Common Misconceptions About Strength Training and the Knee Joint

The vast majority of us will experience pain around the knee joint at some point in our lifetime, making our favourite activities and daily tasks painful and difficult. It is estimated that 40% of total sports injuries occur at the knee joint¹ so if you’re currently suffering from knee pain, you’re not alone!

Fortunately, from decades of research on the knee joint and the rise of the internet, we now have quick and easy access to a massive amount of scientific information. This is great news for those of us looking to learn more about the knee joint but good information can be confusing and hard to find so many common misconceptions about strength training and the knee joint still exist. Many of these misconceptions can be detrimental to the health and recovery of the knee so it’s important that we address these misconceptions so that we can use strength training appropriately to better prepare our bodies against knee pain.

“I’m too old to strength train”

How often do you hear “you shouldn’t be doing this or training like that at that age because it’s bad for your knees?”. Probably quite often! But just because someone is older doesn’t mean that they have to avoid all strenuous activities for their knee. It’s important to keep exercising the knee because when we stop, we take one step closer to not being able to engage in any exercise for the knee anymore. Sure, we might have to modify certain movements or use a lower weight when we’re older, but strength training isn’t exclusive to the younger population. What’s important to realise is that strength training isn’t necessarily about lifting heavy weights. All it is is moving your body in a way which utilises some sort of resistance (often just bodyweight!) to help promote muscular strength and bone density. That means that simple bodyweight leg exercises such as squats, lunges and glute bridges can be used to load the muscles around the knee through their range of motion safely and effectively. Movements such as these can go a long way towards strengthening the muscles around the knee joint and it usually only takes a few weeks of consistent training to start noticing improvements in strength. Remember, it’s never too late to start!

“Strength training is dangerous”

It’s commonly believed that strength training places a dangerous amount of stress on the knee joint which can lead to injury overtime. However, numerous research studies have almost shown the complete opposite – strength training actually reducing the likelihood of injury when playing sport. The key to this is a well-structured training plan which gives the muscles around the knee joint the appropriate stimulus they need to become stronger. Even if you’re someone who doesn’t exercise very often, think about the stresses you place on your knee joint during day-to-day life, whether that be walking up and down a flight of stairs, running around with your kids or bending down to pick up an object, it’s likely have to perform these movements a countless amount of times in our lifetime. Therefore, it’s important that our bodies are able to handle this high workload easily and without having to compensate due to a lack of strength. In fact, 50% of all knee injuries are associated with non-sporting activities², especially those sustained in middle age onward³!

Not only can strength training be a safe and effective activity for improving muscular strength, it also has numerous other health benefits such as:

  • Helping you maintain a healthy weight to help prevent weight-bearing joints such as the knees from being overloaded.
  • Increase muscle carbohydrate uptake and increase the expression of genes involved in carbohydrate metabolism to reduce risk of chronic impairments like diabetes.
  • Help improve cardiovascular health.
  • Help to maintain balance, coordination and mobility.
  • Releasing endorphins (the body’s natural pain killers) to help ease knee pain and boost mood.

“Strength training will make my legs look bulky”

In today’s age, it’s common to see very muscular individuals’ showcasing their workouts on social media and think to yourself that if you do the same exercises or workouts then that’s what you’ll end up looking like. After all, the term ‘strength training’ is strongly associated with the term ‘weightlifting’ and what usually comes to mind is someone in a gym with ripped muscles lifting huge amounts of weights. While it’s true that strength training can involve lifting heavy weights to help you build muscle mass, following a strength training program doesn’t mean you’re going to look like a professional bodybuilder. Not strength training because you’re afraid of getting too bulky, is like not wanting to drive your car to work because you’re afraid you’re going to turn into a professional racing driver! It takes years and years of hard training to reach that level of muscle size so performing some strength training during your rehabilitation process may add a small amount of muscle mass but it won’t significantly change your physique. Instead, it’s likely you’ll be happy with the minor physique changes and increased strength!

“Rest will cure my knee pain”

Traditionally, the way to fix knee pain was to rest more and wait for the body to heal itself. While a bit of extra rest isn’t a bad thing to do to let symptoms calm down in the short term, complete rest may not be the ideal way to recover from a knee injury as, just like most things in life, too much of a good thing can be bad! Research has shown that instead of completely resting your injured knee, performing controlled exercise increases positive load stimulus to the area which can help speed up recovery. It also helps maintain strength in muscles surrounding the knee joint which is very important to prepare your body for when you return to your normal routine so the chance of re-injury is much lower. Finding just the right amount of exercise and activity is crucial to finding balance between recovery and progression rather than taking steps back. Strength training is a great choice for recovery and maintaining strength as the exercises can be performed under full control and as your knee recovers, it can gradually be intensified by increasing the weight, performing more repetitions or switching them up to more challenging variations. After all, it’s called strength training for a reason!

“My knee hurts so my knee must be to blame”

When knee pain strikes, it’s natural to look at the knee joint and think it’s the culprit. However, there is always a reason for pain and purely looking at the knee joint may not address why the pain originated there in the first place. It could be various other reasons such as limited ankle mobility or a lack in strength in muscles around the hip and knee like the glutes or quadriceps. For example, one of the key functions of the glutes is to create stability around the pelvis to ensure correct tracking of the upper leg and knee joint. Therefore, a lack of strength in the glutes may lead to instability in this region and which causes the knees to not track in line with the rest of your leg when moving, resulting in additional stress on the knee. Continually overloading the knee in this way may eventually result in pain at the knee joint despite the knee itself not being the culprit! That’s why taking a holistic approach and utilising strength training is so important to ensure you have adequate mobility and strength in the muscles and joints surrounding the knee, ankle and hip to help manage knee pain.

 

Hopefully you now have a better understanding about strength training and how this applies to you if you’re currently suffering from knee pain. A strength training program may initially seem intimidating but the benefits far outweigh the concerns and at Optimi Health, we are here to guide you through the rehabilitation process. Remember, the body has an amazing ability to adapt to the stresses placed on it but the key thing is to start slowly, listen to your body and gradually progress over time.

For reference, and further reading:

Sancheti, P., Razi, M., Ramanathan, E. and Yung, P., 2010. Injuries around the knee – Symposium. British Journal of Sports Medicine – https://bjsm.bmj.com/content/44/Suppl_1/i1.1

Yawn, B., Amadio, P., Harmsen, W., Hill, J., Ilstrup, D. and Gabriel, S., 2000. Isolated Acute Knee Injuries in the General Population. The Journal of Trauma: Injury, Infection, and Critical Care – https://journals.lww.com/jtrauma/pages/articleviewer.aspx?year=2000&issue=04000&article=00021&type=abstract

Gage, B., McIlvain, N., Collins, C., Fields, S. and Dawn Comstock, R., 2012. Epidemiology of 6.6 Million Knee Injuries Presenting to United States Emergency Departments From 1999 Through 2008. Academic Emergency Medicine – https://pubmed.ncbi.nlm.nih.gov/22506941/

Stanford, K. and Goodyear, L., 2014. Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle. Advances in Physiology Education – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315445/

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