Alright, so with the last two installments we’re all up to date with the latest from knee pain university. It’s enough information to make your head spin though. How can we put all of this information together into a program? Let’s think back and see what we have to work on:
- Ankle Mobility
- Foot Stability
- Strengthen Hip External Rotation and Abduction
- Hip Mobility
- Core Stability
- Improve Technique
Here are some principles to keep in mind:
1) Corrective exercise is exactly that, corrective. Once you’ve cleaned up poor movement with your corrective exercise, you’re done. They don’t need to be used anymore (unless its on the basis of maintenance), continue on to your squats, lunges, deadlifts etc. and use good technique. Keep in mind that this process can take several months though.
2) If corrective exercises end up putting you into a poor position (promoting foot pronation, knee valgus, hip internal rotation, etc.) they’re too difficult and aren’t fixing the problem, only promoting it. Start with the easiest corrective exercise variations and progress as you become proficient at the easier ones.
3) These exercises shouldn’t be painful. If they’re causing pain either while you’re doing them, later in the day after training or the following day, they aren’t doing their job. Working with pain falls in the realm of a professional (doc, therapist chiro). If you can’t do anything without pain then go see someone.
***Pain is usually part of a rehabilitation program but treatment should be directed by a trained professional. If you aren’t able to do much of anything pain free then go see a professional.
4) Technique should always be practiced after corrective stretching and strengthening. We want to utilize that new mobility and stability we just created to help build a permanent motor program (better technique).
Keeping in mind the above principles, I like to place these things into a warm-up session. If you can’t do this prior to your workout and have to do it afterward you won’t be getting the same benefits, but doing them afterwards is definitely better then not at all.
The Healthy Knee Warm-Up
Step 1: Foam Rolling – 5 minutes
- Calves (Special attention to the soleus, spend more time near your achilles tendon/heel)
- Front and outside of the thigh (IT Band, Vastus Lateralis, rectus femoris, vastus intermedius for you anatomy buffs)
- Groin (adductors)
Step 2: Static Stretching – 5 minutes
- Hip Flexors and Quads: Brettzel – Link contains explanations
- Hip External Rotation and The Hip’s Posterior Capsule
Skip to 1:10 for the stretch demo
Step 3: Corrective Exercise
With all strength training exercises we want to keep several principles in mind to keep our knees healthy:
- Keep the knees “in-line” with the toes
- Keep the “short foot” position during all exercises
- Perfect technique on all exercises. Corrective exercises shouldn’t be taken to failure.
- Barefoot: Shoes off is the best way to retrain the foot and lower leg
Mini Band Squat – Progress the exercise with a tighter band or add a kettlebell to make it a Goblet Squat
Split Squat – Progressed with either a band or some weight in hand
The split squat/lunge pattern can be made more difficult with a band
Half Kneeling Chop – Progress with a stronger band or chopping in a split stance position.
***Single Leg Deadlifts
*** Single Leg Dead lifts are very difficult to perform with a good short foot position. Only use this exercise if you can maintain solid technique. Progress this exercise with more weight.
Step 4: Dynamic Warm-up and Exercise
We mentioned technique before being integral to keeping your knees healthy. When we begin working out we can’t throw all of these concepts out of the window. Your feet, knees, hips, low back and trunk all have to be kept in the proper position. Otherwise your knee pain will come right back. Watch Pat deadlift:
He’s still working on his foot and knee position even when he’s got weight in his hands. This step is integral to getting corrective exercise to work. We’re really just picking exercises to help us make the transition to doing the heavy duty “aggressive” exercises like squats, deadlifts, lunges and pistols with good joint biomechanics (ie: good technique).
In this way we’re addressing the “root cause” of knee pain, which is poor movement. We only want to be doing corrective exercise as long as we have to to progress to the “big guns” exercises. This is why I chose corrective exercises that mimic the same positions you see when you’re working out at the gym.
Putting it all together: In reviewing this article it’s an enormous amount of information. Let me try and break it down to something a bit more manageable
- Foam Roll 5 minutes
- Stretching 5-10 minutes
- Corrective Exercises 1-2 sets of 5-10 repetitions
- Dynamic Warm-ups
- Lift some freaking weights
Well, I feel drained after writing this article series. Hopefully this gives you a strategy to start working with your painful knees. I know my knees are starting to feel better already.
Kneecaps of steal,
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