By Dr. Jessica Warnecke PT, DPT, OCS
Why does knee pain occur so often in active people? Besides the obvious fact that active people move around and are on their feet a majority of the day, which increases their chances of feeling pain, knee pain can be present in those that regularly run, bike, lift weights or play sports for a number of reasons not related to suffering one specific injury.
Lack of adequate glute (butt muscles) strength is the single greatest reason for a patient to tell me they have knee pain, yet haven’t suffered any injury. Our gluteal muscles (maximus, medius, and minimus) play a HUGE part in the function of our low back health and lower body movement with literally every activity during the day.
The glute maximus is supposed to carry us through each stride with walking, every stair we take, and any time we get off a chair or out of a car. The glute medius and minimus play an important role in controlling our knee alignment so that we don’t lose tracking of our knee cap or have too great an inward pull from our inside leg muscles. Patients always look at me bewildered when I explain how their butt is affecting their knee. Yes, I know the muscles don’t go all the way to the knee. But, the control they exert is supposed to.
Luckily, this fix is simple- strengthen your glutes. Two of my favorite ways of doing this are through the bridge and clamshell exercises.
Another factor to consider is your training habit. How often are you training? Too much? Not enough? Both can lead to knee pain.
Training too much means your body doesn’t get the necessary rest for recovery. Overtraining can be detrimental to many systems in the body, but if you’re running or weight lifting every day without listening to the body tell you it’s sore and tired, then knee pain can easily develop.
Training too little means there is no consistent foundation being built to allow your body to adapt and grow the way it needs to. There is a reason why people spend months training for a marathon. It isn’t wise to get off the couch one day and go run 26.2 miles, nor is it probably feasible. If you lift weights once/week, and every week you try to add more sets, reps, and weight, your body isn’t ready to take on this big of an increased load.
What’s the bottom line? If you approach your running or your weight training once in a blue moon, or even just 1-2x/week, you may be trying to progress your exercises quicker than your body can improve its tolerance. Consistency is important.
Factor #3: Stretching.
Do you do it? Hopefully. But probably not enough.
A proper warm up (dynamic stretching) and cool down (static stretching) are vital to the health of your knees. Make sure you’re spending 5-10 minutes before you exercise with a gentle dynamic warm up (think walking, high knee marching, butt kicks, etc) to prepare your knees for action. Then, spend 10-15 minutes after you exercise statically stretching your back, hips, quads, hamstrings, and calf muscles. Hold these stretches 30-60 seconds and make sure to do both sides of your body.
I’ll share two more key points: one for runners, one for weight lifters.
My runners out there, what type of surface are you training on? Track? Treadmill? Gravel path? Sidewalk or street?
Your training surface is important to your knee health. Avoid concrete sidewalks or streets as much as you can. The forces from these surfaces are more intense on the knee (+ hip and ankle joints) than a treadmill, track or gravel path.
Also, try not to train on the same path every time you run. I’ve had numerous patients that were avid runners- great strength, good endurance, but they ran on the sidewalk down the same roads every time they trained. If you think about roads and sidewalks, they aren’t completely level everywhere. You may have divots or a slanted decline for much of your journey. If the left side of your body is always running on the side slanted down, then adaptations will occur in the back, hip, knee, ankle, and foot joints.
Easy solution-switch up where you run.
For my weightlifters, and by this I mean people that lift weights or use machines or go to the gym and find a kettlebell, are you training your hamstrings, quads and glutes efficiently? After a leg workout, where do you feel sore?
If you are consistently feeling sore in one area (such as quads) but rarely getting sore in your glutes or hamstrings, then you are overworking one muscle group. Play around with your leg exercises and make sure you’re getting enough hamstring vs quad vs glute action and soreness each week.
I could go on for pages about knee pain, the many things factoring into it, and multiple ways to fix it, but I know no one wants to read that much.
If you have more specific questions or want to schedule a FREE 20-minute consultation to have me check out your knee pain, contact me below so I can help you out!
Meet Your Therapist
Jessica has been in Austin, TX for the past four years. She grew up in Idaho and attended PT school at Idaho State University. She completed an Orthopaedic Residency and became a Board Certified Orthopaedic Clinical Specialist in 2016.