Ok, so last time I went over a few of the "lo-tech" strategies for dealing with knee pain so naturally today I will progress to the more "mid-tech" approach.

 This means toys and tools.

 Let’s take a look.

This is what we’ll call a foam roller.  It looks innocent enough doesn’t it?

This one is simply called "the stick".  Not glamorous sounding but it will get the job done.

   And finally we have a plain old tennis ball.  Cheap and effective.

As I mentioned in the previous installment, knee pain is mostly a symptom of what is going on in the tissues above and below the joint itself.  Using these tools will help us penetrate and alleviate some of the overactive muscles associated with this type of pain.

I like self massage because it’s cheap and it allows you to do it more frequently than you would when dealing with a massage therapist.  The two types of self massage I will be going over are scanning/holding and basic full stroke massage.

1.  Scanning and Holding:  You’ll use this technique to scan your muscles for any "trigger points".  A trigger point is essentially a knot that will prevent the muscle from performing its function normally.  You’ll scan the entire length of the muscle, once a trigger point is found, you want to hold pressure on that spot for no less than 30 seconds (this can be very painful).  Any of the three tools mentioned above can be used for this method.  

2.  Full Stroke Massage:  Getting rid of trigger points can take several days or even weeks.  If you’ve eliminated all trigger points within a muscle it is then time for some tissue quality maintenance.  Here you’ll use either the stick or the foam roller to perform long smooth strokes from the top of the muscle to the bottom.  It’s best if you perform from 8 - 10 strokes.

If we’re dealing with knee pain the main muscles we’ll want to manipulate are the …

• Quadriceps
• IT Band (long sheath of fibrous tissue that runs the outside length of your leg)
• Calves/Peroneals

Quadriceps                                                      IT Band

Calves/Peroneals

Tips

• Trigger points often return.  Become aware of your trouble areas.
• Although the technique is expected to be a little painful.  Do not push yourself past your own threshold.
• The more often you perform self massage the better.  Frequency is key.
• Combine self massage before stretching for even better results.  (see first article)
• Try to incorporate some self massage before your regular workout routine.

Being able to bend at the hips is extremely crucial if you want to avoid future back or knee pain.

Using the One Leg Dead Lift teaches your body to decelerate (lower) your trunk using the strong efficient gluteus muscles and hamstrings.  This is the natural pattern your body was designed to do. 

It may be hard to do at first but keep practicing.  Years of sitting can do some pretty bad damage to the proper motor patterns your body should follow.  The more you repeat this movement the more you’ll groove back those primitive neural pathways that allow you to do this without thinking.

Tips:

1.  If you can, do the exercise without shoes on.  Shoes tend to put you into a foot forward flexed position which is what you don’t want when trying to learn primitive motor patterns. Think caveman.

2.  Brace your abs but keep your breathing natural. (also takes practice)

3.  Shift your weight back and keep your heel down.

4.  Keep your low back flat and your hips level with each other.

5.  When you come back up try and squeeze your butt cheeks at the top.

Primary muscles worked.

• Glutes
• Hamstrings
• Spinal Erectors (stabilizing)

Knee pain.  It sucks and no one should have to deal with it.  When it comes to knee pain I’m a firm believer in exhausting all of your options before submitting to the dreaded knife.  

Surgery is expensive.

Rehab is long, painful, and extremely unrewarding in its early stages.

That being said, I’m no doctor.  You should listen to yours and always consult her/him before engaging in any type of exercise program.

Knee pain, for the most part, is a symptom that tells us that there is some sort of dysfunction above or below the joint and not necessarily within.  Today I’ll explain to you a few "lo-tech" steps you can take to start appropriately dealing with knee pain.

1. Stretching - We’ll start by stretching muscles that are most often associated with knee pain.  Hold each stretch for 30 seconds and do them several times a day to maximize their benefits.                                                            

Gentle Quad Stretch                                     Advanced Quad Stretch

Calf Stretch (back leg)

2. Mobility - If you want the knee joint to be stable that means you want the hips and ankles to be mobile.  Any limited range of motion in the hips or ankles has to be made up at the knee.  This leads to problems.  As you can see on yourself, the hips and ankles were designed to move in many directions.  The knees, not so much .  Repeat each movement 10 - 15 times.

Hip Mobility (hurdle step over a bench)

Ankle Mobility (with the toes elevated gently push the knees over the toes)

3. Activating - The tissues above and below the knee joint can typically become dysfucntional when a few specific muscles are not doing their job.  The glutes mainly.  In this case you want to try and wake these muscles up with a few activation exercises.  Again do about 10 - 15 reps.

Glute Bridge (be sure to squeeze your butt cheeks at the top)

One legged Dead Lift (notice I bend from the hip and do not lean forward at the spine)

Conclusion - This is nowhere near a complete list of the strategies you can use for dealing with knee pain.  These are just a few of the simple lo-tech solutions I use when dealing with clients whom suffer.  Next time I’ll break out a few toys and show some of the more "mid-tech" tricks.

Until then, post any questions below and I’ll be sure to answer them promptly.