How to protect your knees and prevent knee pain…

While adding specific exercises into your routine may help with your knee pain, it is extremely important to know your posture  because that will determine which exercise will actually help you and which might make the problem worse.  While doing acupuncture works tremendously for knee pain, it is imperative that the patient adds necessary exercises/stretches to their routine.  The type of exercise one will need for knee pain will depend on the cause of the knee pain.  

While there are many injuries that can cause knee pain, I am listing some injuries that are related to muscle imbalances and can be helped by adding certain exercises.  For something more serious such as ACL tear, MCL, LCL, meniscus, it is important to work with a specialist like acupuncturist, chiropractor or your orthopedic doctor for more supervised care.  

Knee pain on the lateral side of the knee, may involve iliotibial band.   Medial knee pain  may involve sartorius, gracilis, semitendinosus.  For pain in the front of the knee,  patellar tendon  might be pulling excessively, which can be due to overreactive quadricep muscles.  If someone’s quadriceps are tight and they are continuously performing quad strengthening exercises, their pain might get much worse.   People with anterior tilt (posture that has an increased lordotic curve) might have quadriceps that are too tight and need to be lengthened.  People with posterior tilt (tucking in glutes) might have hamstrings that are too tight and need to stretch those and strengthen quadriceps.  It is important to take all of that into consideration before figuring out which exercise to do.  Here are some general exercises/stretches:

Medial knee pain (involvement of sartorius, semitendinosus and gracilis might be causing this kind of pain).  If the adductors are shortened/too tight, the key is to foam roll them out/stretch them and strengthen IT band with abduction exercises.

To roll out adductors, simply put a foam roller on the floor, lay on top of it by having the foam roll at the top of the medial knee and rolling it towards the middle.  

Another great stretch is to stand with feet wide apart with toes pointed out.  Bend the knee on one side and feel the stretch.  Do the same on the opposite side.

Exercise to add:

Clamshell.  Lay on one side with legs stacked and knees bent at 45 degree angle.  Keeping your feet touching, raise the knee without moving backwards.  Do on both sides.  A band can be added to make it more difficult.

Exercise for IT Band

Start on your hands and feet.  Hands should be right below your shoulders and hips above knees. Lift your left leg away from the body at a 45 degree angle while keeping the knee at 90 degrees.  Lower the leg and repeat for 5-10 more times.  Switch sides.  Bands can be added if this is too easy for you.

Frontal knee pain.  In this situation, the quadriceps might be pulling too hard on the patellar tendon or the vastus lateralis is pulling too hard and vastus medialis is too weak to counteract that pull.  

Quadriceps tight-foam roll them.  For the stretch, stand in front of the chair, take the ankle into your hand and move it backwards giving quadriceps a nice stretch.  It will be important to strengthen the hamstrings as they are the antagonist of the quadriceps.  If quadriceps are too tight/tense, hamstrings might be too weak and will need strengthening exercises such as bridge.

Bridge:  Lay on your back, push your heels into the door and tighten your glutes and abdominal muscles as you lift your hips off the floor.  Hold.

Quadriceps weak- foam roll hamstrings.

To strengthen quadriceps, do knee extension exercises.  While sitting, lift one leg up extending the knee.  This movement should be slow and you should feel quadriceps contracting, slowly lower it.  Do it on both sides.  If you need more challenge, knee extension machines at the gym with weights will also work.

Lateral Knee Pain-IT Band.  In this case IT band might be too tight and adductors might need strengthening.  Foam roll IT band.

Side lying adduction:  lie on your side with your elbow under your head. Bend your top knee so it points toward the ceiling.  Keep the bottom leg straight and the foot flexed.  Lift the bottom leg on a floor slowly while feeling adductors.  Repeat this 10 times.  Switch sides.