The vast majority of us will experience knee pain at some point in our lifetime, often making our favourite activities and daily tasks painful and difficult. It is estimated that about 40% of total sports injuries occur at the knee joint¹ so if you’re currently suffering from knee pain, you’re not alone.
Fortunately, decades of research on the knee joint and the rise of the internet have given us quick and easy access to a massive amount of scientific information. This is great news for those of us looking to learn more about preventing and managing knee injuries, but often the useful information is hard to find and hidden beneath misconceptions and opinions that simply aren’t supported by the latest science. Many of these misconceptions are unhelpful so it’s important to address them and identify the research that does give us clear guidance on how to prevent and manage knee injuries.
“I’m too old to strength train”
How often do you hear “you shouldn’t be doing this or training like that at your age because it’s bad for your knees?”. Sadly too often. Age alone is not a reason to avoid all strenuous activities for the knee. It’s important to keep exercising the knee because when we stop, we lose strength and function, making life much harder. 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. It is simply moving your body in a way which utilises some sort of resistance (often just bodyweight) to help promote the development or maintenance of muscular strength and bone density. Simple bodyweight 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 and maintaining the muscles around the knee joint and it usually only takes a few weeks of consistent training to start noticing improvements in function and pain. Remember, it’s never too late to start and pretty much all of us should be incorporating strength training and prehab into our weekly routine.
“Strength training is dangerous”
It’s sadly sometimes 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 shown the complete opposite – strength training actually reduces the likelihood of injury both in and out of sports settings. The key to these positive findings are the implementation of a well-structured training plan, giving the muscles around the knee the appropriate stimulus they need to become stronger whilst also enabling adequate time for recovery and development.
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. we 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 or mobility. In fact, 50% of all knee injuries are associated with non-sporting activities², especially those sustained in middle age onward³. It’s therefore very important that we engage with decent strength and prehab plans to prevent the risk of injury.
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”
It’s become the norm to see very muscular individuals’ showcasing their workouts on social media and some of us are now thinking that if we strength train then we’ll end up looking the same way. For some of us, the term ‘strength training’ is associated with someone in a gym with big muscles lifting huge amounts of weights. While it’s true that strength training can involve lifting heavy weights and building muscle mass, following a strength training program doesn’t mean you’re going to look anything like a professional bodybuilder. It takes years and years of hard training and dedicated nutrition (and often performance enhancing dugs) to reach very significant levels of muscle mass. For most people, strength training provides beneficial enhancements in strength, function and health and can be used to create an aesthetic of your choice – you certainly won’t get ‘too big’ by accident.
“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 in the very short term to let symptoms settle, complete rest is not the ideal way to recover from a knee injury. Research has shown that instead of completely resting your injured knee, performing controlled exercises 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 as the exercises can be performed under full control and can be gradually intensified by increasing the weight, performing more repetitions or switching them up to more challenging variations.
“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, looking only at the knee joint may not address where the pain originated. Various other reasons, such as limited ankle mobility or a lack of strength in muscles around the hip and knee can cause problems at the knee joint. 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 which can place 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. Taking a holistic approach to understanding the body and our biomechanics is important to appropriately diagnosing and treating knee pain. Once understood, strength training will often be a key component of training the relevant body part to address a specific issue.
Hopefully you now have a better understanding of strength training and it’s importance in preventing and managing knee pain. The body has an amazing ability to positively adapt to the stresses placed on it by strength training – the key thing is to start slowly, listen to your body and gradually progress over time
Sources:
Sancheti, P., Razi, M., Ramanathan, E. and Yung, P., 2010. Injuries around the knee – Symposium. British Journal of SportsMedicine – 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/
