Knee Injury Prevention Part 1

Knee pain is one of the most common musculoskeletal injuries. It affects a variety of people ranging from folks who sit all day long at a desk to professional athletes pushing their bodies to the limit every game. While the pain is typically isolated to the knee, the pain’s cause can sometimes be traced to include multiple joints in the lower body. There are several moving parts to a healthy knee (pun intended), but some basic concepts can be seamlessly added to your regular exercise routine to provide a bulwark against knee injuries. 

The program should be viewed as a functionality spectrum. From the easiest exercise to the hardest, similar muscles and movement patterns are used. The exercises vary in their intensity and how the joints are loaded. I like to break it down into four phases:

Phase 1: Knee Pain Reduction

Phase 2: Knee Strength for Daily Activities

Phase 3: General Physical Preparedness

Phase 4: Field Sports

The first two phases cover the necessary stretches and exercises that everyone should be able to do competently. These standards ensure individuals have the ability to live pain free and do all necessaries activities of daily living.

Phase 1: Knee Pain Reduction

This phase aims to reduce pain, inflammation, and swelling in the knee to allow resumption of daily activities. The exercises and stretches in this phase begin to restore pain free knee joint motion, while simultaneously reducing knee strain redirected from dysfunctional movement elsewhere in the body. An example of this is calf tension. If the calf is too tight to allow the ankle joint to bend, the body acquires the motion from someplace else in the body, specifically by dropping the knee inward. This happens to people with tight calves as they stand up from a chair. While one movement usually won’t cause injury, if it’s repeated many times a day for years to decades, then you have a mechanism of injury.

Exercise Regimen To Do Every Other Day

4 Rounds (click on links to view exercise descriptions)

Mobility Regimen To Do Every Day 

Repeat Stretches 2-3 Times a Day (click on the links for stretch descriptions)

To progress from the Knee Pain Reduction phase to the Basic Knee Strength for Daily Living Phase you must complete the following requirements.

Progression Milestone Tests:

  • 10 reps of open chain knee extension with 10 lbs with no pain.
  • 10 reps of step Up from Step at body-weight with no pain
  • 10 reps of air squats with no pain
  • 10 reps of banded hip hinge with no pain and full range

Phase 2: Knee Strength for Daily Activities

Once you’ve cleared the first phase by passing the progression milestone tests, the next phase increases strength during activities of daily living and further reinforces good movement patterns. Two-legged strength exercises and conditioning the quadriceps muscles to handle load under tension will bolster the knee against injury.

Exercise Regimen To Do Every Other Day

4 Rounds (click on links to view exercise video)

Mobility Regimen To Do Every Day

Repeat Stretches 2-3 Times a Day (click on the links for stretch descriptions)

Just like in the last phase, you must complete the milestone requirements to start the next phase aiming to improve lower body strength and agility.

Progression Milestone Tests:

  • 10 reps of assisted single leg squat with no pain per leg
  • 10 reps of goblet squats with no pain
  • 10 reps of kettlebell deadlifts with no pain

In Conclusion

This article describes the base level of strength needed to have pain free knees in regular life. Unfortunately, most folks are barely functional by these standards. In the next article, I’ll go into the specifics for how to integrate knee strengthening into resistance training and field sports. Taking the time two to three times a week to safeguard your knee health is well worth it.