Exercising with Knee Pain

Exercising with knee pain is a catch-22.

While research shows exercise is often the most effective treatment for many types of knee pain, severe pain can make it difficult to stay active.

This is where a guided exercise program, built for what you and your knee can handle, is important.

The Prevalence of Knee Pain

Knee pain is a common occurrence that can impact function and quality of life. There are factors to knee pain that are out of our control however there are several factors that can be addressed to avoid the onset of knee pain or to recover faster.

According to current research, the prevalence of knee pain has been increasing over the past 20 years.

While many factors can lead to knee pain, both obesity and joint alignment have been found to have a significant impact on predicting knee pain or osteoarthritis (1).

Weight has a profound impact on the knee. During walking, your knees are subject to four times your body weight in pressure (2,3). Yes, that means losing ten pounds can take off forty pounds of pressure from your knee with every step taken!

Weight loss (if necessary) is a good place to start, but what can you safely do if your knees hurt during physical activity?

Strength, Balance, and Flexibility

Strength, balance, and flexibility are crucial pieces of the knee pain relief puzzle.

When developing a strength and balance program, it’s important to think of your body as a whole.

Initial steps to building your exercise program will target the areas AROUND your knee, versus the knee itself. This concept revolves around the idea of improving the supporting cast. If everything around your knee is strong, balanced, and mobile, your knee does not work as hard, therefore reducing pain. One research study found that by improving glute (a.k.a. hip) strength, participants reported less knee pain while negotiating stairs (4).

This same philosophy of the “supporting cast” can be applied to flexibility. Addressing tightness at the hip and ankle will allow your knee to function better — without aggravating your injury.

Flying Below the Radar

Powering through pain to achieve weight loss or strength goals will only worsen the pain you have. It is important to find exercises you can do successfully, without knee pain, and build from there.

A gradual strengthening program can slowly increase the load (work) on the knee, improving its tolerance to exercise.

In developing a strengthening program, you’ll want to fly below the symptom radar. What does this mean? You’ll want to accommodate your workout so as not to aggravate your symptoms.

Multiple adjustments can be made to any exercise program to make you more successful. They can be as simple as modifying your foot position, the depth of an exercise, or even replacing an exercise altogether.

Try to modify or initiate an exercise program that emphasizes low impact on the knee, such as biking and non-weight bearing exercise, and then progress to higher functioning activities, such as squatting and lunging as you build strength.

Be careful with seated machines that emphasize kicking and pulling motions early on, as they isolate the knee and aggravate symptoms.

Avoiding Provocative Tasks

When experiencing knee pain, it’s important to avoid tasks that aggravate symptoms.

You can do all the right things, but if you offset them with compromising positions and tasks, you’ll likely struggle to improve.

For a large percentage of patients, a successful strengthening program can not only slow the progression of wear and tear but may restore full, pain-free function.

Be sure to add strength and flexibility around your knee and remember to fly below the symptom radar — if it hurts, don’t do it!

References:

1. Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med. 2011 Dec 6;155(11):725-32.
2. Felson D, Goggins J, Niu J, Zhang Y, Hunter D. The effect of body weight on progression of knee osteoarthritis is dependent on alignment. Arthritis & Rheumatism 2004 Dec;50(1):3904-3909.
3. Messier S, Gutekunst D, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism July 2005;52(7):2026-2032.
4. Brindle TJ, Mattacola C, McCrory J. Electromyographic changes in the gluteus medius during stair ascent and descent in subjects with anterior knee pain. Knee Surgery, Sports Traumatology, Arthroscopy. 2003 Jul;11(4):244-251.

Struggling with knee pain and not sure what to do?

If knee pain is slowing you down and you’d like a personalized plan to feel and move your best, our Physical and Occupational Therapists can help.

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