Knee bother. Part 2 of 2.

This post follows from my previous post on knee pain. It details the exercises that I did to get myself back to fitness from a knee injury that seemingly wouldn’t go away.

Disclaimer

As with the previous post, I have no medical qualifications and no medical training, and any advice presented here is what worked for me; it might not work for you. I did a lot of research myself but I’m not an expert. If your knees hurt then you should see a doctor or a physio, preferably a specialist, and if you’re still struggling then you might be desperate enough to read my thoughts on it.

Stretches

These should be your bread and butter of recovery, so do them as often as you can. You find them described on YouTube or in any stretching book. Hold stretches for 30 seconds or more, do them with good form, and if it feels painful don’t do it.

If you’ve never been taught how to stretch properly then going to a yoga class or again, a physio, would be invaluable: it makes an enormous difference.

Most people stretch badly and it doesn’t help them. Stretches to try:

  • Hamstring stretches (ones done lying on your back I find best)
  • Quad stretches
  • Calf stretches
  • Crossover stretches for your back
  • Adductor stretches
  • Hhip flexor stretches (in particular, couch stretch)

Foam rolling might help too, particularly of the quads.

Despite the importance of stretching, without some strengthening exercises they won’t necessarily do a lot to help.

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Walk-ins to mountain crags with all the required kit need knees that work…

Physio exercises

The program below is something that’s worked for me. It’s an amalgamation of this online guide on patellafemoral pain (well worth paying for, it’s really good), various physios’ exercises, and some stuff I’ve found on YouTube. They are not designed to make you hench, but to work on muscles that stabilise the knee or which take stress off it.

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Mark Cavendish at the Tour de Yorkshire. You don’t get a sprinter’s legs without doing some exercise.

Some ground rules:

  • The exercises should be challenging. They shouldn’t hurt in the knee, though you might feel it doing something. Any more than about 3/10 in the knee on the pain scale and it’s too much. The last reps should be hard: if they aren’t then make the exercise more difficult.
  • Build up slowly. Start with gentle exercises and move up to harder ones. Build up week by week. Getting the intensity right is critical.
  • Do a selection of the exercises 3 times a week, but try to stretch every day. Focus on generally feeling mobile and agile, not just in your legs but in your back and ankles too.
  • Stick with it: improvement will be slow. You might see results in a few weeks but for me it took months to make real improvements on how my knee felt.
  • Do the exercises with strict form. Don’t cheat or you could make your injury worse. Sometimes you will be embarrassingly bad at the exercises. That’s good: it’s an obvious area for improvement which when fixed might resolve your knee pain. Swallow your ego.
  • If you find an exercise quite easy then make it harder – add weights, do them slower, do them faster, do them differently, or do more of them. Without overload you won’t get stronger.
  • Your body might start to feel different thanks to the exercises. My glutes hurt for days and I noticed my vastus medialis actually doing something. This is good – it means your muscles are firing and hopefully taking stress off the knee, which until now was working too hard.
  • Get someone else to do the exercises with you. It can be a big motivator and a good way to track your progress. They might save themselves from injury further down the line.
  • The more stress you want to put your body under the stronger you need to be. Do you want to run 5k without pain or compete in Ironmans?
  • If doing lots of the exercises in a row, do a warm up. A few minutes of gentle jogging and general limbering up should do it.
  • If you start to lose balance, battle to keep it. You might find your balance is crap on one or both legs.
  • Do both sides, even if your injury is only on one knee. What’s the harm?

While I was still in ‘getting better’ phase I did a few of these exercises every day, usually about 8 reps of the particular exercises I was doing that day. Now I’m doing maintenance stuff I try to do 2-3 sets of 10-12 reps of every exercise once a week, and that seems to be helping strengthen further. In short, if you had a problem like me you need to activate and strengthen your glutes and your hip stabilisers to take pressure off your knees.

The exercises

Leg crossovers

Stand feet together on a line, take one foot off the ground and stretch it out sideways behind your other leg in line with the other, as far as you can. Don’t touch the foot to the ground. Then return to the start, again not touching the floor with the exercising leg. Don’t let your standing leg’s knee come inwards- try to make it track over your middle toe. As you get better you’ll more stable and will reach further.

Leg behind ‘deadlift’

Stand feet together. Bend your standing leg slightly and raise your other foot straight behind you, tipping your body forwards so you are straight. Don’t twist at the hips – your back should be flat and your leg straight behind you, not out to the side or flaying about. This is one I literally couldn’t do a single rep of on one of my legs when I started. I’ve improved but as you can see in the photos I’ve still got some way to go.

Side leg lift

Get in the position of a side plank with one elbow on the ground and one foot on the ground. Make sure your body is completely straight – no sagging at the hip or bending forwards or backwards. Lift your top leg up as high as you can, slowly, and then let it go back down. The foot of the lifting leg should stay parallel to the ground and the leg must lift in line with the body, or slightly behind it. For me, this is the hardest exercise of this set and it took me a while to be able to do 10 in a row.

One leg squat onto chair

Stand on one leg with a chair or box behind you. Folding at the hips, squat down until your bum touches the seat, then come up again. Keep your knee in line with your toes. The picture shows me doing it away from the chair to make it clearer.

Elastic band monster walk

Tie a strong elastic band/theraband/old bike inner tube around your legs, squat down slightly, and then walk forwards, legs pushing hard into the sides of the band to keep it under tension. Walk forwards and backwards. Using a very stiff band is absolutely worth it for this – get the hardest one you can find. 10 steps in one direction with each leg, then ten each leg on the way back, is ten reps. In the pictures I’ve tied the band around my upper legs but it’s probably better round your ankles.

Elastic band sideways walk

As before, but squat slightly and walk sideways one way then back again, like a crab. Move your feet as far as you can with each step and keep tension in the band throughout. 10 steps in one direction with each leg, then ten each leg on the way back, is ten reps.

Elastic band walk-the-line

As per the monster walk but like you are walking on a tight rope, so feet go in front of one another. Push your legsout hard into the band. 10 steps in one direction with each leg, then ten each leg on the way back, is ten reps.

One legged bridge

Lie on your back with knees bent and your feet flat on the ground. Lift one leg up in front of you. Raise up on your grounded leg until your hips are as high off the ground as you can get them. Don’t wobble and keep the foot of your pointing leg static throughout. Slowly lower your hips but keep your pointing foot in the same position, then repeat the raising of your hips.

Split squat

Put the top of one foot (where your shoeslaces are) on a chair behind you and, with your front leg bending, lower your bodyweight down, putting a lot of weight through the back leg. Keep your body straight. Raise up. Try to be as stable as possible.

Sideplank under chair

Lie on your side with your feet just under a chair. Rest your top foot on the top edge of the chair and lift your body so you are horizontal, resting on your forearm. Raise your bottom leg to meet the underside of the chair and lower it back to almost touching the ground. Do this slowly and while keeping absolutely straight – no sagging – and keep squeezing your glutes. 25 reps of this is a pretty good challenge but only go for a fair few once you’ve warmed up a bit.

 

Other stuff that might help

Ice can feel good. Hot pads can feel good. Ibuprofen isn’t bad but doesn’t do a lot unless you keep taking it. Voltarol is pretty effective at taking away pain. Keep the skin on your knees supple my moisturising them as it can remove the itching that can be perceived as pain. Good luck!

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Big days of backpacking in Scotland are pretty hard to beat, but only if you’re pain free.

 

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