Let’s face it. You’re getting older, your life’s passing you by, you’re sitting on the couch, and watching TV. All of the sudden, the Everest College Commercial comes on and reminds you that you need to get an education. So you get up, pick up the phone and…it hurts to walk over to the phone because of your knee pain. Bummer. All jokes aside, there’s a small chance that you’re interested in Everest College. Yet, there’s a greater chance that your knee hurts.
So What Causes Knee Pain?
This has a high potential for getting very scientific; so I’ll explain it in the simplest way possible. Improper patella (knee cap) tracking, is the reason that your knees are sore. What do I mean by tracking? Think of it this way, your patella is held in position by various amounts of fascia (which is attached to muscles) pulling it in multiple directions. With improper tracking, your patella is not centered, and is in a position that could possibly rub against the bone, cartilage, etc, thus causing inflammation and knee pain.
There could be numerous reasons why your knee is tracking improperly, but judging by what I’ve seen in the trenches, the most uncommon reason is that your muscles on the outside of your leg are too strong, and pull your kneecap sideways. That is so 1980’s. The most common cause of this tracking problem (that I’ve seen) is bad Q-angle, poor hip and ankle mobility, and weak glutes (your butt muscles). Combine this with all the long distance running that people do, and you have a recipe for disaster that not even the Demon of Knee Pain could dream of creating.
Q-angle?
This is the angle between the hip and knee. Check out the figure below:
The Q-Angle
Generally, you don’t want your knees caving in. Most women have a tremendous problem with this because they tend to have wider hips (for child birth). This is the reason why I barely ever allow any of my female clients to do long distance running. Look at most female marathon runners. Natural selection has weeded out ones with wider hips, leaving the women with small Q-angles to win the races (pain-free).
Normal vs Abnormal Q-Angle
Hip and ankle mobility?
This is basically the range of motion that your hips and knees have (often confused with flexibility). As you get older, the years of sitting at a desk add up, and you end up getting tight (pretty much everywhere), and start losing your mobility. This is why most children can put their feet over their heads, and the reason why your grandparents have trouble bending down to tie their shoes.
Let’s Get Rid of This Pain
First of all, I’m not a Physiotherapist, so use the methods below at your own discretion. With that being said, even if you don’t have knee pain, a lot of people could benefit from taking the advice I’m about to give.
First of all: if it hurts, stop doing it. Duh! A lot of people play Russian roulette with logic and end up losing. Does your knee really hurt after running that 5K? Then stop running until you’re better. Once you’re better, improve your running mechanics. This means getting a professional to teach you how to run properly, or at least doing a little bit of research.
Start foam rolling:
Invest only 10 minutes of foam rolling per day, and you will thank me and your foam roller.
Activate your glutes with the following exercise. Muscle activation simply means: warming up a specific muscle to “turn it on”. Most people recommend doing muscle activation after mobility work, but I’m a firm believer that activating the glutes (specifically) before mobility work will transfer over to an increased performance during the mobility work.
(This video was shot by my own physiotherapist. Dev is the man.)
Mobilize your hips and ankles with the following 3 exercises (focus on feeling your glutes firing in the latter 2 mobility exercises; also, breathe in by pushing your stomach out, hold this air in and exhale at the end of each repetition):
Last (but not least), start lifting weights properly. Use excellent form (don’t let your knees cave in), and use a lot of single leg exercises and their variations (reverse lunges, single leg deadlifts, etc). Progress slowly. When performing most single leg movements, make sure that your center of weight is on your heals (and not on your toes), and that you can feel the movement being executed (at some point in time) in your butt (and not your knees or back). Good rehab is usually just good (and proper) training. Not sure if you’re performing an exercise properly? Ask a trainer at the gym. Don’t be afraid to ask. Usually, the ones who know what they’re doing are also the ones who will happily help you out. Don’t forget to thank them.
Concluding this madness…
Obviously, there is no one single method to rehab an injury, but your first step should always be to get someone to look at it (I would recommend a good physiotherapist over a Doctor). Or, if you want to try the self experimentation route, my tips above are a great starting point. Just remember that nothing will ever compare with getting one-on-one consultation with a well established movement specialist (physiotherapist, chiropractor, athletic trainer, or strength coach with a good appreciation for continuing education). “Why you making it complicated? It’s easy” (Everest Guy).
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