Nobody likes it when their joints get in the way of doing the things they love to do. This could be in reference to an acute injury, but what I am referring to here is more applicable to chronic achiness / soreness / stiffness and a general lack of confidence in a joint. If you were to poll people who live an active lifestyle about what joints give them the most trouble, I would suspect that the knees would be at the top of the list (or at least close to it).
First things first – if you have an acute injury (for example maybe you just sprained a ligament, or you recently came down with a tendonopathy) then seek care from a qualified medical provider. However, if you are out of the acute phase, and possibly you’ve even been cleared by said provider to return to your activity, but you STILL have problems with or doubts about your knee, then I think the information here will help guide your training.
In these circumstances a multi-faceted approach is often helpful:
- Identify any mobility restrictions (including excessive tension in the soft tissues) and work to improve those.
- Determine if the knee has adequate muscular strength through a full range of motion
- Ensure that you have enough body control / kinesthetic awareness to do your activities while keeping the knee in reasonably safe alignments.
MOBILITY
A healthy joint should be able to achieve full range of motion, and in the case of the knee that means both full extension (a locked knee / straight leg) as well as full flexion (pulling your ankle close to your butt). If your knee is unable to do one (or both) of those things it will most likely lead to problems. Also, if there is a notable difference left side vs. right side, it is also likely that you will be facing some problems.
When working on your knees be sure to address BOTH extension and flexion. It is my experience that people almost completely neglect extension (again, the ability to lock your knee completely). If you lose even a few degrees of extension in your knee it can manifest into big problems.
One other big component of mobility as it pertains to the knees is looking at your hips and ankles, because restrictions in either of those joints will often cause excessive wear & tear on the knees. For example, if someone has decreased mobility at their ankle it will affect the knee’s ability to travel forward over the toes during squats, lunges, or even walking up stairs. What this means is that the knee is not allowed to get into its optimal position for the task (the ankle does not allow it), but the task still is performed … so of course the knee is not going to feel great doing it, since it is not able to get into the position it is meant to be in. Circumstances like this are a common reason that people get excessive wear and tear on their knees.
STRENGTH
It is imperative to understand that strength is positionally dependent. The knee should be able to bend well beyond 90 degrees, however most people spend very little time training the muscles around the knee in that range; meaning they may have fair strength with a semi-straight leg, but when in a deep knee bend they have alarmingly little strength. Even if they do exercises such as squats or lunges, most people do not go all the way to full depth – usually “because it is hard” or “because they can’t lift as much weight that way” … ego anyone?
If you want your knees to be as resilient as possible you must train them in their weakest positions – the only way to make the chain stronger is to fortify the weakest links. This can be accomplished through compound exercises like squats or lunges that take the knee well beyond 90 degrees, and it can be supplemented with isolated / targeted exercises for the hamstrings and quadriceps to help develop strength in both directions from that joint angle.
ALIGNMENT
The knee is primarily a hinge joint – it is more or less designed to go front-to-back with not much else happening. If lateral motions or twisting motions are to occur, the body does much better when that comes from the hip (and to a degree ankle) with only a tiny component coming from the knee itself.
That said, it is important to understand that the knee is the strongest and safest when it is tracking over the toes. That, of course, means that if the knee were to deviate and NOT track over the toes, that both strength and capacity are compromised. When that happens, not only do you lose strength (or the ability to perform), it also means it takes much less force to do damage to your knee (a reduction in capacity).
So, in your training you should be tuned into how your knees are tracking in comparison to your toes. Some general things to watch for:
- It is much more common for the knees to cave inwards (looking “knock kneed”) than the opposite of that. The knees caving inwards is called “valgus”
- Due to hip structure, this is more common in women than men, but still is something everyone needs to watch for
- The knees should track the toes through a full range of motion. It is common for the knees to track well during the top portion of a squat, but as the lifter gets deeper into the bottom position the knees start to cave in.
- It is also common for someone to have good alignment on the entire way down on a squat, and then as they switch directions and start to stand back up, that is when the knees cave inwards
- You should watch for this both on bilateral exercises (squats, deadlifts, kettlebell swings, etc.) as well as unilateral exercises like lunges, or even climbing stairs.
- In fact, most athletic activities share more in common with unilateral movements, so these are especially important to pay attention to.
In summary, a multi-faceted approach is the best way to go about fortifying your knees. Work on mobility, strength, and alignment, and you will have just about all your bases covered.
-Tony Gracia
