Trainer Tuesdays: What Kind of Exercise is Best if I Have Bad Knees?

Trainer Tuesdays

Welcome back to the weekly edition on Trainer Tuesdays. Make sure to check in at our blog every Tuesday evening to learn the expertise of our great staff. Aside from being fantastic exercise coaches, they are also extremely knowledgeable in many aspects of health and fitness; so, it's time that you get to know them a little better! Each week, we will post a frequently asked, or sometimes just a fun fitness related question followed by the answers of each of the trainers at Fitness Together Brecksville.

What Kind of Exercise is Best if I Have Bad Knees?

Adam Teplitz: Unfortunately, knee pain is a condition many people suffer from. However, this should not hinder you from exercising. It's actually beneficial to focus on strengthening the muscles around the knees. Stretching is also extremely beneficial. You can use a foam roller to stretch out the quads, IT band and inner thigh muscles.

It's important to know the mechanics of the knee joint. You want to be sure that your shins stay perpendicular to the ground when training legs. The knees should stay behind the toes. A great exercise to learn the proper movement is box squats. Box squats help ensure that you're kicking your hips backward and not leaning forward.
In addition to box squats, straight leg raises and knee extensions with short and long arcs will help strengthen the quads.
Reverse lunges are another option. Lunging forward can cause unwanted knee stress. A reverse lunge puts more emphasis on the glutes and hamstrings as well, which are often neglected.
Training the glutes and hamstrings are key to avoiding a muscle imbalance. Focus on stiff leg deadlifts, glute bridges and good mornings to train the posterior chain, or the muscles on the backside of your body.

Knee pain should not hinder your workouts. It's important to be cautious in exercise form, while strengthening the quads, hamstrings, glutes, and calf muscles.

Bronson Rotaru: When dealing with the knees you are always going to want to play it safe. For general cardio try riding a bicycle outdoors. It’s not only a good exercise for the muscles supporting your knee joint, but it can also be really fun…utilize the metro parks and trails we have! Besides aerobic activity, the TRX is really helpful for knee pain. You can use it to squat, lunge etc. and by holding the straps with your upper body it will help to alleviate some of the pressure off of your lower limbs. You're going to want to avoid running, jumping, heavy lifting. Be very careful squatting.

Lisa Clark: If you have experienced knee pain, you may be apt to abstain from most physical activity, however there are still a lot of exercises for the legs you can do. Typically low impact cardio such as an elliptical or a stationary bike, are not going to put any stress on the knees, however where bike riding is concerned, you want to be careful not to ride up hills or with a lot of tension on the gears. Strengthening the muscles around the joint protects you from injury by decreasing stress on the knee. A few rules of thumb are remembering never to bend your knees to the point where your knees stick out past your toes, that puts a lot of pressure under the kneecap. Exercises such as Romanian deadlifts or straight leg dead lifts don't require too much knee movement, just be careful of these exercises if you have any history of lower back issues.

Kelly Bailey: Knee problems are very common, but it's not a good reason to throw in the towel on your workouts. In fact, working out can strengthen knee structure, alleviate pain, and prevent future knee problems from occurring. During strength training, the key is to do weight-bearing exercises that will strengthen the muscles surrounding the knees. A few exercises that can accomplish this are hip bridges, calf raises, hip adduction and abduction exercises, and half-squats. To maintain cardiovascular health while caring for bad knees, stay away from high-impact exercises like running or jumping. Instead, swimming and cycling are great cardio workouts that will take the pressure off of your knees.

Steven Madden: I have helped work with several clients who have had bad knees, never mind my father and father-in-law too.  Generally, it's not just a matter of doing normal exercises with less weight, there are some you should do, and some to avoid.

Step-ups are great, with or without weight.  Partial squats also help, provided you are only squatting about half the distance you would travel to sit in a chair.  Side leg lifts will also help strengthen the musculature around the knee as well. Couple that with inner thigh leg lifts and calf raises---these exercises should help bad knees.

However, you need to know to avoid full range of motion squats, any deep knee bends or lunges, and absolutely avoid hurdler's stretches.

Taynee Pearson: There are various exercises to do for a bad knee. To improve your range of motion and keep your bad knee mobile, certain exercises need to be performed. Exercises which could aggravate a bad knee are lunges, walking lunges and certain squatting exercises. It is important to strengthen the muscles around the knee and the hamstrings. Leg extensions are important to strengthen the quads. Lateral leg raises are important to strengthen the abductor muscles, wall sits are important to strengthen the quads as well. Wall sits are a good option in case wall squats or any type of squatting movement hurts the knees.

Sean Sullivan: At Fitness Together Brecksville, we have helped a multitude of clients who had previously complained of having bad knees. We have even trained clients leading up to a knee replacement to help make them as strong as possible beforehand, and in order to assist their recovery. I hear it all the time in my initial consultations that people feel discouraged and frustrated because every time they start a program, they begin seeing results; and then they hurt their knees again forcing them to give up! I also hear from people that they are afraid to exercise because they will aggravate their knees. One of the best reasons to work out with a personal trainer is to learn the proper form and technique while performing exercises so that you can prevent creating injuries in any of your major joints. Any time you have pain in your joints, it’s important to start every workout by properly warming it up, wear a brace while exercising if possible, and to put ice on it for 20 minutes afterwards to help any swelling and inflammation to go down.

It’s important to understand that not all “bad knees” are created equally. The important thing is to find out what exactly is wrong with your knees first. As nationally accredited personal trainers, our staff is equipped to treat an injury with exercise once we know what the problem is, but we are not able to diagnose the injury! When a client comes to us with knee pain but has not received any diagnosis from their physician, we will generally include exercises in their program that avoid the knee joint altogether. There are plenty of exercises you can do to work your legs without even bending or extending your knees. Sometimes just getting active and stronger will allow the pain to subside. If after a few weeks the knee pain is the same or worse, I will suggest for that client to see their physician and get a formal diagnosis of the injury so that we know how exactly to treat it. It’s also important to communicate with your trainer if certain movements hurt. We will keep track of that in your file and make sure to work the same muscle group in a different way.

Once we receive a formal diagnosis from your doctor, then we have a much better idea of what we can and can not do to help improve your condition. If you have arthritis in your joint, sometimes this is the best news. This means that exercise can not make the condition any worse, so it just becomes a matter of how much pain can you tolerate? As we work to strengthen the muscles surrounding the arthritic joint, your knee will be supported better and the pain should subside. If you have a problem where your knee-cap is being pulled off center and moving laterally, or you have a sharp pain along the outside of your knee, this may mean that you have very tight IT Bands. The IT Band is a tendon along the side of your leg that essentially goes from your hip-bone down to your shin. A certain series of stretches, especially using a foam roller, can help to increase flexibility in that tendon and alleviate the pain. Other examples of diagnosis could include small tears in your meniscus, bone chips in your knee-cap, small tears in your collateral ligaments, tendonitis or perhaps you’ve simply worn down the cartilage in your knees over time. All of these conditions would be treated completely differently. Sometimes, the condition may be so severe that your doctor recommends you to avoid exercise altogether until you go through some physical therapy.

If you’re experiencing knee pain, please consult your physician before starting an exercise regimen. Do not let this news discourage you, because we have seen and worked with clients with all different types of knee injuries and restrictions  be able to improve their overall health and fitness, get rid of their pain, and exceed their goals.  

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