There isn’t much that is more annoying, or worrisome, than chronic knee pain. Luckily, there are many techniques and exercises to help your clients have healthier and happier knees!
Personal trainers aren’t allowed to directly treat pain, but you can strengthen the muscles supporting the joint to hopefully alleviate it as an outcome.
Non-injury related knee pain is a common issue trainers come across. Like most chronic joint pain, it is often due to overuse, misalignment, or muscular strength imbalances. Knees are quite susceptible to these causes, considering the overwhelming prevalence of bad posture, sitting most of the day, and weekend warriors.
Don’t misunderstand, I do not find it “wrong” to only workout here and there when time allows. However, it is the sporadic participation in high-intensity activity common with weekend warriors that can put the body at risk for pain or injury. When one is not necessarily accustomed to regular exercise, misalignment, and improper body mechanics can be a result.
Running, biking and other extreme sports clients may not have had an actual injury, but their knees are likely tired and may not have been properly cared for.
Why Do Knees Cause Problems?
One of the common reasons for knee pain and injury is improper tracking of the kneecap. The hip joints are wider than the knee joints in a neutral standing position. Unfortunately, the natural human anatomy promotes an uneven contraction of the quadriceps.
The effect is that when the knees are straightened the kneecaps is slightly pulled in a lateral direction. The vastus medialis is responsible for correcting this lateral diversion, and also one of the most neglected muscles of the quadriceps group.
It tends to be the outer thigh muscles that have all the oomph. With the outer thigh muscles already naturally dispositioned to be stronger contractors, and the Vastus Medialis tending to be weak, improper tracking of the kneecap is, unfortunately, a common outcome.
Six Knee Injury Prevention and Restoration Exercises
Whether a client is a weekend warrior, an overworking joint abuser, or suffering from some biomechanical malfunctions, these exercises are great for reinforcing and rebuilding knee strength and movement.
The exercises are listed from least advanced to most, so from the most dire knee situation to one that just needs a little extra love.
Exercise 1 – Simple Contraction
For those clients that are just starting to get back into exercise and are struggling with knee mobility and strength.
Sitting with the back against a wall and legs extended in front.
Place a foam roller under the knees.
Be sure that the client is sitting up straight, engaging the abdominal wall to maintain posture. The knees and toes are pointing up towards the ceiling.
One side at a time instruct the client to contract the muscles of the leg to straighten the knee, and then relax.
On the side that the client started with, then instruct them to externally rotate that leg and again begin the contractions.
Depending on the client’s current abilities have them do 8-15 reps of the simple contraction in both positions. Ending the set with a 10-second contraction hold.
Exercise 2 – Supine Leg Lifts
Have the client lay on the ground.
Bend one knee and bring that foot flat on the ground.
The other leg will be lifted to a 90-degree angle to the hip, or as close as they can reach, and then lowered back down.
– Be sure the client is keeping their lifting leg as straight as possible
– Instruct them to strongly flex the foot of the lifting leg, it will help keep the leg muscles active and contracted
– During the set, the lifting leg doesn’t return all the way to the ground. Have the client maintain at least an inch between the ground and the working leg during the decent.
Complete 3 sets of 12 reps per side
Progression: Add ankle weights
Exercise 3 – Single Leg Extension in Bridge
Have the client lie on the ground/mat flexing both knees so the feet may lie flat on the ground/mat.
Check that the client’s arms are at their side, and their fingertips can brush the backs of the heels.
With arms at their sides and hands pressing down, instruct the client to lift their hips towards the ceiling whiling grounding through their heels.
Without the client’s hips shifting down, have them extend one leg, pointing the bottom of the foot towards the ceiling.
Without the client’s hips shifting up or down, they will return the extended leg to the bridge postion, and begin on the other side.
The hips maintain the bridge position the entire set
Alternating legs: 8 reps each side, 3 sets
Progression: Add ankle weights
Exercise 4 – Standing Front Leg Lifts
With the client standing, instruct them to point one foot ahead of them with all the body’s weight supported on the other leg
Without allowing the pelvis to tuck or bend through the standing knee, have the client lift the leg towards the ceiling
Gently lower the leg until the toes are on the ground again, maintaining the weight in the standing leg.
Complete 10 reps 3 sets
Exercise 5 – Moving Warrior II
This yoga pose is especially good for strengthening and bringing awareness to the Vastus Medialis muscle.
On a yoga mat, from standing, have the client step the left foot back into a runners lunge.
The right foot will maintain pointing towards the top of the mat, while the left foot externally rotates until the toes are pointing to the side and the foot is flat on the ground.
The hips and torso rotate open as well, and the arms reach out to the sides.
The right leg is bent, with knee lining over right ankle and the heel of the right foot lining with the inside center of the left foot
With the client keeping the right knee line matching with the right shin and second toe line, hold the pose for 5 full inhales and exhales
Then rotate the right foot so both the feet are facing the side of the mat and the client is in a wide straddle. Then rotate the left foot so the toes are pointing towards what was the back of the mat. The right foot maintains its position, flat and pointing to the side of the mat. Again, hold for 5 full inhales and exhales. This is all 1 rep.
Complete 4 reps 3 sets
Exercise 6 – Resistance Band Supported Sit Back
With a very heavy resistance looped band, secure one end to something sturdy.
Have the client step within the free end of the band.
The band will rest across the backs of the legs at the very top of the calves, just below the knee joint.
Instruct them to step back until they feel resistance from the band firmly pressing into the legs.
Have the client sit back with the hips, flexing in the knees and allow the band to support the lower legs so they may maintain an almost vertical position in the torso.
By implementing these exercise throughout a client’s regiment, their knees should be strong and sturdy in no time!
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