How to Correct Knee Pain
Knee pain can be classified as acute/chronic pain that is located in the knee, or the structures surrounding the knee due to injuries and conditions such as osteoarthritis and chondromalacia. Other common factors of knee pain are physical trauma injuries (football, basketball), muscle imbalances and repetitive motions (marathon runner, weightlifting) and system conditions such as osteoarthritis.
The Anatomy of the Knee
The knee joint is composed of the femur (thigh bone), tibia (shin bone) and the patella (knee cap). All three of these joints articulate with each other to form what we know as the knee joint. It is also considered a modified hinge joint that allows for flexion (bringing the heels towards your butt), extension (straightening the knee) and a small amount of rotation. There are also a lot of muscles that originate around the hip that run through the knee and can have a major influence on knee pain. Because the knee joint also allows for slight rotation, injuries such as sprains and torn ligaments are also very common in any physical activity that requires you to quickly change directions (basketball, mixed martial arts, weightlifting).
How Does Knee Pain Happen?
Knee pain can happen for a number of reasons; from muscle imbalances that pull the knee out of alignment to physical trauma from sports. One of the most common causes of knee pain is due to tightness and weakness of specific muscles that contribute to the knee joint. Muscles that are generally tight pull on bones and cause physical deviations. For example, if you’re a cyclist or runner, you may have pain on the outside of the knee because the muscles on the outside of the hip are pulling on the outside of the knee. This causes an imbalance between the agonist muscles (in this case, the outside of the thigh) and the antagonist muscles (inside of the thigh).
What Muscles do I Strengthen?
As mentioned above, knee pain could happen for a number of reasons. But in most cases, strengthening a specific muscle called the vastus medialis (inside of the thigh) can contribute to a stronger and more stable knee. This muscle is responsible for extending the knee and is considered to be one of the four quadricep muscles. However, this muscle is often neglected because we often find ourselves strengthening on the vatus lateralis (outside of the thigh) through different exercises such as walking, running and squatting. Instead, we should be focusing on strengthening the weaker muscles to correct the imbalances.
The vastus medialis is most recruited during the first and last 10 – 15 degrees (differs from person to person) on knee flexion and extension. Performing the last 10 – 15 degrees of leg extension at a lighter weigh for a higher repetition range would be a perfect exercise. Externally rotating the hips during the leg extension (having the knees face outwards) will further increase the recruitment of the vastus medialis. Alternatively, exercises such as high step ups will also isolate the vastus medialis but requires more stabilization and is considered a progression.
What Muscles do I Stretch?
Stretching the muscles (specifically the muscles on the outside of the knee) will lengthen and increase the muscle’s flexibility. The muscles on the outside of the hip and knee are generally tighter than the inside because daily activities such as walking focus more on the muscles on the outside. Some of the muscles that we should be stretching are the piriformis (small muscle that rotates the hip outwards), tensor fascia latae, vastus lateralis and the iliotibial band. Stretching these muscles will help alleviate the tension on the outside compartment of the hip/thigh to decrease stress on the knee.
Below is a video that demonstrates three different knee stretches. Hold the stretches for at least 30 seconds and perform them throughout the day or after exercise.