Won Body Won Life,Ep 7: 5 Best Exercises For Knee Pain Revealed

What are the absolute best exercises for knee pain? 

The answer is: it depends… 

Every individual is different, and every knee is different as well. 

However, these 5 exercises I reveal are truly some of the best exercises to alleviate knee pain and get your knees to start movin’ and groovin’ like you want them to! 

For some of the 5 exercises I talk about, if you don’t have the equipment for it but want to give it a go, I’ll link you below to some items I currently have and use for keeping my knees healthy. 

1. Monster bands for terminal knee extension exercise: https://amzn.to/3AMY4D8 . Ideally get one that is 60-150 lbs in tension. 

2. Resistance loop exercise bands for squats, hamstring curls, side planks. If using bands for squats or side planks, place band around knees. If performing hamstring curls, place band around ankles: https://amzn.to/3EZzykS 

3. ProForm Dumbbells for squats or heel raises: https://amzn.to/3AGaOvt 

Thanks and hope you can start getting relief from knee pain today! 

Scroll down for the show transcript.

Welcome to the Won Body Won Life podcast. Hi, I'm your host, Dr. Jason Won lifestyle physical therapist, I talk about everything health and wellness related so you too can have a more resilient body any more fulfilling life. If you haven't yet, please support the channel by hitting that subscribe or follow button so you never miss out on another podcast episode. Also, if you could please leave a review or ranking before leaving this episode. That way more people will be able to benefit from the context of my podcast.

Today I'll be talking about five grand exercises to relieve knee pain. Knee pain is something very common that many people will experience in their life. Low back pain actually being the most common, but the second and third most common might be knee pain. And the reason being is because the knee joint is a hinge joint, it doesn't have a lot of degrees of range of motion like the shoulder, so it is subjected to whatever happens around the ankle or the hip. The hip has a lot of range of motion, the knee does not the knee is strictly a hinge joint mostly is involved with just flexion and extension also has some degrees of internal and external rotation.

However, today, I'm going to be sharing with you five of my favorite knee pain relief exercises that when incorporated on a weekly basis, or at least a twice per week basis, can really alleviate your knee and allow you to squats run and move more proficiently.

So the first exercise that I want to share with you is simply the squat. And I know that many people think that the squats may not be the right exercise for them, because it causes knee pain. Or maybe you've been told that you shouldn't squat if you have knee pain, because squats will make it worse. A lot of that is honestly hodgepodge, there is actually a plethora of benefits to squatting to strengthen your quads, your hamstrings, your glutes, the entire lower body chain.

However, there is a lot of negative narrative narratives and stigma around squats. Because if you've ever squatted, and all of a sudden you felt either a crack or a pinch or some pain on the way down or the way up, you may think to avoid squats. However, avoidance is never the key when it comes to avoiding painful movements, that actually puts it in the do not do list, which then disables you from doing very simple things like going down the stairs, walking down a hill, or even just squatting to go to eat dinner or to even sit down on the toilet. So squat is a very quad dominant exercise. And the purpose of strengthening your quads is to help with knee extension that is to help straighten your knee. So when you're picking up something from the floor, it allows you to straighten your knees back up back up into a standing position without falling down to the floor. Now another myth that I want to debunk right now is keeping the knees behind the toes. So keeping the knees behind the toes.

If you've ever done that before, it's a little bit awkward and makes you feel like you're falling backwards. But you might notice that it actually alleviates your knee or at least it decreases the stress to the knee. And this is actually proven in research. There was a study done in 2003 by the University of Memphis that talked about the joints and torque angles. And where you apply stress is when you keep your knees either over your toes or keep the knees behind your toes.

Now, what the research shows is that when you get your knees over your toes even just slightly, that increases the stress to your knee by about 28%. So that it seems like a lot initially. But when you look at the subjects that kept their knees behind the toes, that means that the tibial angle was relatively perpendicular to the floor. That means that the knee was directly over the ankle, and the knee did not pass the toes. Now it did decrease the stress to the knee by a little bit. But what it did was it increased the stress to the lower back and the hip by about 979%. That is a huge trade off when it comes to stress in the knee just 28% versus risking a hip or lower back injury because it increases the stress to those areas so much more. So getting your knees over your toes on a squat, even if it's just small range of motion, and slowly progressing to larger range of motion will be in your favor. Your knees rely on getting over your toes to do simple things again like going down the hill or sitting on On a toilet, so that way, that's why the squat is the most fundamental exercise known to men. And it's something that you should not avoid, as well as not avoiding knees coming over the toes when you squat. Alright, so the second exercise is called terminal knee extension, aka T Ke. With a monster band. If you don't know what a monster band is, I will link that in the show notes. So feel free to go to the descriptions, and check out some of the monster bands that I recommend and that I use myself. But whenever somebody has knee pain, it's very often that they will benefit from terminal knee extension. And the reason being is because it strengthens the quadricep at the end range of motion. Restoring your knee extension is likely more important than restoring knee flexion. knee flexion is bending the knee bringing the heels towards the butt.

So in daily life, though, is not very often that we have to bend our knees to extreme ranges of motion. However, just to be able to walk across a room, it is imperative to get your knee range of motion back into full knee extension. Very commonly when I see women and men with knee osteoarthritis is that they'll start to lack both flexion but they'll lack a good amount of knee extension. Now to make sense of this on why knee extension is more important for knee flexion. When it comes to your gait pattern when you are walking and when your heel is about to strike the floor, you ideally want to strike it the floor with a knee that has full knee extension. However, if the knee lacks any extension, that's going to put a lot more stress at the knee joints is going to put a lot more stress at the hamstring to pull yourself forward into propulsion when you walk forward. And it will cause actually a lot more stress to the proximal tibial femoral joint which is basically the knee joint lining between your femur, which is your thigh as well as your tibia, which is your shin. So when you restore for knee extension, it's very common when you do this terminal knee extension exercise, you will notice that you should be able to walk a little bit better, most people will be able to walk better almost immediately. And how the setup goes is that you either get a monster Ben, and you'll attach the band to some sort of anchor point. This could be a very heavy sofa leg, it could be a railing from a stair or it could be any pole or anything around your house. you'll attach the band to the pole and then you'll put the band behind the back of your knees your knee cap will be facing the anchor point you will step backwards so that you have a little bit of resistance and the band is pulling your knee into flexion and you're going to straighten your knee against that band.

Usually I would recommend for pain relief doing anywhere between three to six repetitions 10 to 22nd holds and your leg will get fatigue but you will restore some of that knee extension. If you are doing this more for just generalized knee strengthening or hypertrophy, you may want to increase your repetitions to anywhere between eight to even 20 repetitions. So that is the terminal knee extension. And this can be progressed by either moving further away from the anchor points, or you can simply just add a heavier monster ban. If there is any chafing or anything behind your knee like the band is rubbing against your skin and it's causing some irritation. Simply just put a towel between the band and the back of your knee and that will make it a lot more comfortable. Alright, so the third exercise is a hamstring curl. The hamstring is a muscle that attaches from your ischial tuberosity, which is basically your butt bone and attaches to the back of your knee. Now because it attaches to two different areas, the hamstrings do aid in hip extension which is kicking your leg backwards. And it also aids in bending your heel towards your butt which is called knee flexion. That hamstring curl is extremely important because it's one of the main muscles to help with moving faster. And it also helps from preventing the shin from moving forward too quickly. Let's say when you are running and you're trying to stop or let's say you're trying to sprint you want to be able to pull that foot backwards. Once that heel strikes the floor and the hamstrings are the most important muscle to do that. And the hamstring is one of the primary muscles of the posterior chain which is the back of your leg including the glute complex as well. So the hamstrings I see very often that you can do this in many different positions. You can either attach a looped band around your ankles and you pull your heel toward your butt. That'd be a Standing hamstring curl, you can go to a gym, and they'll often have hamstring machines where you're lying down on your belly, or you're in a seated position. And that actually does matter because when you are in a seated position that puts more stretch on your hamstring, so it often aids in more hypertrophy of the musculature. But the prone hamstring curl is a very effective option as well, it just depends on the intended goal. I often see that when people do hamstring curls, their knee will actually feel looser immediately, they will notice that a lot of times that their heel strikes the floor that they're able to either move quicker, or their knee hurts less when their foot strikes the floor. So the second exercise is the TK E, which is terminally extension that helps strengthen your quads helps and alleviates the knee and aids in knee extension straightening of the knee. But the hamstring curls are equally as important. Having a strong posterior chain will allow you to move quicker and more efficiently. It may not aid with your balance per se. But it definitely will help protect the knee, strengthen the knee and preserve the knee from incurring any arthritis or speeding up of arthritis, I oftentimes will incorporate hamstring curls in every single one of my leg workouts, I find that extremely important. I actually have a history of a meniscus tear. And I've also torn my medial collateral ligament.

So hamstring curls are definitely a staple exercise in my own program, along with a lot of my clients with chronic knee issues. Right, so the for exercise is a side plank. And this is actually an exercise that does aid in balance. Now when we've talked initially, about how the knee is subjected to whatever the hips and the ankles want to do, so if the hip has any weakness, or if the ankles are super stiff, then what happens is is going to incur more strain at the knee. So if we strengthen our hip muscles, then that will usually allow us to feel more balanced. And that will take stress off of the knee. And I hope that makes sense, is basically like not sending a warrior or somebody into war, and sending them out by themselves, versus sending them out with their buddies or their other other other people who will help them in war, we want to make sure that we strengthen not just the muscles around the knee, which is our quads and hamstrings, and also our calves mainly. But we want to strengthen the muscles above which is our hips. And so old school, conventional physical therapy used to look at every single patient with knee pain, as in we need to get the kneecap moving. They often said that the kneecap is either misaligned, though feel like Oh there they have tight it, man. So the kneecap is moving in some direction. And very rarely is that simply the case where if you just start moving your kneecap back and forth, right and left up and down, that is going to alleviate the pain long term. It rarely is that I rarely will give anybody nowadays patellar glides, which is basically pushing that kneecap up down left and right, I find that that's very, very wasteful of your time. And it's not very effective. So this is kind of the analogy of when you have a train on a track the train is the kneecap. And the train track is basically your thigh and your shin. They used to think that we need to just simply move the train back on Switch Track and everything will be squared away, everything will feel a lot better. And they were showing that a lot of these patients were just moving their kneecap around, we're getting very negligible results. But what they figured that instead of moving the kneecap, why don't we fix the truck? Why don't we actually realign the truck and actually make the truck stronger and more stable. So that's essentially what a side plank will do for you is that the side plank mainly strengthens the lateral core musculature and also strengthens your glutes, but mainly it's your hip AB doctors it is the muscles that bring your hips out to the side is basically like a side kickout.

So when you're strengthening in a side plank, and there are many different side plank variations, it will strengthen the outer parts of your hip. And you can think of this as like when you're rolling a bowling ball down the lane, and sometimes you get a gutter. But instead you won't get a gutter. If you put up the basically the bars if you put it the bars on that side, then there's no way that that ball is going to move into the gutter. And that's kind of like the kneecap. So if we can strengthen it by strengthening the side musculature that will allow the kneecap and they'll allow the structures around the knee to incur less stress when you're doing your day to day activities. So I'm a huge fan of side planks often see that when I incorporate side planks for some of my clients, that you recheck how they're walking or you recheck how they squat, and the quality of that motion becomes a lot better. are so sigh planks is number four. The last and final exercise I want to give to you is the bent knee cavalry's the bent knee carries is when you incorporate a very small squats, sometimes as little as 10 degrees, but as much as 20 to 30 degrees of knee bend, and you're simply bringing your heels up and down, which is called a calf raise. So the calf is composed of two muscles, which is the gastrocnemius, but also the soleus. And the difference between that is the gastroc and the soleus. They both attach to the Achilles tendon and detaches down into your heel. But the gastroc also crosses the knee so that you can actually strengthen your calf by bending the knee. The soleus, though is more of an endurance based muscle, and that soleus attaches strictly to the tibia and does not cross the knee. So in order to strengthen the soleus, you want to bend your knee to take the gastroc out of the equation, and you want to strengthen the soleus by moving your heels up and down. Now why that's important is for two folds one, the soleus is more of an endurance based muscle.

So being able to walk or even light jog and do that for a long period of time, that will actually protect the knee because that muscle will have a lot more endurance. If the soleus is undertrained, then the calves are going to get very sore or the calves are going to be not supporting the musculature up above which will then increase the stress to the knee. The second reason why bent knee calf raises are important outside of just the endurance aspects is that when you do enough bent knee calf raises, it will make your ankles more flexible, it will increase the joint and the tissue mobility around the ankle complex. That is very important because when you're squatting down or when you're doing any sort of movement where your knees are bending, you want to have good flexible ankles. Sometimes my knees will actually hurt more because I've had a number of ankle injuries in the past I've sprained my ankle and basketball. And because I've have some scar tissue, I need to continuously work on my ankle mobility. Otherwise, when I do squats, my knees will actually hurt more. But when I incorporate more bent knee calf raises into my life or into my strength regimen, I noticed that my ankles are more flexible. And I'm able to do a lot more things like going down the stairs, or walking down a hill with much less knee pain. So the bendy carries both are important straight knee calf raises are important as well, because the gastroc is a more powerful muscle that helps you to jump and run and sprint faster. The soleus also aids in that but the soleus is more of an endurance based muscle. And because you're bending your knees, it will allow you to increase your ankle joint mobility.

So just to recap on those exercise number one most important exercise is the squat. Number two, I put the terminal knee extension with a monster ban, you can see a link in my description if you want to look at that. Number three is hamstring curls. Number four is a side plank. And number five is a bent knee cabarets. Now, this is a very generalized exercise plan, but it encompasses every lower body muscle that you do need to strengthen your body. This would not be just a generalized plan where if I was actually seeing you as a client, I might create certain things where you're really strengthen your quads more, or your hamstrings more, or maybe I see a big ankle mobility deficits. And I give you a lot more ankle mobility stuff. So every person with knee pain is different. But I want to give you at least five exercises that I think that if you can apply, you can start to get some relief from your knee today.

If you do need more help, well I do have programs, which is called the pain free Academy. The pain free Academy is a program that you can apply for by going to go dot flex with Dr. j.com/apply. And you can fill out a simple application and apply there. Once we review your application, we can either approve it or we can send you more resources. But this is a program that I truly believe in. And I've seen a number of clients benefit from from all around the world. Of course, these five exercises, I think is a great place to start. If you're listening to this podcast, if you start to incorporate this maybe two to three days a week. This can be something that can truly change things for you, especially if you've had a lot of chronic knee issues. But that's what I got for you guys today. If you have any questions, feel free to send me an email Jason at Fletcher Dr. day.com. I love if you can give me some feedback on this podcast. But also if there's anything else that you'd like to learn, I always take that into account and I will use it for future episodes.

And also if you do like this episode or like any of my podcasts, I'd love if you can subscribe or follow and also leave a review that way other people will be able to see this and it will be broadcasted to a larger audience. I'll see you guys on the next one.