One of the most common (and debilitating…as I can certainly vouch for!) sources of pain for an athlete or active gym goer is anterior knee pain…or in laymen’s terms….pain at the front of the knee. If you’ve got it, you certainly know what I’m talking about.
If you don’t have it (yet) let me describe for you quickly what the sensation feels like. Picture John Rambo carving out your kneecap like a Thanksgiving Turkey with a hunting knife he dipped in salt water! Yep…it hurts!! But there’s hope!!
OVER THE KNEECAP AND THROUGH THE JOINT…
The main culprit of pain in the kneecap or at the front of the knee is a biomechanical imbalance between the two major muscle groups that control motion at the knee joint….the quads and the hamstrings! Generally, relative weakness of the quadriceps muscles are paired with tightness of the hamstring muscles behind the thigh. In biomechanical terms this has the effect of walking on a permanently bent (flexed) knee. This increases the pressure on the patella and produces anterior knee pain with every single step you take!
Over time…this will wear down the joint and create a vicious cycle. The pain starts, you stop doing your leg workouts, the muscles get weaker, you have less control of the joint, the joint reflexively tightens to provide the stability that the missing strength cannot…and everything gets worse! The key is to NOT ABANDON strengthening the knees through exercise, but making sure to do so SMARTLY…by choosing the right exercises (more on that in a second)!
The other part to the cure is to START STRETCHING THOSE HAMSTRINGS DAILY! Not sure what it is about stretching, but I bet I could find more guys willing to watch a Desperate Housewives marathon with their wives than take part in regular stretching! It doesn’t have to be a long commitment each day, but it really should be EACH DAY if you want to make measurable gains.
IT’S LUNGE TIME!
First the strengthening. By far one of the most effective lower body exercises (but at the same time…most uncomfortable for people with knee pain) is the lunge! By combining hip and quad contributions in almost equal amounts, it’s simply one of the most functional and best moves you can do to develop your legs! That said, when you’ve got knee pain, the act of stepping forward and planting an already “biomechanically flexed” knee is going to essentially simulate the cardinal sin of “LETTING YOUR KNEES GO BEYOND YOUR TOES”…a surefire recipe for long term knee destruction.
So, the answer will require us to step back for a second……LITERALLY! A backwards lunge!! Since the working leg will remain in the front, you will be able to now train that leg without the anterior shear force created by the forward step. The joint pressure is now being REMOVED from the front knee at the same time that that leg is doing the brunt of the work. Try it and see if it doesn’t reduce your pain by at least 75% (if not entirely).
SWING AND MISS…YOUR KNEE PAIN FOREVER
That said, remember, that’s only 1/2 of the solution! Right before your next leg workout….do this one thing for me. Perform 20-25 leg swings on each leg…trying to kick your leg out in front of you as high as you can. This dynamic flexibility drill should provide you with just enough loosening of the hamstrings to normalize joint mechanics, even just slightly, to greatly reduce the pain…especially when combined with the SMART exercise substitution above!
Try this one-two combo and see if it doesn’t knockout that discomfort that has been holding you back from attacking your leg workouts in recent weeks! If your pain is unchanged and these fixes don’t help…then I’d suggest a visit to an orthopedic MD or Physical Therapist. If you can’t get an appointment with either one…call me, I’ll see what I can do about getting you an appointment with John Rambo!
Stay Strong….
Jeff
Jeff Cavaliere M.S.P.T, CSCS
Jeff Cavaliere is a Physical Therapist, Strength Coach and creator of the ATHLEAN-X Training Programs and ATHLEAN-Rx Supplements. He has a Masters in Physical Therapy (MSPT) and has worked as Head Physical Therapist for the New York Mets, as well as training many elite professional athletes in Major League Baseball, NFL, MMA and professional wrestling. His programs produce “next level” achievements in muscle size, strength and performance for professional athletes and anyone looking to build a muscular athletic physique.
