Do you have knee pain that increases when you run, jump, climb stairs or sit too long? Did it come on gradually without a traumatic event? Is it located under your knee cap or in front of your knee? If so, you may have patellofemoral pain (PFP). For an accurate diagnosis, please contact your medical provider. This blog is might to be informative!
Many people think that if they have knee pain, they need to strengthen their thigh muscles and specifically the quadriceps.
However, research shows that it may be more effective to strengthen the hips and improve torso endurance. Once strength gains have been achieved, then work on correcting bad habits with squatting, lunging and jumping. With consistent exercise and with good form PFP should be gone!
CONCISE PLAN:
1. Strengthen Hips (hip abduction, hip extension and hip lateral rotation) for 5 times a week for 2-3 weeks.
2. Improve endurance of the torso (front, sides and back) for 5 times a 2-3 weeks
3. During activities of daily living such as going up and down stairs - remind yourself to lean torso forward as you bend through your hips.
4. After 2-3 weeks of getting stronger in your hips and torso, then work on breaking bad habits with squatting and lunging.
PLAN in DETAIL:
Hip Abduction Exercise do 3 sets of 15 with a 5 second hold at the top of the movement. Once you able to do this with good form, then add an ankle cuff weight to continue to increase strength staring with 2# and working up to 6#. The All Pro cuff weights are great because they are adjustable!
TIPS: Make sure you feel the work in the side of the butt (gluteus medius), just behind the hip joint - not in front of the hip joint! Keep core organized and in, lift leg from the hip joint not from the waistline and watch that you do not roll back, stay on the knife edge of your body.
Hip Extension Exercise: Do 3 sets of 15 with a 5 second hold at the top of the movement. Once you able to do this with good form, then add an ankle cuff weight to continue to increase strength staring with 2# and working up to 8#.
TIPS: Keep leg straight to target gluteus maximus. Shoulders are down and core drawn in. Pelvis square to the mat.
Hip Lateral Rotation Exercise: Elevated Clamshell, this is preferred over regular Clamshell. Having the feet lifted, allows for more range of motion. Do 3 sets of 15 with a pause at the top of the movement. Then add resistance with a band. The HANDIBANDS (my patented product) is great here because the foot loops stays put on your foot!
Hip Lateral Rotation on Your Stomach Exercise: This is preferred over seated hip lateral rotation. Lying on your stomach stretches the hip flexors and does not allow them to "cheat" the exercise. Do 3 sets of 15 with a 5 second hold with a resistance band. The HANDIBAND works great because it attaches inside of a door jamb with either the handle out or the foot loop out. They also adjust. Thus, by shortening the length you increase resistance.
TIPS: Make sure the pelvis is grounded to the mat. Rotate the femur (thigh bone) not the pelvis. Keep core engaged.
Target the endurance of the front of your torso with Planks: Create a straight line from hands to your feet. If weight bearing bothers your hands, you can be on your elbows. Hold 10 - 60 seconds and do 3 times.
TIPS: Squeeze your core, gluts and thighs. Do not sag in low back back. Keep shoulders down and ribs knitted in.
Target the side of your torso with Side Planks: NOTE: if your left knee hurts you should have your left elbow on the mat - strengthening your left side of your torso. Hold 10 - 60 seconds and do 3 times.
TIPS: Keep waistline lifted and shoulder stabilized away form ear.
Strengthen the Back of the Torso with Hypers: If at the gym, go to the hyper machine and lift torso. Hold the position for 5 seconds and do 3 sets of 15. Then add a weight.
If you are not at the gym, you can do at home with a BOSU or the MINIMAX (my other patented product). Ground down through your toes, squeeze gluts and abs, lift torso and hold 5 seconds for 3 sets of 15.
TIPS: Protect low back from over exertion with strong squeeze of gluts and abs.
PHASE TWO AFTER 2-3 WEEKS OF PERFORMING THE ABOVE EXERCISES AT LEAST 5 TIMES A WEEK...
BREAK BAD HABITS
1. When squatting make sure that you are bending at hips as your torso comes forward with a straight spine. "Reach your butt back as your knees bend". When you look down at your feet you should be able to see your toes.
2. When lunging, doing single leg exercises, jumping or hopping, make sure the knee cap is aligned straight forward. Not squinting inward - which is a collapse of the knee.
I hope these exercises and tips help you in decreasing your knee pain. Please reach out with any questions. If you find this information helpful, please share.
In health,
Martina P.T, PMA-CPT
Founder of Hooked on Pilates®: Inventor of the patented MINIMAX (The All-in-One Yoga & Pilates Tool) and HANDIBAND (The All-in-One Resistance Band)