences, and it’s important to understand that it’s how we do these exercises that is the deciding factor in creating pain or not. Let’s use two of those sample movements and talk about their do’s and dont’s in order to prevent pain.

 

Squatting

It’s hard to go one day in life without squatting, from sitting on a chair, sofa, car seat etc, to jumping/landing in sports. It’s simply intensified within a fitness environment. Where in daily life squatting generally involves only our bodyweight, in the gym we apply extra load to that same movement. Now although we could write an entirely other article on the complexities of squat technique, the short of it is that if those other lower body joints, the hip and ankle don’t do their job, then we are prone to allowing our knees to buckle inward or slide outward during squat movements. When this happens, those tissue structures inside your knees, such as your meniscus and supporting ligaments, become compromised. You then have that “pain inside the knee” feeling.

 

Lunging

There are an infinite varieties of lunges that we can attempt within the fitness universe: Reverse Lunges, Curtsey Lunges, walking, stationary; the list goes on and on. Yet, there’s one underlying common necessity when performing them: DO NOT allow your knee cap to lean forward beyond your toe line. Simple rule of thumb: Imagine a dotted line running from your big toe up to the sky, or perhaps a broomstick in front of your toe. As we lunge, don’t allow that knee cap to cross that line or hit the broomstick. Should this “illegal crossing” occur over and over, you run the increased risk of gradual pressure on the underside of your patella, where shiny, beautiful glossy material called articular cartilage resides. So smooth actually, think ice skating rink glossy after the Zamboni machine rides over it. Put enough mileage and pressure on that cartilage, then no more smooth ice skating rink. Degeneration over time, i.e. potholes and divots, leads to Chondramalacia, i.e. painful cartilage.

 

With proper education of form during squats and lunges, we can greatly reduce the chance of tissue wear and tear. Here are a few key pointers on each exercise:

 

Squat Form

**Use of a mirror for front and side views is recommended

The set up:

“Natural anatomical position”:

- Body in “A” Frame: feet slightly wider than shoulders

- Slightly turn your feet outward as your hip will naturally lead you to

- Arms long and resting by your side

- Neutral head, with eyes gazing straight forward

The movement:

**As most exercisers think of squatting as “up-down-up”, consider it more as “front-back-front”

1) Starting from the top, imagine a chair or stability ball resting slightly behind you. The first exact move to begin is to hinge from the hips and reach posteriorly towards that chair target.

2) As the hips lower and reach behind you, raise your long straight arms out in front of you, fingertips reaching out ahead. This allows for proper distribution of weight in front and back. (Watch with mirror side view)

3)Maintain natural erect “S Curve” of your spine as you continue to lower.

4)  Continuing the downward motion, notice your knee positions. With your feet in the proper slightly turned out position, a good rule of thumb is to allow your knees to follow the second and third rays/toe lines. (Watch with mirror front view)

5) Motion can continue downward until your thigh is parallel with the floor.

6) Pause for at least second at the bottom, as the presence of a pause is the presence of control.

7) From that base point, reverse your motion, returning your way towards top position. As you approach completion, focus on contraction of your glutes, to ensure you’re bringing your hip not only to the top, but to the front.

8) You’ve now completed your first successful repetition. 65 more! Just kidding :)


Squat Do’s

Squat Don’t’s

Lunge Form

*Due to the wide variety of lunge styles, we’ll simply review one form: Stationary Lunge

The set up:

1) Begin with feet shoulder width apart

2) Place your feet in a staggered stance by having the front foot  approx. 2-3 feet ahead of the hind one, with the toes of the hind foot “spiked” into the ground

3) Now in staggered position, your legs will feel like they’re on train track rails, as opposed to a single line tight rope.

4) Center your bodyweight evenly between both legs, keep the chest up tall,  to maintain weight directly over the hips.

5) Begin to slowly lower your body towards the floor, allowing knees to bend. The hip of the front foot will also bend, yet the hip of the back leg will now extend, feeling a slight stretch.

6) Continue lowering until your front thigh is parallel with the ground, as you’ve now achieved a 90 degree bend at the knee. If you’re performing this in a side view from the mirror, pay attention to your knee cap in relation to the toe line. Push your foot into the ground and raise your body up, following the same path line you lowered from. You’ve now completed you’re first lunge! Now repeat!

 

Lunge Form Assessment

**If your knee maintains position over your ankle, you’re in great form!

   

**If you’ve shifted too far forward, and knee cap crosses the toe line, re-center your weight above the hips and try again. You should feel more weight bearing on your gluteal than your quadriceps as you move up and down. That might be the trick. Continue your motion and with each rep, perfect that form.

 

Lunge Do’s and Don’t’s

             

Take Home Message

 

As we noted earlier, the knee is a reactive joint that can fall victim to what the rest of the body does. Being conscious of form quality before load quantity, will help you ensure preservation of your knee anatomy and longevity of exercise enjoyment. Allow these helpful movement hints for squatting and lunging to be your guide to good form.

 

At Gravity + Oxygen Fitness, we are extremely mindful of quality movement throughout our entire programming. If there is any way we can be of further help in guiding you to a successful and healthy lifestyle, we encourage you contact us. Live well and GO great!

 

 

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