"Oh my aching knees!” At some point in time, sooner or later, we are all bound to utter that statement. Whether you’re a long-time exerciser or a weekend warrior, a 25 year old college athlete, or a 75 year old mall-walker, knee pain is bound to creep into your life. It’s practically inevitable. Now, obviously, knee pain caused by blunt force trauma (car accidents, for example) and other acute injuries (like torn ACL tears, meniscus tears, and shattered patellas) are a result of extenuating circumstances. These situations will require surgery in most cases, with requisite physical therapy, and the potentiality of some level of chronic pain due to the knee structure being permanently altered in some way. However, outside of these specific situations, chronic knee pain does not have to be a part of your daily life if you can take steps in your strength training program to prevent it.
First, in order to know how certain exercises can help with alleviating knee pain, it helps to have a little understanding of the anatomy of the knee joint itself. While relatively delicate, the knee is a surprisingly resilient joint that is formed where the femur (thigh bone) and tibia (shin bone) meet, and is protected in the front by the patella (knee cap). Additionally, there are a number of soft-tissue structures that help keep the bones of the knee in place:
- The ACL (anterior cruciate ligament) keeps the tibia from sliding too far forward from the femur
- The PCL (posterior cruciate ligament) keeps the tibia from sliding too far backwards from the femur
- The LCL (lateral collateral ligament) keeps the outside of the knee joint stable
- The MCL (medial collateral ligament) keeps the inside of the knee joint stable
- The menisci (medial meniscus and lateral meniscus) help to absorb shock in the joint during running and jumping
- The patellar tendon helps keep the patella bone in place by not letting slide around
Additionally, there are a number of big muscle groups that all attach to the knee joint that are responsible for controlling knee movement, namely the quadriceps group and hamstring group. Understanding proper exercises to strengthen and balance these muscles is vital to keeping your knees pain free.
One of the biggest issues that cause knee problems in most people, again, outside of major injury, is the imbalance of strength between their quadriceps group and hamstring group. Much of our daily activity (ex. walking, running, climbing stairs, getting out of chairs) puts a large emphasis on the activation of the quadriceps group versus the hamstring group. As a result, over years and years of moving in these repetitive patterns, your body compensates naturally by growing stronger through the quadriceps in relation to the hamstrings. This muscular imbalance creates an uneven force on the knee joint, causing stress on certain ligaments more so than others, and also potentially leading to arthritis.
In order to help correct this common imbalance there are a couple of things to remember when you are in the gym. First, make sure that you are activating your hamstrings as best you can on all of your lower body movements such as your squat, deadlift, and leg press/hip sled. The best practical way to ensure this is to always be conscious of “pushing your heels through the floor.” This simple coaching cue will help to keep you from raising your heels off of the floor, and prevent you from using too much quadriceps activation as you are extending your legs through the movement. Additionally, these auxiliary exercises make great additions to your overall strength program: lateral step-ups, step-downs, drop lunges, and hip bridges.
When you really stop and think about it, our knees are sensational structures! Though relatively simple in construction, they take on incredible demands on a consistent basis every single day we are alive, let alone what they allow us to do in athletic situations on the field or court. However, whether through bad injury, or neglect in the weight room, they can also be a source of major pain and frustration. Hopefully, with a little knowledge of how they are built, and how to keep them strong, healthy, and balanced, you will never have to experience kneeproblems again, and you can enjoy a life filled with all the activities you love!
The time is finally here. You’ve been waiting for it since Thanksgiving. You made up your mind after Christmas that THIS is the year you are going to be in better shape; THIS is the year that you make exercise a staple of your weekly schedule; THIS is the year you transform your body into the one of your dreams. You’ve done everything you need to do to plan: you’ve mapped out the closest gym to your home or office and you may have even gotten some new threads or sneakers from Santa! You know everything you need to know to make this the best fitness year yet…now what?
Sound familiar? All too often this scenario fits for millions of Americans who are desperately trying to make each new year a healthier one than the year before. But, unfortunately, these efforts quickly get thwarted and never move out of the beginning phase of starting a workout program, and the person is derailed by February. Why? Most of the time it is simply because “you don’t know what you don’t know.” It’s hard to know where to turn to when you are looking for advice. Whether you simply don’t know who to ask, or maybe you’ve had a bad experience in the past that you are trying to avoid this time, these little uncertainties can have negative ramifications when it comes to you achieving your fitness goals. Fortunately, there’s help.
The first thing you will want to do is decide whether you want to use a trainer or just handle designing your program on your own. There are some obvious pros and cons to going either route, but here are a few benefits of using a trainer that you might not be aware of:
1. Proper exercise technique- if you are new to weight training, having an educated person with you is extremely valuable to have in order to make sure that you are doing exercises correctly and safely.
2. Proficient program design-having someone who knows how to take care of all the details of your workout regimen like reps/sets schemes, is a great way to make sure that you are continually progressing and improving; making life easy for you since there is no guesswork involved, and making your time in the gym as efficient and productive as possible.
3. Accountability-knowing that you have a person dedicated to your needs can be a great way to keep you motivated to continue working out, and make sure you don’t “fall off the wagon.”
4. Partnership-knowing that you have someone encouraging and supporting you every step of the way to ensure that you get the absolute maximum benefit out of each workout, and therefore achieve your goals and desires, may sometimes be the only missing link you needed in the past in order to succeed.
One final point: if choosing a trainer is the route you plan on trying this year, there are a few things to keep in mind when you are making your decision. First, make sure that he/she is educated. One of the major issues that people run into is that they’ll take the first-available trainer, settle with whomever the gym they belong to puts in front of them, or pick the “best-looking person in the gym” (more times than not, the best looking trainer, is the least knowledgeable one). Make sure you don’t settle. Pick someone with a high-level certification (for example, NSCA-CSCS, NSCA-CPT, ACSM), and if possible, at least a bachelor’s degree in exercise science or related field (ex. Kinesiology, sports science). Second, make sure you are clear about what you expect from them; this is an investment that you are making in yourself, and you want to be certain that the person who you choose to help you is going to give you what you want. If you do an initial consult/assessment with a trainer (which they should offer to you anyway!), make sure you are clear about what help you specifically need from them in order to achieve what you want. Any trainer worth using will not only appreciate your clarity, but will also make sure that they accommodate you accordingly. This is all about YOU!
Creating a fitness lifestyle is arguably one of the most important things you can do to have an enjoyable and fulfilling life. As a result, it is imperative to make sure you put yourself in the best position to succeed safely and efficiently. There is no reason you shouldn't seek and demand the advice, guidance, and support you need from a reliable source in order to create the best version of yourself through exercise. You were given one body with which to achieve great things, and with a little qualified help when needed, you will be surprised at what you are capable of.
One of the most fulfilling aspects of our job is playing a supportive role in the lives of each of our clients. That role becomes especially important with any female client that becomes pregnant during the time we train them. There is a lot of excitement and change that occurs for a woman during the pregnancy process, especially on the physical side. As a result, our job as strength coaches is to ensure the safety and health of both the expecting mother and the fetus while training during the 9 month term. Therefore, there are a few key considerations that need to be taken into account when you are about to embark on your journey of exercising while pregnant.
First and foremost, you must make sure to check with your doctor about how exercise, especially resistance exercise, will affect your body. Every woman is different, and the stress that is put on the body will cause different reactions within the body during each pregnancy. Therefore it is imperative that your doctor give you the green light to exercise before you begin a training routine.
Secondly, it is a great idea to invest in a heart rate monitor. Because the extra life growing inside the woman’s body requires an increase in blood and oxygen levels which, are higher than normal. Therefore, if there is to be the added exertion of exercise which has an additional elevating effect on HR and BP, very close attention needs to be paid to monitor the woman’s heart rate during the workout sessions so as not to put the fetus at risk. Along with monitoring the heart rate, the proper breathing technique should also be taught and mastered during working out.
Finally the last, and perhaps the most important, consideration before beginning a workout program while pregnant should be to always “listen to your body.” There is a multitude of hormonal and structural changes that the woman experiences during pregnancy that have dramatic effects on the function of the body overall. Common issues that could be made worse from exercise if they are not handled properly by the trainer range from joint hypermobility, ligament laxity, and the change in center of gravity due to the new baby bump. While none of these roadblocks are enough to derail the exercise program during the* 9 months, they are vital to keep in mind when the resistance program is being designed, and the possibility for on-the-fly modifications should always be accounted for.
In order to consider all of the above factors, modifications to traditional strength exercises should be employed. For instance, the incline pushup instead of the traditional pushup, and the seated chest press instead of the lying bench press are great substitutions that will still work the chest, shoulders and triceps without requiring the mother to get in and out of the lying position; thus lessening the possibility of unsafe rise in blood pressure. Also, the bodyweight-loaded prisoner squat or step ups are good alternatives to the back squat or heavy deadlift. Although the squat and deadlift are staples to any strength program, the need to hold your breath at the bottom of the range of motion in each exercise would put an unsafe amount of pressure on the uterus and could seriously harm the baby. It's best just to hold off until after your bundle of joy is born before you get back into doing those particular lifts!
Having a baby is one of the biggest joys of life that humans can experience. While there are a lot of changes to your body that require a little more attention, there are too many benefits of resistance training for the expectant mother not to participate. As long as you are safe, smart, and aware of how your body is reacting, you are sure to find that exercise will have a beautiful and healthy effect on both the mother and child.
Joe Gernetzke CSCS