5 Tips on Saving Your Knees

If you’re interested in reading more on ideas presented in the article below, I suggest reading Dynamic Aging. If you’d like movement instruction via video, start with Alignment Snacks: A Balanced Approach to Hip Strength.

Today is my mom’s birthday. She is 60. Happy Birthday, Mom!! I love you. Thank you for everything you have ever done. It got me where I am today. Which is up at 5:30 AM writing this blog. Thanks a lot.

This is a picture of my 60-year old mom when she was living in some European communist country about 75 years ago.

I’m not sure why people used all-metal strollers or let their children pet wild animals back in the day. I love her shoes. I love that the monkey is on her stroller. I love that everything happening in this picture is highly illegal today.

Anyhow, during delivery, my mom broke her tailbone. I guess I broke her tailbone, although not on purpose. I didn’t mean to break her tailbone, in the same way I didn’t mean to break her brand new tile-top kitchen table when I was twelve. I must have accidentally bonked my head on her coccyx on the way out just like I accidentally threw my baseball mitt-with-the-ball-still-in-it onto the two-day old tiled top table.

What was not an accident was my setting the now-broken table in the middle of the afternoon to hide the cracked tile. I mean the whole enchilada too – place mats, cloth napkins, silverware, plates, glasses, and a filled water pitcher. At 3:30 in the afternoon. Also not an accident was my exclaiming “Wow! Did you hear that?” when my mom placed the casserole-from-the-oven onto the table about 7 inches from the covered crack. Another non-accident was me exclaiming “What’d you do?” when pulling back the tablecloth to reveal the crack in the table.

She thought she cracked it until I came clean about 20 years later. Just kidding, I’m coming clean now. Just kidding, I already told her, but she couldn’t hear me over the broken tail bone. Just kidding, she doesn’t have a tail so how could she have a tail bone? Just kidding, she has a tail bone and it’s called a coccyx, which is why I wasn’t allowed to call it that when I was young. Just kidding, I was never young. I was born this age, thirty-five. Just kidding, I was born young, but I was thirty-five inches tall. Just kidding, I was born regular sized, only my mother must have a gigantic tailbone that got in the way. Just kidding. Just kidding. Just kidding.

But you’re reading this for knee tips, right?

So anyway, her broken tail bone caused some tucking that she only just began to work on about a year ago. So what happens after years of tucking, pushing the pelvis forward, and holding the body with the psoas and quads? Knee osteoarthritis.

In honor of mom, here are five things that you should do starting today, as often as you can, to save those knees!

1. Stretch, stretch, stretch your calves! This might be the single-best habit you could cultivate for healthy knees. And why the calves?

Why is it bad to have the quads tense all of the time? See #5. (I’ve always wanted to write a choose-your-own adventure book. Remember those? I loved them!) For a couple different calf stretches, check out this post (click).

2. Stop wearing heeled shoes. The research linking positive heeled shoes to increased risk for knee osteoarthritis is abundant. Here is a picture from my new book Every Woman’s Guide to Foot Pain Relief:

© Restorative Exercise, Inc.

Your knees and pelvis have to balance out the angle changes at the feet. Even a “small” heel as found on many a comfort footwear brand can change the loading angles at the joints by 20-30°. Boo. And for those of you who are always looking for something professional-yet-healthy when it comes to foot wear, someone sent me a link to these all-leather flats (click). They seem expensive, and probably not suitable for serious weather, but I like to give you guys options. And they are beautiful. I’m putting the copper or nude ones on my Christmas list. I hope someone in my family actually reads my blog. Probably not.

3. Get off the couch and onto the floor. There are a couple of reasons for this. The first is, you need to decrease the amount of time you spend in the 90° hip/90° knee position. Seriously, you’re in it for hours a day. Sitting on the floor helps the joints articulate in new positions, which provides relief for old ones as well as stimulates different muscle groups. Also, when you’re on the floor more, you just start stretching more. See if you can go all-floor after dinner time. Try it. It’s awesome. Can’t figure out which way to sit? Why don’t you take a look at some of these positions used around the world!

4. Don’t use this machine at the gym…ever.

Photo from Wikipedia

Last year there was an article including this piece of machinery — What NOT to use at the gym. The article had great references, yet the online commentary was ridiculous. Personal trainers spouting off “Well I do it all of the time and I have great knees”. Wow. This kind of commentary makes me want to poke stuff in my eye. Hey, you, don’t argue with joint kinetics, ok? This machine causes very high and inappropriate forces within the knee. It should NOT be on the floor of a gym nor should it be found in any sort of knee-rehab program. There are much safer and better ways to strengthen your knees.

5. Relax your quads. The tighter your quads, the more their upward tension pulls the patella (knee cap) back into the joint space increasing friction and then inflammation. See?:

It is important to learn how to relax the quads while you are standing. It is not enough to stretch them — you need to learn how to turn them off at will. Not thrusting your pelvis is the first step. Are you a pelvis thruster? Click (here) to see what’s inside the Ancient Mummy Castle!

If you want additional exercises, I recommend the Knees & Hips DVD for the super-gentle basics, and my Save Your Knees, Build A Butt webinar for the next level!

Biomechanical considerations in patellofemoral joint rehabilitation. American J Sports Med June 1993 vol. 21 no. 3 438-444

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29 thoughts on “5 Tips on Saving Your Knees

  1. You need a health and safety disclaimer at the top of your blog warning readers not to drink coffee while reading because the ensuing laughter will make it come out your nose!

    Also, if you’re looking for requests for online classes, I would love a full body alignment check that can be done throughout the day and also something on walking. I read the blog and see that you have wonderful detailed entries already that will give me that information, but I really do much better with exercises when they are on video – and I’m happy to support your work by paying for the classes!

    1. I am working on more classes. I just moved and am trying to get a new training center going, the work it takes to get the new book to market, and starting a huge pelvic floor project! It is exhilarating! Your support of paying for a $15 class here and there is what keeps this blog going. If it weren’t for you, I’d have to close it all down, so a huge thanks!

      1. You are an amazing hard working woman! So excited about your pelvic floor project. I recommend your stuff all the time. : >

  2. Thanks for brightening my day with that picture, Katy, and the comment that everything in it are highly illegal today. 🙂 I wonder if they plopped that little girl in the stroller when she was tiny and just let her sit there for years, growing inside it. She’s soooo big for that stroller and should have been out chasing that monkey up a tree! Laughable and sad all at the same time….. I used to wear shoes like that, in the 60s….

  3. Hey Katy, I’ve also been working on squats (in addition to calf and other leg muscle stretching), approaching squats with caution of course because my tight tight tight hip muscles cause my knees to torque a bit while going down or up from the squat. Squats are also nice because you get a two-fer (or is that a 5-fer) of releases in joints from the SI on down to the ball of the foot. I’ve also added a few minutes of sitting on the floor in half lotus each night before bed (couldnt’ really manage this w/out a whole lot of knee pain a few months ago). Finally, I highly recommend deep tissue massage/myofascial release of the upper and lower leg muscles around the knee joint as well as that pesky popliteus. MANY THANKS to Tim Harris for helping me get my knee straightened out !!! I’ve been pain free in my knee for several months now, which is remarkable. Hope you are well. Best to the family.

    1. I second the Hip Hip Hooray for Tim Harris. Tim Harris is rad. I also love fascial work. Fasica work is also rad. You heard it here.

  4. I like your mom’s outfit. especially her little hat. But why is she on a leash? HA. just kidding. Also, those shoes are very beautiful. I’m gonna go share some links on facebook. And guess what? I put a blanket on the floor this morning so I could spend more time on the floor with my baby. I like this all floor idea!

  5. Great information! I am going to have my brother who has sinus tarsus syndrome read this. He can’t even release his kneecaps his quads are so tight. Hope your mom has a wonderful birthday today!

  6. oh thank God for talking about the hideousness of the leg extension machine. It has baffled my mind for YEARS that physical therapists were using this to rehab knees! Are you kidding me!?! P.S. I am a personal trainer and I would NEVER use this machine for myself or anyone else! Great post.

  7. i’m wondering about the leg press machines at the gym, if you think they are bad as well? it’s interesting what you say about the leg extension machine being bad-i injured my knee from a fall a number of years ago and went to a physical therapist who had me using this machine! but just one leg at a time and very slowly-not sure if that makes a difference or not.

    i must admit i have no idea what you mean when you say it uses high and inappropriate forces-could you explain that more for us layfolks?

    currently i get really bad knee pain if i do squats or lunges, even going down stairs can be very painful. can you recommend some strengthening exercises that are safe?

    1. The leg press is a bit better than the extension, if your feet are positioned so that in the full down motion (when the weight is closest to you, your shins are perpendicular to the standing place. At the bottom of the article, I put a link to a good kinematic comparison between the leg press and the extension machine. It’s not easy reading – you have to know a lot of the terms and it’s too much to teach a full kinesiology and biomechanics session via a blog. I don’t have enough time!
      If you check out this webinar, http://restorativeexercise.com/2011/save-your-knees-build-a-butt/
      it will show you lots of deep muscle strengthening that doesn’t hurt your knees. Right now your knees are telling you that your current program is not working for them 🙂

  8. I’m so glad your mother birthed you!! What a woman, eh?! And I think your 5:30 am writing is delicious! When ever I start a “Katy says” sentence to someone who hasn’t yet heard me go on and on about you, I always have to explain that in addition to being brilliant and excellent at teaching and explaining, you are HI-LAR-I-OUS. At least 4 syllables of funny, you are.

    SO, are there other classes online that I’ve missed? I’ve poked around the restorative exercise site before and only seen the wopping big one (saving up all my b-days and Christmases for that one) and the Psoas and the soon to be pregnant one. And then I poked the other day it was like actual Christmas when I saw the knees and butt one, are there others previous to August or July that I missed? (I’m a new reader).

    Thanks for it all!

    1. I’m glad my mom birthed me too 🙂
      Four syllables of funny. I love it.
      There are, online, the full course, the psoas, the no more kegels, which includes Female Physics. Then there are three exercise classes – knees and butt, shoulders, and the ball. I’m trying to add one exercise class a month, but I skipped this month with the move, and the baby, and I got sick, excuses excuses… 🙂 If you go to “take a class” on the RE site, you can find the $15 ones 🙂

    2. I’m glad my mom birthed me too 🙂
      Four syllables of funny. I love it.
      There are, online, the full course, the psoas, the no more kegels, which includes Female Physics. Then there are three exercise classes – knees and butt, shoulders, and the ball. I’m trying to add one exercise class a month, but I skipped this month with the move, and the baby, and I got sick, excuses excuses… 🙂

  9. Learning to relax my knee caps was huge for me as well as the external rotation of the thighs. I have legs that bent way backwards before I found saw the knee video so I was always trying to keep my legs a little bit bent. Even so I never really had any knee pain. I have a question though.. I have been having some pain/soreness on the inside of my knee. Not really the joint, but where muscles etc pass over the joint on the inside . For a while it only hurt if I sat with crossed legs for a while and then got up, but it has been bothering me more often lately. I spend quite a lot of time doing restorative exercise and working on alignment so I’m not really sure what I’m doing to cause it. Both hamstring stretches and calf stretches seem to pull on the sore part. I’m still doing them, but with caution. Any ideas?

    1. Work on the shank rotation piece a bit, that will help. When you’re doing legs on the wall, does that get to the same area?

  10. Legs on the wall feels good and that is what I thought of doing for inner knee, but my legs drop out quite wide without much trouble or sensation even when I really keep tailbone down. I tend to do cobler and stacked cobbler more often because I get a lot of stretch with those, but way up high. I will try to work on shank rotation. I’ll go back and watch that part of wba again. I have been working on getting the ball of my foot down while in external rotation when walking maybe that is why knee is hurting?

    Thanks for linking to the immune boosting stretches again. That was one of the first RE things I did. Can’t help but evaluate the model’s alignment though. Check out those ribs on floor angels!

    Also, glad to hear you are taking up knitting. If you get hooked remind me to send a picture of a berry picking basket I use to knit while standing.

    1. Okay, I’ve been working on legs on the wall a bit and found that if I move my hips closer to the wall I don’t drop right open and I do get a good stretch of the sore inner knee. I also remembered that in one of the Gaiam DVDs you do an inner thigh stretch during the strap stretch. That works too and I kind of like doing each leg on it’s own.

      Working on the shank rotation too. It’s starting to come together!

      It’s is feeling better already and I walked for 3 or 4 hours yesterday.

      Thanks!

  11. the link for positions for sitting on the floor still doesn’t work. i searched for it on the net but couldn’t find it. can you fix the link please? i will share other things i found while looking:

    http://www.ics.org/Abstracts/Publish/106/000583.pdf
    STUDY OF PELVIC FLOOR MUSCLES IN DIFFERENT SITTING-POSITIONS … tone and tension when the pelvis is titled at different angle whilst sitting.

    a story from one of the comments at: http://www.marksdailyapple.com/floor-living-do-you-spend-enough-time-on-the-ground/#ixzz2e45XxNOb :

    Once upon a time, everyone squatted. This was a good thing.

    But one day, some people, who felt they were stronger, smarter, better-looking, and generally superior than everybody else, decided to make a public show of their perceived superiority by sitting higher –MUCH higher– than everyone around them.

    These SNOBs (Sitting Nobly On Butt) ventured out and found stones and logs and sundry other flotsam and jetsam, which they fashioned into platforms of varying heights, each according to his or her means.

    And upon these platforms, they proceeded to sit on their butts, with legs dangling, pelvis tucking, and shoulders slumping. And all who saw them marveled, for who could deny the greatness of those who boldly defied Nature and its miracles of design?

    Many of the squatters desperately wanted to join the ranks of the SNOBs, but lacked the wherewithal to create sitting platforms. They were just too busy hunting and gathering and avoiding large, ravenous beasties. So they continued to squat on their haunches, while the SNOBs continued to build bigger, better, comfier, and more elaborately decorated butt-sitting platforms.

    In time, the two groups, the squatters and the SNOBs, found they had nothing much in common. Culturally, they grew further and further apart. The squatters were looked down on –both literally and figuratively– by the SNOBs, who lolled about on their platforms, delighting in the belief that, because they sat higher, they must also BE higher on the evolutionary scale.

    The SNOBs started putting on airs and ordering the squatters around and creating hereditary butt-sitting positions, and generally behaving rather badly.

    This was not a good thing, and was the direct cause of absolute monarchy, colonialism, and La-Z-Boy Heated Massage Recliners.

    In due time, agriculture was invented and the squatters had more free time to wander about looking for stuff with which to build sitting platforms. They, too, began to loll about and aspire to be just like the SNOBs.

    In time, a group’s level of civilisation and cultural refinement became directly proportional to its number of SNOBs. And the number of squatters dwindled until the few who remained were seen as, at best, odd, yet quaint; and at worst, backward, ignorant, and subservient.

    Although this was a bad thing, it did provide work for chiropractors.

    (and for biomechanists!)

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