This article was first published online Mint newspaper on 3rd April 2017 & in paper on 4th April 2017. Below is an edited elongated version.
Knee pain has become a common problem in today’s sedentary world. As is the case with back pain, the common cause of knee pain isn’t what many believe it to be. In other words, it’s not osteoarthritis.
Even if it is, however, knee replacement surgery shouldn’t be considered as the first, or only, option. A recent study published in the British Medical Journal shows, in fact, that surgery leads to minimal change in quality of life—the study, done over nine years, had 4,498 participants aged 45-79 with or at high risk of knee osteoarthritis. The problem is not the knee replacements, but selection of patients who undergo the knife. The researchers of the above study suggest that if the procedure were restricted to more severely affected patients, its effectiveness would rise, with practice becoming economically more attractive than its current use.
In most cases, knee pain is attributed to osteoarthritis (wear and tear of the cartilage). That is an effect. Muscle imbalance, further leading to poor posture and poor gait is the cause.
Unfortunately, most don't understand that we are more than just a skeleton. It's muscles, tendon and ligaments that not only keep the skeleton together, but moves it too.
Even though the knees happen to be major weight-bearing joints, they are not stable joints by design, like the ball and socket hip joint. They involve the thigh bone (femur) sitting on top of a plateau formed by the shin bone (tibia). The kneecap (patella) rests on the femur. Each of these bones has a protective coating (cartilage), allowing cushioning between the bones. The cartilage also enables the smooth gliding of bones on top of each other when the knee moves, thus reducing friction. And, from the inside, it is covered with synovium, which secretes fluid to lubricate the joint and provide nourishment.
The ligaments that stabilize the knee from forward-backward movement are called anterior and posterior cruciate ligaments that are attached to the femur and the tibia. Then there are two C-shaped discs in each knee between the femur and tibia called menisci that not only stabilize the knees during the rotational forces and reduce friction during movement, but also help in absorbing the pounding that the knees take while walking and running.
Knee pain can also be due to injury to either the cruciate ligaments or the menisci. And as much as cruciate ligaments and menisci stabilize the knee, they need all the support and back-up they can get from the muscles around.
But when you are dealing with knee pain, you also need to address the foot, ankle, hip and low back, as well as the muscles around these areas, rather than just the knees.
The following exercises can help strengthen the lower part of the body. These are basic beginner-level exercises and aren’t supposed to replace medical advice but they can help. Do consult your doctor before trying, though.
Toe curl walk
This will help you strengthen the weak inside arches of your feet.
Sit barefoot on a newspaper or a cloth. Focus on one leg at a time. Curl your toes such that you crunch the newspaper or the cloth up. Hold it for 2-3 seconds and then let go again.
Repeat 20-25 times on each leg. Do four sets throughout the day.
Stand tall like a puppet on the edge of a step with the front half of the feet on the step. Now, keeping your knees straight, slowly come up all the way on the toes of both feet. Hold for a second. Slowly come down again.
Repeat 10 times. Do four sets throughout the day.
Lean against the wall with your back. Have your feet 2-3 feet away from the wall. Have your knees and thighs parallel to each other. Slide down, bending your knees to 90 degrees. If getting down all the way puts pressure on your knees, slide up a bit. Hold that position for 2-3 seconds to start with. Repeat 10-15 times. Do 4-6 sets throughout the day. In 2-3 weeks you'll be able to hold it for longer and even go further down to 90 degrees. At all times remember to relax your upper body.
Gluteus maximus activation
Lie flat on your tummy. Now tighten your gluteus maximus muscle—the butt. Hold this for 5 seconds. Slowly let go. Repeat 10 times. Do 10 sets throughout the day.
Sit tall like a puppet. Put your right forearm above or just behind your head. Hold the right elbow with your left hand. Gradually start pulling your right elbow with your left hand to the left side. Go as far as you comfortably can. Repeat for the other side.
Do 10 repeats for both sides. Do four sets throughout the day.
Over time, increase the repetitions. Even if your knee is damaged beyond repair and needs replacement, these exercises can help correct your muscle balance. It is always advisable to do exercises under supervision.