Did you know that almost 50 million Americans experience some form of knee pain each and every day? Your knees bear the weight of your body in every activity you do, from simply walking around to climbing up the stairs. The amount of weight that your knee joints bear is almost four times the amount of your total body weight. So it makes sense that your knees are the most commonly injured joint in your body.
The good thing is that even if the joint is damaged you can still do something about the knee pain. Sometimes by just exercising the muscles which surround your knee joints you can significantly reduce the knee pain to manageable levels.
The primary muscles around the knee include:
- Quadriceps – this is the muscle in the front of your thigh
- Hamstrings – your back thigh muscles
- Abductor – your outside thigh muscle
- Abductor – your inside thigh muscle
- Popliteal- behind the knee
- Gastrocnemius- behind the knee
These muscles act as a complex sling that works along with a network of ligaments and tendons to stabilize and leverage the knee during activity. By strengthening all of these muscles you will be making this sling stronger and will be making the knee less susceptible to injuries.
Why is exercise important for joint pain?
Our joints are lined by a special lining called articular cartilage. This cartilage is a smooth lubricated surface that offers less frictional resistance than ice. Healthy cartilage is highly resilient and somewhat elastic acting as a shock absorber for our joints. Unfortunately it has a very poor blood supply, and must get it’s oxygen and nutrients from the surrounding joint fluid. Whenever a joint is loaded, the pressure squeezes fluid (including waste products) out of the cartilage, and when the pressure is relieved, the fluid sucks back in along with fresh oxygen and nutrients. Because of this, the health of your joints depend on movement. Unfortunately, when the joint is immobile or stiff, it starves causing it to suffer. For this reason, it is imperative to keep your joints moving.
Below is a list of common yet effective exercises to help you start building strength. The exercises are listed in order of increasing difficulty with the first set requiring less balance and stability. If your knee is moderately or severely painful begin with the easier open chain (feet not touching any surface) exercises then progress as able to more difficult exercises. It is also highly recommended that you do these exercises under the guidance of your chiropractor if you are beginning with the closed chain exercises.
Recommended Knee Stretches
Chair Knee Extension – you want to sit in a chair and rest your foot on another chair so that your knee is at a slightly raised level. Then push your raised knee towards the floor by using your leg muscles. Hold this position for 10 seconds and release. Repeat up to 5 times per leg.
Heel Slide Extension – for this exercise you want to lie on your back with one of your knees bent so that your foot is flat on the floor. You want to slowly slide your heel away from your body until both legs are parallel. Hold this position for 5 to 10 seconds and then return your leg to the starting position. Repeat 5 times with each leg.
Quad stretch – Stand holding the back of a chair or stand next to a wall for balance. Bend one knee so your foot comes near your buttock. With the same side hand reach down and grip your foot and try to pull your heal towards your glute until you feel a stretch in your front thigh. Hold for 30 seconds to 1 minute and repeat 2-3 times
Hamstring Stretch – this is done in a standing position. Place one foot in front of you with your toes pointing straight. Use a chair for balance and bend the opposite knee and hip slightly forward until you feel your hamstrings stretch. Make sure you are only bending forward from your hips. Hold for 5 to 10 seconds and repeat 5 times with each leg.
Recommended Strength Training Exercises
As well as stretching your muscles it is important to strengthen them too. Perform the following exercises and only do as much as you can without causing your knees undo pain.
Bent Leg Raises – (open chain) this is done while sitting in a chair with one leg straightened out in the air, do not lock your knee. Hold this position for up to one minute, if possible. Then bend your knee and lower your leg halfway to the floor level. Hold in this position for 30 seconds and then return to the starting position. Attempt to work up to doing at least 4 reps per leg.
Straight Leg Raises – (open chain) again do this sitting in a chair while resting one foot on another chair. Lift your foot off the chair a few inches while keeping your leg straight. Hold this position for 5 seconds and then return to the resting position. Your goal should be to repeat this at least 5 times and to be able to hold your leg up for 2 minutes.
Abductor Raise – (open chain) to do this exercise you want to lie on your side propped up on one elbow. Bend the leg that is directly on the floor for support. Work on lifting your top leg and holding it for 5 seconds before lowering it. Aim for 1 – 3 sets with 12 reps for each set. As this becomes easier you can use ankle weights for increased resistance.
Hamstring Curls – (open chain) you want to use a solid surface for support with this exercise. You can stand with your thighs directly against a table or with your hands on a table for support. Lift your lower leg behind you until it is at a 90 degree angle, only go as far as you are comfortable with at first. Hold this position for 5 to 10 seconds and then lower slowly. If possible lift the leg again before your toes hit the floor. Aim to do 1 – 3 sets with 12 reps in each set. If you have to touch the floor in between reps at first that is fine. When this becomes easier use ankle weights to increase the intensity.
Wall Slide – (closed chain) use an exercise ball placed in the small of your back. You want to be in a sitting position with the ball between you and the wall. Slowly slide down the wall and then straighten up again by rolling the ball slowly. If you keep your feet and legs parallel this will be easier to do and ensure that your knees do not point outwards over your toes. Work up to a point where you can comfortably repeat this 5 – 10 times.
Step Ups – (closed chain) use a stair on low bench about 8 to 10 inches in height. Simply step up onto the stair or bench straighten your knee without letting it lock and then step down again. Try to do this at a steady pace and when comfortable use your arms to add extra intensity. Try to maintain this for at least one minute and then work up from there.
Biking – (closed chain) using a stationary bike is an excellent way to strengthen your knee and your range of motion. Most chiropractors recommend this as their number one method of reducing knee pain. Start with 5 minutes of cycling per day and then increase this amount every few days.
You do not have to use all the exercise above. A good starting point is to choose 2 or 3 exercises from each group and concentrate on doing those. When your knee feels better you can add in another exercise. If possible, try biking every day as it is not only good for strength but offers great cardiovascular benefits as well. .
If you find you cannot do many reps that’s okay. Start with a few each time, but try to do them two or three times over the course of the day. Stretching will really help your knee joint feel less stiff and will help to reduce the amount of aches and pains you experience.
At first it may also be a good idea to ice your knee after exercising for 10 minutes. Use a bag of ice or even a pack of frozen vegetables over your knee area. It helps to place the ice pack in between a towel so that your skin does not burn from the ice. It may also help to place your leg on a chair while icing it.
About the Author: Dr. Graham Pommerehn is a board certified chiropractic physician with a degree in exercise physiology and special training in sports rehabilitation, myofascial release techniques, and strength and conditioning. He has spent extensive time treating athletes in all ranges of disciplines; with additional experience working in spinal cord injury, and cardiopulmonary rehab. In his decade of working with a wide range of athletes, he has gained extensive knowledge accelerated healing and sports injury recover.