Resolving Pain - Part One: The Knee



2017 is here, and everyone is looking to commit to New Year's resolutions. There will be an increase in gym memberships, a boost in healthy eating, and friends and family committing to be “more active.” Put simply, health and wellness has gone viral.

Within this widespread interest in fitness, weight lifting is taking the lead as a main craze. Everything from Olympic lifting, kettle bell workouts, and CrossFit have all become extremely popular.

The payoffs of these trends are clear: increase in strength, stamina and overall physical appearance. However, with each workout there is a natural tendency for injuries due to improper movement and form.

We’ve seen such cases at at Allied Health and Chiropractic. What we offer is corrected movement through instruction and pain treated with appropriate care. The result: patient’s perform proper movements and excel in their chosen exercise.

For the next series of posts we will highlight common pain complaints athletes experience as a result of extensive weight lifting.

First, we’ll look at the Knee.

The knee is a complex joint. It’s the articulation between the upper and lower leg. It also has a bone–the patella–that articulates with the upper leg (femur). This protects the front surface of the joint and the important ligaments in that region.

For the purposes of this post, we’ll look to two types of common knee complaints:

  • Patellar tendinitis
  • Sharp pinching pain above the knee

These complaints are common in weightlifters, especially when the knee experiences excessive stress.  

Pain below the knee is often tendinitis and should be treated with rest in addition to conservative therapy by a chiropractic physician or doctor of physical therapy. One treatment option is Graston technique. This helps to reduce inflammation and eliminate scar tissue within the patellar tendon. 

Another common complaint is sharp pinching pain just above the knee. This is seen in lifters and also impact sports like basketball and running. The issue arises from a muscle called Articularis Genu. Its sole job is to position the suprapatellar bursa, which allows for smooth movement of your quad on the femur, when the knee goes into extension.

When this muscle is not functioning, the bursa becomes pinched. Active Release Technique is a great treatment to release the impingement. 

But what causes these pain complaints? Improper form. And what makes your form improper? See the video below. 

Most importantly, a forward lunge is not a forward lean. This means don’t lean over your knee. The front knee should be at 90 degrees over the front toes but not ahead of them. The lunge should resemble a one-legged sit. Inactive gluts and hamstrings can hinder an individual’s ability to do this.

Without proper activation of those muscles, the hips are not able to go into full hip extension during the lunge. This is what causes falling or leaning forward resulting in an increase in the stress/strain of the front knee. In addition, the back knee should be controlled and should hover right above the ground. Kneeling down without control onto your patella will hurt–and doing it over and over again will cause pain and injury.

How is this corrected?

Activate your gluteal musculature with hip extension and external rotation resistance exercises. Band work for these activation areas coupled with conservative treatments as seen above are great to remove pain from the knee.

Below is a forward lunge we should all strive for. The knee is at 90 degrees, above the toes with good hip extension in order to sit into the lunge. The movement is controlled and there are no excessive forces on either of the knees.

We hope this helps improve your form the next time a lunge is in your workout plan.

Coming up: look for our next post targeting the low back with lifts like the back squat and deadlift.

Please feel free to post any questions or comments below.