My previous post An Update on My Knee Pain – Plus Tips You Can Use is a background on how I’m approaching my knee issues. The short version is that I am using a combination of exercises to strengthen my foot, ankle, and hip, while also stretching my inner thigh, hamstring, and calf muscles.
I think this might be the strategy that finally makes a difference. This issue has been a problem for far too long. And if it doesn’t work, well at least I know I’ve tried some new ideas and building strength in these areas can’t be bad.
For those interested in what exercises I’m doing, here is my plan.
Foot / Ankle
Ankle Pushout – Hunter found a short video that demonstrates this exercise which helps to reverse a collapsed arch.
Single-Leg Band Rotation – Anchor band on side of the planted foot. Pull band across body and balance.
Floss Calf / Rotate Foot – Cross leg, place on top of knee, rotate ankle while pressing into the calf. You can use lacrosse ball. Also, twist the bottom of the foot up and hold the stretch.
Band Stretches – Strap foot with a band. Bend / rotate in different directions.
Golf-Ball Roll-out – Roll foot over a golf ball.
Towel Crunches – Use toes to grab a small towel. 50 reps with each foot.
Toe Spreads – No socks, spread/contract toes.
Inner Thigh Stretch (Adductors)
Zen / Butterfly Stretch – Place soles of feet together, stretch. Can use elbows for a deeper stretch. (30-60 seconds 2-3x)
Frog Pose Stretch – Prone, rock up and down. (see wikiHow)
Hips
High-Knee Raise – Lift knee above 90 degrees, hold for 15+ seconds, place hands behind head.
Band Knee and Twist – Place band on the knee and fix to something stable. Twist outward and hold.
Side Leg Raise (aka the Jane Fonda) – Point toe forward. (see wikiHow)
Banded Squats – Also fires glutes, 1x week. I do slow bodyweight for now but eventually will use goblet squats with either a kettlebell or dumbbell.
Quads
Leg Raises – I use two variations. One with the toe pointing up and the other with the foot turned outward 45 degrees.
Bridges – For this one I’m careful not to go too deeply into the bend or my knee will hurt.
Leg Press (abbreviated) – Recently, I’ve been able to use reduced reps and static holds from shallow bends on the leg press. I can target my quads while only using a reduced bend in my knees.
Combo
Standing Jane Fonda – The best exercise I am using now is a combination of the Ankle Pushout and the Side Leg Raise. It is done from a standing position. My foot, ankle, and hip are all engaged at the same time. I knock out 10 reps on each side a few times a day.
More
I also stretch the calf and hamstring muscles. I also have a hip mobility routine known as opening and closing the gate. (see video)
So Far, So Good
Maybe one of these exercises will help you. I’m hoping they help me heal completely. So far things are progressing better than they have since I first got injured many months ago.
Hunter
Jun 11, 2018 — 5:42 pm
I’m glad that you found the video helpful! I actually do the Ankle Pushout while I’m performing my squats and deadlifts, and it makes a significant difference. This one is a deep read, but I think you’d get some good info out of this 3 part series too. https://fitnesspainfree.com/6-common-causes-of-knee-pain-and-how-to-fix-them-part-1/
I had an extremely stubborn case of patellar tendonosus in both my knees a few years back, and it’s the reason I changed my major to kinesiology in college. For the most part, I think you’re on the right track with your recovery plan. Here’s a few of my thoughts on the subject, and I hope you find in value in them.
There’s something called the Joint By Joint approach, which states that some joint’s primary need is stability, while other joint’s primary need is mobility. For example, your wrist needs plenty of mobility to function correctly whilst your elbow’s primary need is stability, which is why it only hinges back and forth.
The knee is a stable joint that sits between two mobile joints (The ankles and hips). When there’s a dysfunction in a mobile joint, the stable joint is forced to pick up the slack. However, a stable joint is not meant to perform this task, and it leads to pain and damage to the structure. In this case that could be a lack of ankle strength/mobility shifting stress up the kinetic chain to the knee joint, or a lack of hip strength/mobility shifting stress down the kinetic chain to the knee. It’s likely some of both, as was the case for me. So your time will be well spent focusing on hip and ankle mobility and strength. (On a side note: immobile hips also send dysfunction up the chain to the lumbar spine, which requires stability. So stiff hips and weak glutes also lead to lower back pain as well as knee pain.)
In addition to working on hip and ankle mobility, I would suggest:
Learn how to Hip Hinge extremely well http://tonygentilcore.com/2014/01/hip-hinge-like-boss/
Once you’ve grooved the hip hinge pattern in, start to add load with hip dominant exercises like Pull Throughs and Hip Thrusts. This alone gave my knees great relief. Beforehand, everything I did was over powered by my Quads, which stressed my knees big time. I’ve found that most people with knee issues are extremely Quad-dominant. Learning to use your hips will even this out. For me and my clients, the hip hinge has been a game changer for joint pain and building strength.
Performing Glute Activation exercises daily and in your warm up.
Most of us spend a lot of time sitting. This shuts our glutes down and tightens our hip flexors, which is the opposite of what we want. The Jane Fonda things is a kind of glute activation exercise. Consider looking up Clam Shells, Bird Dogs, and Single Leg Glute Bridge. I also love Deadbugs for core activation.
This is getting a little long, so I’ll cut it short, but I really hope this has been useful. I’m cool with answering any questions about what I’ve written and discussing these concepts further.
MAS
Jun 12, 2018 — 7:40 am
@Hunter – Thanks for the resources. I’ll add a few glute activation exercises to my routine.