I was contemplating for a while what to write for my first fitness post. So I chose something meaningful and close to my heart. Knee injuries are the most common problems I see in group classes and personal training. Everyone seems to have pain and discomfort, meniscus problems or knee surgeries of some sort. It is very concerning that such a big part of the population has a problem with a joint, that is supposed to carry all their weight for the rest of their lives.
I myself had knee problems as a teenager, putting my dancing career on hold. It took many years of learning everything I could about anatomy and how the body works, to heal myself from this. I am here to tell you, a knee injury doesn’t mean you have to give up your favorite sport or sit on a couch for the rest of your life (the contrary actually!). A knee injury will be with you forever, though. You will get better and be able to do all the movements you desire, however, you will always have to pay special attention to your knees.
The most common misconception is that people think they injured themselves in one specific moment. Unless someone ran into you like a player at the Football World Cup, it is unlikely that your knee injury came from one moment. Most of the time, we are doing a movement, like the simple squat, wrong for many years and decades. This is what causes a knee problem that will take time to reverse.
Let’s look at the 3 most common reasons I see for knee problems:
Every body is different - there are no two human bodies alike. Even if you are twins, the way you move, nourish your body, and walk through life are different. The biggest cause for knee problems - I believe - is an inward rolling of the feet (pronation) or outward (supination). This causes the legs to lean towards an X- or an O-shape respectively. Just a one degree tilt of the feet can cause longterm pain in the knees, traveling all the way up to the hips, back, and shoulders over the course of your life.
Other factors that influence how you walk on your feet every day are the natural curve of your spine or the length of your limbs, as well as any load you may be carrying like a suitcase or shopping bags.
As Pilates teachers, we learn the “perfect alignment” for an exercise. The reality is though, that not a lot of people get close to this because of their anatomy. They are purely not able to bring their limbs into a specific position. For example, look at people with slight O-legs. Asking them to squeeze their inner thighs together is impossible, they will never touch. What does this mean for their knees? The way they walk, the pressure will be distributed to the outside of the knee versus someone who has very flat feet and tends to put more pressure on the inside of the knee. In training, all we can do is correct the posture to align everyone to THEIR perfect alignment, meaning they can train safely and efficiently.
This was my downfall when I started suffering from knee problems. I was extremely hyper-flexible as a child and my ligaments were loose and all over the place. What did this mean for my knees? Standing tall I could push my knees through towards the back behind me a lot. It also meant when I was doing any lateral movements side to side, my knee cap wasn’t held in place very well. When this stability goes, the knee cap pops in and out often causing pain, swelling, and immobility. My sister even had to have her leg in a cast for a month because of the same problem!
If you suffer from hyper-flexible joints, it is so important to incorporate strength training into your routine. I love to dance, and still do so - but I know that I have to do an hour of knee specific strengthening for every hour I dance. That is just the way it is, and in my opinion a much easier solution than surgery and life long knee pain.
3. Bad alignment learned
I can not remember any of my PE teachers ever looking for right alignment in any of the exercises we were taught or sports we were playing. Our bodies were just supposed to bend a specific way without every questioning how that is going to happen. Fast forward to college when I started to attend ubiquitous fitness classes. The odd instructor would tell us to lift the head a certain way, but no one ever checked the alignment of knees in squat or lunging positions. Looking back it makes me cringe.
Most people that I work with have learnt bad alignment at some point in their lives. If you do the exercise once with bad alignment, it will probably not hurt you. Even 10 or 100 times might still be ok. If you do an exercise with bad alignment for years and decades, you have got yourself an injury that will never go away.
Bad alignment can be righted and re-learned, it just takes time and determination. Although I am a fan of all the ways you can get a workout in big group classes, there is nothing like working one on one with someone to determine the best alignment for you.
I hope this post shows you that no matter what reason is behind your knee problems, you don’t have to live with pain. There is always a solution to make exercising safe, fun, and pain free.