Knee pain is a common and debilitating problem. More than any other joint it has the ability to stop you in your tracks and limit your ability to function. It’s difficult to heal if you cannot rest it and give it time to recover properly. And it is best to address these issues early before you go on to serious wear and tear in later years.
What causes knee pain?
It could be injury, ruptured ligaments, torn or damaged cartilage. It may be arthritis, Osteoarthritis is wear and tear, Rheumatoid Arthritis autoimmune inflammation and degradation. Inflammation due to infection or gout. Also muscle weakness and imbalance, a faulty gait, over tightness of the Myofascial Trains which have great influence in the knees and ankles. Or maybe active Trigger Points that need attention.
So obviously the ones first mentioned will require surgery, physiotherapy and finally rehabilitation (at which point you may visit a Pilates Instructor). But if it is muscle weakness – a faulty gait (walking pattern) – over tightness through muscles and/or the Anatomy Trains, or unhappy trigger Points, then Pilates can really help.
So let’s look at each individually
Can Pilates help with Muscle Weakness?
Weak muscles are the leading cause of knee injuries. You’ll benefit from building up your quadriceps and hamstrings, the muscles on the front and back of your thighs that help support your knees. Balance and stability training helps the muscles around your knees work together more effectively. Proprioceptive work for the ankles and the knees are all part of every Pilates Class through the execution of multiple exercises.
The squat is the MOST important functional movement for humans. We should be strong enough in our leg muscles to squat and then stand with ease, not just once but multiple times a day. Once we lose the ability to do that we are already moving towards disability. I always say if you were a member of an African tribe you would squat for hours a day and then squat and stand countless times. This functional movement is part of their daily life. Sitting on sofas is not a normal activity for humans.
Each time you squat you stretch your myofascia. You will slightly compress your spine and then strongly relax it when stand. You balance the pelvis and stretch its muscles. Stretch and strengthen hips – knees – ankles – obliques – abs – pelvic floor muscles. A squat activates the deep spinal muscles 4 times more than a plank. It is a core strengthening exercise. It works every muscle in the Body to some degree and also increases blood circulation. It challenges your brain and is linked with
good functional movement in the elderly.
One deep squat a day is all you need for functionality. And 10 medium squats daily for strength, flexibility , coordination and balance.
If that seems too hard watch my video on sit to stand to start easy and build your strength gradually to regain core strength – stability and also flexibility. The Squat is the number 1 exercise to maintain. Try to make it part of your daily routine your knee pain should become a thing of the past. Also because tight muscles also can contribute to injury, stretching is important. Try to include flexibility exercises in your workouts again all part of every pilates class you ever do. (when squatting aggravates an existing knee condition stop straight away and see your doctor).
How to address a faulty Gait?
Here you need to go to the videos that tackle Hip stabilisation and tightness. If we are tight in our mid thoracic area ie: Thoracolumbar Fascia. Or our Quadratus Lumborum and Pelvic muscles we will not be centred or grounded correctly which will load the knees unevenly causing wear and injury and pain. Injuries or weakness to our ankles, if we have overtightened fascia in the legs and Iliotibial band our gait will be altered. Over time that is going to cause knee and hip pain.
Does Pilates address Over Tightness in Leg Muscles?
Often with knee pain the main culprit is the Iliotibial band. The strong band of fascia that runs down the side of the leg connecting the pelvis to the outer knee. This band merges into the lateral quadricep ( Vastus Lateralis) so much so that you cannot delineate between the two in autopsies.
It is active in every step we take but over loaded by some sports particularly running. Also ill fitting trainers can be an aggravating factor. The Iliotibial band is usually the first place to look when runners have knee pain for example. Just a short time of massage with hands, balls or rollers and you find your knee feels instantly better. My videos show you many ways to address this issue and ways that are less painful than the roller option which is particularly nasty!
Also stretches you can do once you have relaxed that line of tension to maintain balance If you look at the Spiral Line – the Lateral Line – the Deep Core Line you will also find ways to balance your knees and improve your gait in walking and running.
Can Trigger Point Work fix Knee Pain?
There are specific Trigger Points in the leg muscles that can be the cause of Knee Pain. Where your pain is will clearly show which muscle group needs attention. Also looking above ie: the Quads and Hamstrings and below ie: Anterior/ Posterior Tibialis and the Calf Muscles will be beneficial.
Learning how to find Your active Trigger Points means that you can address these things yourself and prevent over tightness and injuries in the future.
Other things to consider:
- LOOK at your shoes – make sure they are correctly fitting and haven’t worn down which will change your gait. Make sure that they are appropriate for the purpose ie: good and properly fitting running shoes for YOUR feet for running or trail shoes for cross country running.
- Watch your weight – extra kgs will overload your knees.
- Walk daily and stay active – keep leg muscles strong.
- Listen to your body and squat mindfully with care and attention – it only take one bad squat to hurt your knees.
- Get strong and flexible ie: PILATES
- Be WISE if you do have Arthritis choose low impact sports like swimming – take rest days to allow inflammation to settle – don’t train hard on days you are in pain.
- When you do need knee replacement surgery get good Physiotherapy pre and post operatively. Do Pilates when you are ready to ensure you return to balanced and strong walking.
When to see a doctor – Call your doctor if you:
- Can’t bear weight on your knee or feel as if your knee is unstable or gives out
- Have marked knee swelling
- Are unable to fully extend or flex your knee
- See an obvious deformity in your leg or knee
- Have a fever, in addition to redness, pain and swelling in your knee
- Have severe knee pain that is associated with an injury