Athletic Therapy, Biomechanics, Chronic Pain, Free Workouts, Posture, Wellness

Knee pain: It’s not complicated (usually)

After seeing an older woman in the clinic the other day a few weeks into her post-knee replacement rehabilitation- her daughter approached me stating she knew she was headed in the same direction as here mom (aka, was already having knee and hip pain in her life) and wanted to know if there was anything she could do to prevent the process.. or if it was just inherent that she too would eventually have to replace a joint or two.

If there is one thing I want to get across to people it’s that nothing to do with our health is guaranteed.

What I mean by that is.. just because you have a family history of something does not mean it can’t be prevented or course corrected. ESPECIALLY when it comes to our movement health!

When it comes to the knees.. generally the actual problem is coming from the hips and/or feet. I refer to the knee as a bridge joint. It is designed to improve efficiency of transit, absorb and transfer force. If the lines of force get messed with (aka you lack stability in the joints above and below), then the efficiency of that joint and it’s movement go right out the window. Stress builds up and that leads to warning signs (pain), inflammation, stiffening, and of course eventually degeneration of the structures within the joint. This can present via tendonopathies, osteoarthritis, runner’s knee/jumper’s knee (both tendonopathies), patellofemoral syndrome or patellar chondromalacia, and even increase your risk of ACL/MCL and meniscal injuries.

Barring external trauma (but yes postural dysfunction can even contribute to the risk of this), pain and issues in the knee generally are coming from above or below.

This is why I always recommend those passionate about running or other repetitive movement based activities get their gait screened by a professional. Catching dysfunction early and prescribing appropriate corrective movements is key in preventing problems down the chain.

Here are 4 “simple” exercises I prescribe routinely to clients experiencing knee/hip/back pain or rehabbing a joint replacement.

1. Clamshells.

You’ve probably seen these before. Designed to activate the lateral stabilizers in the hip, you should feel the burn on the top side of your hip as that is where the activation should come from. Laying on your side with knees bent to approx. 90deg, hips and ankles stacked- clamshell the knee open lifting from the hip. Do not let your hips fall backwards, they should remain stacked and level throughout the movement. Hold the clam at the top range of motion (wherever you can raise to without your hip sliding back!) for 10seconds, slowly return back to the start position.

Repeat 3 sets of 10-15 routinely in your day. The more you activate the muscles properly, the more the brain makes it automatic.

2. Gait Activation

Laying on your stomach, tuck your chin to lift your head (nose should remain pointed down to the ground!), and squeeze your butt cheeks together. Holding and maintaining this position, press opposite arm and leg to the ground while lifting the other opposite limbs off the floor. Hold for 4seconds, switch and repeat process.

This activates Deep postural muscles and connects the brain to a proper gait transfer pattern. It also cues butt activation and neck stabilizers.

Repeat 3-5round of 20 a day.

3. Single Leg Bridging

If you struggle with regular bridging, this is a advanced progression- so work towards it with holds before movements. Glute activation is key here!

Finding your bridge, lift one leg off the ground maintaining your glute activation. Lower the pelvis down half way and then push back up to full bridge on the one leg. Your hips should be the pivot point, not your low back! Core should remain strong, and glutes should be the main push to full hip extension. Drive up through the supporting heel to help engage the back half of the body/butt.

Repeat 6-10/leg for 3 – 5 rounds.

4. Side Bridges

Classic hip hinging activation exercise. All these movements also double as releases for the front of the hip (tight hip flexors anyone??).

On your side, supported by your elbow, shoulder, and core activation, pivoting from the knees- use glutes to actively push hips up and forward through a hinge motion. Hold at the top for 5-10seconds, then sit back and down through the hip hinge.

Common mistakes here: slouching into the shoulder (push UP through the ground/elbow and squeeze shoulder blades together), lack of core activation/bracing allowing for the spine to hinge instead of the hips (think of a squat motion at the hips!), lifting up THEN forwards.. try and make this simultaneous, as if your hips are moving up and down a ramp.

Repeat 6-12x for rounds of 3-5. Great used as a warm-up to other activities.

You would also do well to add in some foot exercises! @thefootcollective on instagram is one of my fav resources- but you can also refer to our existing post about old person feet here!

Struggling to figure these out? We offer complimentary movement assessments and consults to new clients. Prevention and rehab programs for all sorts of clients are available. Have questions? Leave a comment or find us directly at katmahtraining@gmail.com. We’re always happy to help you get your movement right!

Have fun kids!

Athletic Therapy, Biomechanics, Chronic Pain, Conditioning, Equestrian, Free Workouts, Motor Learning, strength training, Weight Loss, Wellness

At your age…

Here’s a fun tidbit I hear OFTEN second hand from clients after their friends/family/peers find out what their training and therapy plans consist of…

“At your age, should you really be lifting weights?”

“Isn’t weight training dangerous for your joints? Does that really help you feel better?”

“Aren’t you worried about getting injured again?”

“I heard that weight training is bad for you- doesn’t it cause arthritis”

First off.. I’m honestly not sure where people are finding that last bit of information from, at this point in our history. Secondly I’m also endlessly grateful that I’ve stopped frequently hearing that weight training will make women bulky- at last that myth has been put out of it’s misery. Third off- weight training is highly effective for arthritis rehabilitation and management- WHEN IT IS DONE CORRECTLY. The only time it’s going to cause arthritis is if you don’t do it in good form. This is why having the guidance of a trained professional is imperative when starting any new program. At the very least get a movement assessment and see where you need to work!

Would I tell someone of ANY age to just go and start lifting weights (no matter how much)? NOPE.

Do I prescribe and coach programs for ALL ages (yes, all the way up to 90-somethings- seriously) that involve various amounts of loaded movements, functional movements, dynamic movements, and stability training? You bet I do!

Here’s the neat things about the body.. it works on an adaptation based system. Which means- invariably- to IMPROVE our systems we have to STRESS our systems.

Here’s the feedback I get from my dedicated clients:

“I don’t wake up at 3am anymore with back pain”

“I sleep through the night and don’t wake up stiff in the mornings anymore”

“I don’t get tired during the day”

“My joints aren’t bugging me as much since I started training”

“I’m making healthier choices elsewhere in my life since starting this training routine.”

“I FEEL GOOD”

When we apply GOOD, healthy stress to our system- things change for the better. We also develop a higher tolerance for negative stressors, which means we function just overall more kick ass.

It no longer new information that the mind and the body are one coordinating unit.

Exercise, movement- of any kind- is the BEST and most EFFECTIVE medicine. The stats support it. Check these out.

According to the Conference Board of Canada, if we were to decrease the number of inactive Canadians by even 10%, we’d see a 30% reduction in all-cause mortality and major savings in health care. It is in fact estimated that more than $2.4 billion, or 3.7 per cent of all healthcare costs, were attributed to the direct cost of treating illness and disease due to physical inactivity1. The financial impact of poor health amounts to a loss of more than $4.3 billion to the Canadian economy, and the negative repercussions of inactivity cost the healthcare system $89 billion per year in Canada2. According to several studies, properly structured and supported exercise program, designed and delivered by a kinesiologist can, among other benefits:

  • Reduce the risk of high blood pressure and heart disease by 40%;
  • Reduce the incidence of type 2 diabetes by 50% and be twice as effective as standard insulin in treating the condition;
  • Help the function of muscles for people affected by Parkinson’s disease and Multiple Sclerosis;
  • Decrease depression as effectively as pharmacological or behavioural therapy;5
  • Reduce the risk of stroke by 27%;
  • Reduce the risk of colon cancer by 60%;
  • Reduce mortality and risk of recurrent cancer by 50%;

(Based on year 2009. Jansen et al., 2012 2 Based on year 2013. 3 Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women.
Barlow CE et al. Am J Epidemiol 2006; 163:142-50. 4 Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. DPP Research Group. New England Journal of Medicine 2002; 346:393-403. 5 Exercise treatment for depression: efficacy and dose response.
Dunn A et al. American Journal of Preventive Medicine 2005. 6 Physical activity and colon cancer: confounding or interaction? Medicine & Science in Sports & Exercise:
June 2002 – Volume 34 – Issue 6 – pp 913-919)

Weight training- when done intelligently for each individual- is just as effective as other types of exercise in improving health. It has it’s own set of extra benefits and of course risk factors. Just like that Tylenol you like to pop for your back pain.

There is no one way to utilize the benefits of movement. Some people to pick things up and put them down.. others like to yoga.. some like to do step classes, and others just like to go for regular walks and stretch. IT’S ALL GOOD.

The biggest emphasis I am trying to make is that adding weight to your routine when you’re doing it correctly for YOUR SYSTEM (this is where the help of a trained professional often comes in), you’re looking at more resilience throughout your body and mind.

Don’t knock it til you try it 😉

(With the correct prescription and educated advice, of course!)