Yesterday, Dr. Shah blogged about running for Heart Month. When women start an exercise routine or really ramp it up, sometimes, knee pain can slow us down. As women, the last thing we can do is slow down (right, @DoctorViv?) So, what can you do to help your knees?
Women’s knees are just one body area that can be highly susceptible to joint pain or weakness. The knees are crucial to help maintain a healthy lifestyle and for doing basic activities of daily living like squatting, stooping, crawling, or kneeling. This can include playing with our children, cleaning the house, or working in the yard. Really, have you ever tried to go down the stairs or sit without bending your knees? Knee pain and weakness go hand-in-hand, but which came first, the chicken or the egg?
Patients often enter my clinic with a report of gradual knee pain without a known mechanism of injury. One common cause of knee pain is due to patellofemoral pain syndrome, which can occur with repetitive activities such as squatting, running, or jumping. This can simply be described as pain in the front of the knee, usually at the patella (knee cap).
The cause of this pain can be due to abnormal forces of the quadriceps (the large thigh muscle) and the retinaculum, which is a fibrous sheath that surrounds the patella. These atypical forces are related to weakness of specific portions of the quadriceps. The end result is poor tracking and alignment of the patella, which places abnormal stress to the cartilage and can cause a cascade of events. It may lead to chondromalacia, which is a thinning of the cartilage on the patella or at the femur. Other secondary issues can also be present, such as osteoarthritis.
What can you do to help your knees? Strengthening the quadriceps, specifically the vastus medial oblique which surrounds the inner portion of the knee, is imperative to assist with improved tracking of the patella. Another area of frequent muscle weakness is the gluteus medius, which are the side hip (butt) muscles. When these two areas are weak, the end result can be a knocked-knee position. The diminished strength will also be more apparent during specific activities, such as squatting or going down the stairs, at which point you’ll find your knee will move inward or it might feel like it will buckle.
You might ask, “How can you squat without putting abnormal stress on the knees?”
- First, be aware of your body position.
- Try to keep your weight on your heels, and do not let your knees go over your toes.
- Move your bottom as if you are going to sit in a chair.
- As you lower your body, move with good control. Now, this can be extremely challenging, especially if you are already susceptible to knee pain, generalized leg weakness, or poor balance.
Exercises such as mini squats within a controlled and pain-free range of motion can help to improve your tolerance for these good mechanics. For those of you that are gym-goers, I suggest the leg-press machine. For busy women and working moms, you can do these in the kitchen while waiting for your coffee to brew, during commercials of your favorite TV show, or even at work during a break at your desk.
I cannot discuss knee pain without mentioning flexibility and stretching. This is a component of fitness that many of us ignore. Just because a muscle might be tight does not indicate that it is strong. There is an optimal length at which the muscles are meant to move without causing dysfunction. Important areas to stretch include the hamstrings and gastrocnemius (calf) as these two muscles cross behind the knee. (Speaking of stretching – did you request your FREE resistance band from Summa’s Facebook page this month?)
Another question I get often is, “My knees make a lot of noise? – is this bad?” These sounds are called, “crepitus” which sounds like something out of a recent episode of The Walking Dead television show, but I can tell you typically sounds are not a problem unless it comes with pain.
I encourage you to protect yourself now and in the future and simply be aware of your body position. The human body is an incredible machine that will adapt to both activity and inactivity (good and bad). Remember that not all knee pain is due to weakness, but muscles can become weak because of pain.
The recommendations provided above are general guidelines. If your pain is persistent, please contact a specialist so we can keep you moving!
Kim Koran PT, DPT
Summa Health Center at Western Reserve