How Are Your Knees? A Virtual Physio’s Guide to Healthy, Pain-Free Knees

We often take our knees for granted. They’re the unsung heroes of movement, whether we’re walking, running, dancing, or even just getting in and out of chairs. Knee pain is the second most common Musculoskeletal complaint (after back pain) in adults. It’s quite likely most of us have experienced it at some point! So, how can we keep our knees healthy, pain-free, and functioning at their best?

1. Understanding Knee Pain: What’s Really Going On?

Before we jump into prevention, it’s important to understand why knees can hurt. The knee joint is a complex structure that involves bones, cartilage, ligaments, tendons, and muscles. The knee bears a lot of weight and is often in motion so that it can be prone to pain or discomfort occasionally. Here are some of the most common causes of knee pain:

• Osteoarthritis is a common cause of knee pain in older adults. It occurs when the protective cartilage in the knee joint gradually wears down, leading to pain, stiffness, and swelling.
• Patellofemoral pain syndrome (Runner’s Knee): This is pain experienced around or behind the kneecap, which can be caused by a multitude of factors. Commonly, this can be a change or increase in activity. In some runners, the load at the knee can be more than four times bodyweight, so ensuring good support and control can be paramount to a comfortable knee!
• Ligament injuries: A torn or even partially damaged ligament can cause significant knee pain, often the result of a sudden impact or twisting type injury (think football or perhaps skiing!).
• Tendinitis/Tendinopathy occurs when the tendons around the knee become painful due to repetitive stress or overuse.

These are only a few causes of knee pain; however, the good news is that there are many steps we can take to help prevent knee pain.

2. Strengthen the Muscles Around Your Knees

Strong muscles in the thighs (quadriceps and hamstrings) and the hips provide stability to the knee and can help absorb shock, reducing strain on the joint.

Here are a few key exercises to strengthen the muscles that protect your knees:

• Squats: Did you know the force through your knees when you squat is 4-5 times your bodyweight? Squats, even without any weight, are an excellent exercise for building strength. Stand with your feet shoulder-width apart, then lower your hips back and down as if sitting in a chair. Keep your chest up and your knees behind your toes. Squats strengthen the quads, hamstrings, and glutes—crucial muscles for knee support. If you find squats hard, you can modify the depth or even place your back against a wall to help support you in the squat.
• Lunges: Take a step forward with one leg, lowering your back knee toward the ground while keeping your front knee aligned with your ankle. This exercise works both the quads and the glutes.
• Glute Bridge: Lie on your back with both knees bent at about 90 degrees, with both feet flat on the floor. Slowly lift your bottom up by pushing through your heels and squeezing your glutes. Keep your knees in line with your feet. Avoid arching your back and slowly lowering your bottom towards the floor. This can be a great exercise if you’re struggling with knee pain, as it engages with gluteal muscles without placing too much weight through the knee.
• Step-ups: Step onto a low step or bench, leading with one leg, then bring the other leg up to join it. This exercise engages the quads, hamstrings, and glutes.

Incorporating strength training into your routine 2-3 times a week can make a huge difference in knee health, providing support for the joint and maintaining good joint and bone health.

3. Flexibility and Mobility Matter Too

Just as strength is important, so is flexibility. Tight muscles and poor mobility in the hips, calves, and hamstrings can put extra strain on the knees. Regular stretching and activity that challenge your mobility can help keep your body limber, preventing stiffness and discomfort.

Yoga and Pilates are also great examples of exercise that can help not only build muscle strength and support but also keep your joints flexible.

Some stretching examples that can help include:

• Hamstring stretch: Sit on the floor with one leg extended straight in front of you and the other bent. Reach towards your toes while keeping your back straight. This stretch targets the hamstrings, which can affect knee function if they’re tight.
• Quadriceps stretch: Stand on one leg, and bring the opposite foot toward your bottom, holding your ankle with your hand. This stretches the quads, which are important for knee stability.
• Calf stretches: Stand with your hands against a wall and step one foot back, keeping your heel on the ground. This stretches the calves, which can help maintain good knee alignment.

4. Focus on Form and Regular Movement

How often you move and how you do it matters regarding knee health. Good form and efficiency can help reduce the risk of knee strain and injury with certain activities.

• When walking or running: If you experience knee pain when walking or running, consider seeing a physiotherapist for tailored exercises and a review of your movement.
• When lifting weights: Avoid lifting more than you can manage or progressing the weight too quickly in exercises like squats or lunges. As with any joint, the knee responds well to gradual and progressive increments in weight and increases in activity over time. We’ve all overdone it at some point and felt our knees, so don’t panic! Speak to a Physiotherapist, though, if you have persistent knee pain.
• When sitting, avoid sitting with your knees bent for long periods, especially in uncomfortable positions. Try to change positions often to prevent the knees from becoming stiff. Many little movement breaks throughout the day can help keep the joint and soft tissues mobile and help keep you pain-free.

5. Appropriate Footwear

Your feet and knees are closely connected—if your shoes don’t provide enough support or cushion, your knees can be subjected to more impact. Whether walking, running, or standing for long periods, choosing the right footwear can help protect your knees.

1. Running trainers are great for running, walking, and commuting! If you spend a lot of time on your feet, supportive, well-cushioned running trainers can really help cushion the load through the knees.
2. Rigid or unsupportive shoes, such as pumps or flip-flops, are often fine for short periods, but try to limit wearing them for longer periods and completely if you are experiencing any knee pain. There is no need to give them up around the pool on holiday!
3. Heels – they look great! And again, these alone won’t cause knee pain. It is more likely how often they are worn or how long they are used which may contribute to knee discomfort. Try to give your feet and knees a break from time to time and change from heels to flats or trainers.
4. Maintain a Healthy Weight – Probably one of the most impactful lifestyle changes we can make for our knees is losing any excess weight. Losing weight can significantly reduce the strain on your knee joints, particularly during activities where the load through the knee is increased, such as stair climbing or walking. If you are currently experiencing knee pain and are overweight, weight loss, alongside other strategies directed by your Physiotherapist, can help support you in your recovery.

Incorporating a balanced diet with plenty of whole foods, fruits, and vegetables, alongside regular exercise, can help you maintain a healthy weight and protect your knees long-term.

7. When to Seek Professional Help

If you’re already experiencing knee pain, seeking early advice is best. Most knee pain isn’t serious, and with the right advice and treatment, it can resolve quickly. A physiotherapist can help you identify the root cause of your knee pain and recommend specific exercises and strategies to resolve your issue.

If you’re unsure or need more guidance, our virtual physio team is here to help.

Virtual Physiotherapy