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.
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 firstname.lastname@example.org. We’re always happy to help you get your movement right!
Have fun kids!