Trying to achieve your fitness goals while you hurt is NOT a recipe for great success. Injuries or just general discomfort can plague even the most well intended fitness program. People are SO eager to find a solution to such problems that they will try just about anything and this is something that I can relate to well. Having a very serious degenerative disease of my spine, not having pain or discomfort, and being able to do what I want is very important to me and I’ve tried literally everything there is and remain open to more.
You can imagine my frustration then when people get told things as “facts” to solve their issues of pain or discomfort and those things really aren’t founded on anything really strong. Knee pain tends to be a good example of such issues. No, UP FRONT, if you have pain you should ALWAYS go see your doctor or a health professional that is qualified to discuss with you what could be happening with your pain. Going to social media is NOT an appropriate place to get medical recommendations (even as good as I pride our blogs being, you should absolutely consult with your doctor first!).
Knee pain, like all pain, can range greatly in its causes and the severity. Assuming you have been cleared by your doctor and see the appropriate health professionals there are things we should be mindful of and avoid when it comes to discomfort and knee pain. There are A LOT of myths out there so we are going to combine some recommendations with avoiding some of the most common myths.
Your Quads Are Weak
Renowned strength coach, Mike Boyle, used to have a saying, “there is a bad case of weakness going around.” That statement can be every true but we need to be more mindful of what we are saying. A lot of people are saying that knee pain is due to weak quads and the truth is “kinda, sorta” but this is a really weak statement.
The idea that one’s knee pain is due to ONLY weak quads is a misinterpretation of what we know about knee pain. Can weak quads contribute to knee pain? Yes, but not in the way people often think and neither is the solution. For one, “weak quads” are relative to one’s activity level. You probably have strong enough quads to go about most of the activities in a normal daily life. However, if you start going out to obstacle course races, playing recreational sports, or lifting competitions, you are going to need a higher level of strength.
Even then, the idea that your quads are weak and nothing else is; is a huge problem. It would be wonderful if that was the case because we could just throw you on some leg extension machines and build up your quads and VOILA! Your knee pain would be gone. However, that isn’t the case as the whole chain of the lower body (as well as the pelvis and core) have to be strong TOGETHER!
Yes, that second part is key! We know from research that the way our quads are used on a leg extension are different than in a squat even though they both have knee flexion and extension. The difference comes in the squat that other muscles have to work in conjunction to perform the movement as the quote from research explains below.
Just saying you need strong quads is rather meaningless because it is important the strength and the way the muscles work together of the entire lower body, pelvis, and core.
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Exercises like DVRT UK Master, Greg Perlaki shows above is really key in helping produce strength and stability in the knee.
Foot Stability & Ankle Mobility
When people talk about “quads” for helping knee pain, I often know they are not getting the right messages. Largely because the literature about the muscles of the quads individually contributing to knee pain and health is pretty poor. As this study flat out states…
The important part about this study was it was a review of 20 other studies on the topic!
That is the bodybuilding trap holding us back from getting better results through deeper understanding. There IS a TON of research that shows foot stability and ankle mobility have a HUGE impact upon our knees.
That means training foot stability and ankle mobility at the same time can make a HUGE impact on our knee pain and health. What should we do? Exercises like physical therapist, Jessica Bento shows opens up some ideas.
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You Need To Get Your Knees Over Your Toes
Most people don’t know that we have a pretty good idea how injuries occur. Eliminating injuries completely is impossible because there are so many factors that can cause an injury resulting in knee pain as you see below.
You can see it is MUCH easier to tell people they have “weak quads” or that they should get their knees over their toes. For one, most people don’t suffer an injury or pain because their knees went over their toes in a very controlled and gradual manner. Many injuries occur from very rapid movements with lots of a deceleration and finding what part of the body didn’t work right at the right time (having hip and ankle mobility issues along with core and foot stability can contribute a lot to this).
Why is putting your knees over your toes so popular? For a great deal of people this means putting their heels on a wedge and taking away the need to build that ankle mobility so it gives an illusion of better movement. This changes the entire kinetic chain because force travels up our body from the ground up, so while you may look like you have a great squat, you are actually building movement that will transfer poorly to when you are NOT wedged!
How much so? I sat down and spoke with renowned strength and conditioning coach, Robert Dos Remedios about this very topic. Check out the interview below and why wedging and knees over toes are NOT great suggestions to help your knees or overall lower body strength. This is part of a MUCH bigger discussion about knee pain (we can’t cover it one post but I suggest you check out Physical Therapist, Jessica Bento’s DVRT Rx Knee Program HERE if you want to go into detail) but should help you have a filter to know what is taking you in the right direction and what isn’t.
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Listen to just the audio HERE
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