“There’s no way I could ever pull off that move with my knees!” Hands up if this sounds like you or someone you know? Most of us have had some experience with knee pain caused by exercise.
It may seem like knee pain is a complex, confusing thing. But it turns out there are usually consistent causes of pain, and thankfully some pretty basic fixes and exercises for strengthening knees.
I want to give you a basic understanding of how your knees function with the rest of your body, so you can better interpret your pain and then know what to do to help yourself, or when it’s time to see a professional.
As a fit and active FIT member, one of the more common areas you may experience knee pain is just below the knee cap at the patellar tendon (which attaches the bottom of your kneecap to the top of your shinbone). The inside aspect or medial knee (where your two knees touch when you’re standing with your legs together) is another easily aggravated area if you’re doing a lot of high-intensity exercises.
Knee pain can range from a mild dull or tight sensation to a sharp and stabbing pain that really makes you want to stop moving. Let’s take a look at some general types of knee pain and their common causes.
Dull, aching, stiff, or twinging pain usually means something isn’t warmed up or moving well. (Mental note: Don’t skip your warm-ups!)
If your knees feel sore or tight, think muscle problems.
Tightness accompanied by redness, swelling or throbbing can signal vascular (circulation) issues or infection.
Numbness, tingling, a prickly or crawling sensation, or temperature sensitivity in your knees implies there’s a nerve issue.
Instability, clicking, or your knee giving out when you put weight on it often means a ligament or meniscus (the cartilage between your bones) injury.
Sharp and stabbing pain may be due to an overlapping of any of the above causes.
Of course, it’s important to know that this list doesn’t cover every possibility – it could be a combination of factors that may be causing you pain.
The three most common causes of knee pain are acute injury, stiffness and weakness. Let’s take a closer look.
1. Acute injury
Knee pain caused by an injury, like landing awkwardly after a jump, will result in immediate pain. If this pain prevents you from walking normally, is sharp or stabbing, or doesn’t improve within a few days, you should see a healthcare professional to get a more thorough examination of your knee.
Stiffness can be because of normal aging changes (such as arthritis), tight muscles, or not having adequate mobility above and below your knee. Stiffness may immediately set in when you start a new workout routine or do too much of a new exercise. Or it may come on more gradually if your surrounding muscles and joints are weak.
I explain it to my patients like this: our body has areas of stability and areas of mobility. Our neck, lower back, knees and feet need to be stable. Our spine, hips, ankles and toes need to be mobile. When we have limitations in areas of mobility this causes pain in areas of stability. So your stiff knees may be caused by weakness and lack of mobility in your hips.
If you feel stiffness in your knees, try doing a few mobility exercises for your hips and ankles – like a deep squat focusing on sitting back into your heels, or a pigeon pose stretch – and your knees should start to feel better quickly.
A deep squat with your weight on your heels is a great mobility exercise, which can help reduce knee pain.
Weakness in your feet, hips, and core (including your pelvic floor!) can lead to pain in your knees. This is typically a more gradual onset of knee pain, that may get worse as the weeks go by.
How do these connections work? Say you have a weak outer hip which causes your knee to cave in unnecessarily during squats – that could cause medial knee pain while walking down stairs.
If your pelvic floor is too tight, unstable and not working in unison with the rest of your core and adductor muscles, you won’t be able to maintain stability at the knee. That instability can cause pain at the bottom, inside or outside of the knee, depending on the motion you’re performing. Focusing on foot control (especially throughout the arch of your foot) by doing barefoot leg workouts or adding balance exercises to your routine are simple ways to improve strength in your knees.
Doing hip rotational exercises and single-leg movements such as lunges, squats, and hip hinges are also a great way to get supporting muscles (including your glutes) firing to stabilise your knees. Watch out for your knees collapsing inwards when doing lower-body workouts.
Other adjustments that may help your knee pain include using a standing desk (rather than sitting) during your work day, aiming for a soft landing when running or jumping and – sorry shoe lovers! – avoiding high heels.
If you have tried some of these tips and you still aren’t seeing much of an improvement in your pain and discomfort, it’s time to go see your doctor or physiotherapist (physical therapist).
Physios are specialists of the musculoskeletal system. If you follow a sporting team, you’ve no doubt seen them in action on the sidelines treating players. They will assess your nerves, muscles, bones, joints, ligaments and tendons and provide an individualised program that will help target your injury and promote healing.
You may already be doing the right exercises but perhaps not enough, too much or not at the right time. Your physiotherapist will give you specific recommendations so you don’t waste your time and can get back to your workouts safely.
Dr. Jessica Warnecke is a physical therapist based in Austin, TX, who is dedicated to keeping you moving at your best in every stage of life – from pregnancy to peak fitness and strength. As well as holding a BS in Exercise Science and a Doctorate Degree, Jessica is a Board Certified Orthopaedic Clinical Specialist and a certified Postpartum Corrective Exercise Specialist.
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