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Why Your Quads Aren’t The Knee Pain Solution

knee pain

It is never our goal to make things seem complicated, but the truth is that helping issues like knee pain isn’t ever just about ONE thing! Of course, that isn’t the way to sell you on this or that, it would be so much easier if I picked a muscle in the lower body and told you that it was THIS muscle that was the root of all your issues. That way you could go off and train that muscle and feel like you were helping your knee pain, until you realized it really wasn’t helping very much.

One of the biggest issues in addressing knee pain, especially online, is that there are many different types of issues that can impact knee pain. Let’s look though at a few of the most common ones and what research actually tells us are the most productive ways of addressing such issues.

Patellar Tendionopathy

This is one that we hear about all the time and is the one that is most commonly associated with “hey, train your quads more” types of advice. First, let’s understand the difference between two similar sounding knee pain problems that many even resources may tend to lump together. That is patellar tendonitis and tendinopathy which can have similar experiences and both deal with the patellar tendon (as the name implies). Tendonitis tends to be an overuse injury and that is why it also has the name “jumper’s knee”. That is because it is a common issue with athletes that do a lot of jumping such as basketball. You don’t have to be an athlete to develop such an issue as it is often commonly associated with people that start too fast in doing too much in their training, or anyone that tends to overtrain.

knee pain

There are other factors that can put someone at risk for this sort of knee pain, being a bigger person, flatter feet, lack of flexibility in the lower body, poor ankle mobility, as well as strength of pretty much every muscle in the lower body. So, trying to emphasize or focus on one particular muscle goes against the research. In fat, the same study explains, “Kinetic chain function is always affected; the leg ‘spring’ has poor function, and is commonly stiff at the knee and soft at the ankle and hip. The quality of movement can be assessed with various single-leg hop tests and specific change of direction tasks.”

Usually the recommendation involves some rest to reduce inflammation along with anti-inflammatories. Rest doesn’t mean zero activity, just greatly reducing the specific training (maybe like jumping or running) for a period of time.

Patellar tendinopathy often refers to more of a degeneration of the collagen fibers of the patellar tendon. So tendonitis is more inflammatory and tendinopathy is more degenerative. So, you can see you have to be careful especially on social media, what type of conditions are we specifically talking about. This doesn’t even get into things like osteoarthritis, ACL issues, and so forth that all have their own considerations (we will discuss this week).

What about training though? Exercise is still recommended and this is where you will hear A LOT of people talking about both training the quads more and using things like heel elevated squats.

People often misunderstand the use of heel elevated squats as the ONLY heel elevated squats evaluated for being effective for knee pain don’t look like how most people would assume as you can see below…

knee pain

Yes, that is the MAXIMAL depth studies use on decline squats

In reality, research has shown just good strength focused on loading the lower body can offer similar pain reduction, but also improve qualities like collagen turnover in the knee. The funny part is studies that say such things don’t do a tremendous job in those exercises and you can see below.

knee pain

This study actually compared the three lifting exercises with both steroid injections and the decline squat and found that overall the “heavy lifting” had the biggest benefits. Now imagine if we applied good functional training to a better workout. 

knee pain

You can see with patellar tendinopathy that using exercises that rebuild the collagen like in good strength training is more effective in helping such issues than the decline squat would provide overall. The moral here is that you don’t need extremes or specific muscles to improve your knee pain, especially if we are looking at patellar tendinopathy. What does good training look like? Coach Robin Paget shows what a good overall body workout with these qualities built in looks like..

Don’t miss our NEW upcoming 6-week online CEU Foot, Ankle, & Knee Masterclass where we dive into how to better understand the issues of this kinetic chain that impacts so much of how we perform and our most common injuries. Our early bird won’t last long, don’t miss it HERE


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