Chronic pain or arthritis pain affects millions of people over the world. In the U.S., according to CDC, 1 in 4 adults (15 million) are suffering from severe case of arthritis. Knee pain is one of the issues.
Although knee replacement and physical therapy is an option to relieve pain, however, there are several exercises that you can try before considering knee replacement. Yet, you should consult with your physician before you start the following exercise. Depending on degree of arthritis, joint replacement procedure may become necessary.
Anatomy of the Knee
Before I share exercises, let dive into the anatomy of the knee. When I say knee, most people think about connection between femur (thigh bone) and tibia (shin bone). Then you have patella, also known as knee cap covering the joint. When the cartilage meniscus rub against each other, due to overweight or physical stress, that is when you start experiencing pain. So when you have knee replacement those are the two things that will be replaced with artificial joints. Procedure may vary depending on how severe the damage is.
However, this is talking about the symptom. The question comes why the pain all of the sudden start to kick in. Some people think it's their weight, age, and type of physical activity they do and those are all true. But let's look at what is happening at anatomical level. Majority of time people focus on knee from the front view. Just for the fun of it, let's view from the backside. On the left, you can see the muscle position for knee from the back. Muscle above the knee is hamstring and below is the calf. As you can see the hamstring actually attach to tibia, which is the shin bone and calf connects from head of femur, which is the thigh. Meaning those muscles overlaps the knee joints which allow the knee to flex. Let me ask you this, if the calf muscles and hamstrings gets tight, what would happen to the knee joints itself? The answer is femur and tibia get pulled towards each other which causes friction between the joints then lead to arthritis.
So the exercise that I'll be sharing is to stretch and mobilize the tight muscles so that knee joints have more freedom to move. Please make sure to understand that the exercises are not to reverse arthritis. Even when you feel the pain is gone, this does not mean that arthritis is gone. It's just means that your knee joint got freed.
Exercise 1: Foam Rolling Top Calf
The first is foam rolling the calf. As mentioned earlier, area we are working on is crossed over with both calf muscles and hamstring. If this part is tight, you may feel severe tenderness and may hurt but need to be worked on. In the video, I am using the device called foam roller. You can purchase online and there are so many variations. If you do not have it, you can purchase it online or you can substitute with sports balls, such as baseball, softball, lacrosse ball and so on.
I have my right leg on top of my left to give extra compression. If it is too much pressure without the leg on top, start off without having extra compression. Spend about 1-2 minutes per side. You may not be able to get all the tenderness out with one session so work on it on regular basis until the tenderness is minimized.
Exercise 2: Foam Rolling Gracilis
There is muscle that is not shown on above picture, however, plays important roll in knee stabilization called gracilis. The muscle connects from bottom portion of the pubic bone and attach to top inner portion of the tibia. When sitting for extended period of time or if you have tendency to cross your leg, this muscle gets tight as well and may cause irritation to the knee. So in the video I'm rolling out my inner thigh but more towards the knee area. You can start from your groin and work your way down, which will have more benefit. Once you find a tender spot you can rotate your leg up and down to apply cross friction to the muscle.
Exercise 3: Foam Rolling TFL
TFL is stand for tensor fasciae latae. The muscle itself sits by your iliac crest, which is your hip bone and it also connect with IT band that connects at the top of tibia in outer side of the knee. A lot of times people wants to loosen up their IT band and focus on rolling out the tendon but it is difficult to loosen up without loosening up the TFL. Find your hip bone and work on it. It is small area so if foam roller is not working then something like baseball or lacrosse ball may work better. This portion usually gives a dull ache rather than sharp pain like it does with calf.
Exercise 4: Calf Reactivation
Once the muscles are loose or worked on, you want to get the movement back. Think of it as reeducating the muscles for how you want them to function. On the video, I'm using a step of the stair but you can use pretty much anything. Key point is to drop your heel as low as you can to get the stretch of the calf and hold it for 2-3 seconds. Then lift your heel up as high as you can. When the calf is still tight you may not be able to lift the heel as high but keep working. Perform 3 sets of 8-12 repetitions.
Exercise 5: Assisted squat
Now you want to test your knee function. In the video, I'm using TRX strap to perform assisted squat but you can hold on to pillar, dining table, kitchen counter, chair or anything that can support your squat. You should be challenging yourself by pushing your knees forward and squatting without heel elevated. Another key to improve your squatting is to point your knees and toes out. This will allow the knee to move more freely and reduce pressure to the knees. Perform 3 sets of 10-15 repetitions. If the pain starts to kick in, do not squat any lower.
Although you may not see too much progress just by doing the exercise once but you will be able to see the improvement in few weeks.
Kota Shimada
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