The Importance of Keeping Your Knees Healthy.

We often take our health for granted and ignore early warning signs. The knee is no exception. When you keep your knees healthy allows us to easily get up and down from the floor, maintain balance on uneven surfaces and walk for long distances without discomfort. Even occasional knee pain should be an early warning sign to take heed and pay attention to your knees.

A healthy knee has four important components:

Muscular strength
Flexibility
Proprioception
Endurance

You can improve all four components through exercise.

There are many muscles surrounding the knee but the most important for knee health are the quadriceps muscles (or quads). The quadriceps are four distinct muscles that start at the top of the leg or hip and end right below the knee. Balancing strength across all four muscles is important. The quad running down the inside part of the leg is frequently neglected and can cause problems with proper tracking of the knee cap. All four muscles converge to form a common patella tendon that attaches to the kneecap (or patella) and then onto the front of the lower leg bone. If this tendon ruptures, surgery is required immediately.

Strength for stability.

Good strength in the quadriceps muscle stabilizes the knee joint against injury. There are two important ligaments inside the knee joint (anterior and posterior cruciate ligaments) and two on the outside of the joint (medial and lateral collateral ligaments). Strong quads help to protect these important ligaments against sprains, tears and rupture. The anterior cruciate ligament (ACL), in particular, is vital to good knee function and frequently requires surgical repair if ruptured.

The patella tendon helps to keep the kneecap tracking correctly in its’ groove as we bend and straighten the leg. The kneecap is vulnerable to wear and tear injuries and is a common source of knee pain. The fragile cartilage on the back of the kneecap can be worn down if it rubs rather than slides across bone. These patello-femoral syndromes, including chondromalacia, can be quite painful when walking, running or using stairs. Strengthening the quads as a whole with particular attention to balancing the strength of the medial and lateral quads will help track the patella appropriately.

You need to be able to flex, extend and rotate.

The knee primarily flexes, extends and rotates. We need about 135 degrees of flexion to accomplish activities of daily living with ease. Less than 120 degrees of flexion makes it difficult to get up and down off the floor, and less than 100 degrees of flexion makes walking stairs or getting in and out of a car very taxing. Lack of full extension of the leg impairs walking often creating a limp and makes it difficult to lie face down for long periods of time. Too much rotation or inability to control rotation with sudden forces (like tripping) can cause injury to important joint ligaments.

Proprioception is the ability to figure out where your knee is in space without visual feedback. Good proprioception is dependent on adequate neural connections between the knee and brain. This is critically important for maintaining balance. Endurance is the ability to maintain muscular strength over a prolonged period of time since our knees are one of the most active joints in our body.

In our Studio, we build quad strength and endurance in multiple ways. Footwork on the reformer in a variety of leg positions helps to balance strength in all four quads, and jump board is a great way to build quad endurance. Safe knee stretches within an appropriate range of motion can be easily achieved using Pilates equipment and props. Balance work and single legwork build proprioceptive feedback.

Keep your knees healthy and pain free!