Exercising With Knee Problems

by Andrew Sacks, Certified Personal Trainer, NSCA-CPT

I have a unique perspective when it comes to bad knees. I have worked in a physical therapy clinic with knee patients whose problems ranged from meniscus damage to double knee replacements. I have trained post-rehab athletes recovering from ACL surgeries and non-athletes with patellar tendonitis. I have also dealt with my own share of knee problems, and successfully played through and recovered from them.

At one point in my life, I was playing college baseball with a torn PCL in my right knee and a torn ACL in my left knee. Neither of my knees at this point could be classified as “good.” However, I was able to get myself to a point where I could still play sports at a high level without having to miss a season due to excessive pain, instability or needed surgery. If you have enough willpower (and the right plan), you can still live your life the way you want to even with bad knees. Notice I said “can” and not “will." Unfortunately, not all knee conditions are things you can just grit your teeth and play through.

Whether or not you should continue playing sports and running with injured knees depends on the type of problems you have, your level of pain tolerance, and what you’re willing to sacrifice later in life. If you’re dealing with meniscus damage, there’s a good chance you’re going to have arthritis when you’re older. The cartilage that makes up the menisci in your knee joints does not heal itself well, and usually the only way to alleviate pain from meniscus damage is to “clip” the portion of the disc that is damaged. Also, there isn’t currently a reliable surgical option to replace menisci, so unfortunately you’re stuck with what you have.

If you are dealing with knee pain or dysfunction, the best thing you can do to prevent further damage is to strengthen the musculature of the lower body. The stronger your leg muscles are, the less stress will be placed on your knee ligaments and other supporting structures while running, jumping or cutting. Extra attention should be paid to strengthening the glutes and hip muscles. Many knee problems stem from a lack of glute and hip strength, which requires the knees to do extra work during locomotion. 

Many medical professionals feel the best way to strengthen your legs while minimizing risk of further damage to your knees is through “closed-chain” exercises. These are exercises performed with your feet flat on the ground in a stable position, such as the squat. The theory is that open-chain exercises, like leg extensions or hamstring curls, exert a high amount of shearing forces on the knee which can damage connective tissue.  If your feet are on the ground, these shearing forces are much lower and, in theory, safer for the knees.

Ask a qualified professional to show you how to perform closed-chain exercises while focusing on hip and glute recruitment, and you may decrease or eliminate your knee pain.