Why So Many Knee Issues?

So what's the deal with those knee issues? I mean, come on, it's not like you are on them all of the time. Sorry, had to do a Seinfeld-esque statement there. But seriously, why does it seem there are increasingly more and more knee injuries and people with knee problems? Just get to the record straight, I am not going into hereditary, low bone density, arthritis, old age, and similar causes of knee problems. I am focused on people who were fine for most of their lives until one day they all of the sudden had knee problems.

The common issue is usually plain and simple; a person injured their knee from a sports activity or falling down for one reason or another. This person needs to get usually needs rehab, and maybe some pins, maybe some bio-gel do fill in lost cartilage, or maybe some surgery.

So what about everyone else? I personally never had knee injuries until I got into long distance running and multi-sports. I hate to admit this, but I figured it was just the extra impact on my knees from the extra distances I was going. I was so wrong...and this is a common way to think for most people. I therefore had to do some root cause analysis and figure out how this could have happened. In short, in 2012, the year after I recovered from my second car accident, I got back into running and wanted to do long distance; 10ks and half marathons. I had knee issues for my first triathlon during the running segment. I ignored this issue because I just assumed it was from me just swimming 1.5km and cycling 24.8 miles. However, later that year I collapsed 3 times during the Philly Half Marathon. Was it from overuse, bad running form, something else?

I went to a sport medicine doctor and he said there were two issues; 1) I had extremely high collapsing arches, but with each foot collapsing differently. 2) My leg strength and flexibility were atrocious (the doctor used a harsher explanation than this...which is good because I needed to hear it). The arch issue was easily resolved by insanely expensive custom orthotics. They are definitely not a solution for everyone, but they worked miracles for me...and still do. The surprise to me was leg strength and flexibility.

Flexibility and Your Knees

When it comes to your knees, the range of motion is fixed; straight through bent all of the way back where your heel touches your butt. Sadly, I could not get my knee to bend that far. But that actually doesn't matter as much, since I don't need to ever bend my knee like that for any activity I am doing. This was still an issue that needed to be addressed (exercises and stretches will be in another article). There is more of course; the rest of my legs. My hips and legs were also not very flexible and extremely tight all of the time. Even after doing basic dynamic stretches, I was still always tight. When your muscles are tight, they do not handle impact very well. This causes more impact to be distributed to your bones, which results in lots of problems. The buffer between your muscles and bones are the tendons. Their elasticity makes them an extremely efficient buffer for everyday activity and impact. However, they can only handle so much. Therefore, you need to make sure you are lose before exercising. Yes, some people are naturally loose, but I am focusing on the majority of people. It is recommended that you perform dynamic stretches before you workout, followed by static stretches after you are done working out. Your stretches should not only be focused on the areas you worked out, but rather your whole body. Yoga is a great after-workout routine for getting full body stretching. Things like lunges, jumping jacks, arm rolls, and many more are good examples of dynamic stretches.

Leg Strength is Vital

When it comes to impact, it goes in the following order: muscles, then tendons, then bones. Your tendons can be strengthened via your standard core and leg strength training routines. Most leg workouts, especially for your thigh and calf muscles, will strengthen your tendons in your legs. A lot of people with knee issues will focus on reducing leg strength training during cardio training in order to keep their legs from getting too sore...but this is counterproductive. Your knee is the final point for impact to end. For example, if you jump in the air and land, assuming you land on your toes, you will start with impact dispersion via the feet, lower leg, then upper leg, then lower back, and then you knees. The less muscle you have in those other areas, the more impact the knees will take. An extremely cushioned shoe may help a little more, but ultimately, you need to build up your leg muscles. During my training season, I fit in 1-2 strength training sessions just for legs. This is an addition to the cardio work to strengthen legs, such as hill work. During off-season, which is typically late fall and winter, I will work my legs at 3 times a week in addition to any cardio I am doing.

So, there is even more you need to worry about for leg strength. You also need strength balance between your upper and lower legs. For example, one of my issues with my knees was that my calf muscles were really strong, but my thighs and quadriceps were extremely weak. So, this caused an imbalance for when I took impact. So, because my upper legs did not balance out the impact that the lower legs were taking, my knees ended up taking extra impact. Fortunately, striking a balance is pretty easy. All you need to do is make sure your leg workouts target calves, glutes, hips (abductor and adductor muscles), quads, thighs, and hamstrings. Basically you need to be doing a full leg and lower core routine. Lower core is defined as your stabilizer muscles and primary muscles for your abs and lower back.

Other Common Reasons for Knee Issues

I am a BeachBody coach, yes. But that doesn't stop me from stressing how awful workout programs like Insanity are for your knees. If done properly, Insanity is a killer program and has awesome results. However, it shouldn't be done by someone just getting back into working out. Also, even fit people commonly get hurt in exercise programs such as this, or aerobic classes that focus on a lot of jumping exercises (examples are box jumps and burpees). The reason is pretty simple; form and technique. So many exercise classes and routines focus on the exercise, but usually very little on proper form and technique. I recommend asking your instructor or watching videos online to see proper form. Always watch more than one video, as even professionals can tend to use improper form, even if they know what the proper form should be.

The other big reason is improper gear. Many people think they are experts on their bodies. Maybe you can judge how you feel and if you are pushing yourself too hard, but that is usually the extent of an individual's expertise on themselves. Therefore, for runners and other cardio athletes, you need to make sure you are wearing properly fitting socks, and have a professional make sure you are using the proper shoes. If you look at my feet, it appears I have a normal foot. On closer inspection you can see I have a collapsing high arch. However, it took an X-Ray to see how severe my high arch actually was. In addition, it took analysis of each of my feet to see that they collapse and roll differently.

Summing It All Up

If you plan on being a distance runner or a multi-sport athlete, then your legs are vital to your success and avoidance of unwanted injuries. All of your cardio training is easily wasted if your leg muscles overall are not strong enough. Yes, there people who have always had strong legs and don't need to strength train to keep their leg muscles strong. As I stated before, this is the exception, not the norm. I'll be following up this article with workouts to help with stretching, legs, and lower core.