Bad Knees? How To Exercise with Unbearable Knee Pain
One of the most common complaints I hear from clients is knee pain. Someone will tell me they can’t exercise because they have bad knees, or I will hear they don’t want to exercise for fear of hurting their knees. Knee pain is something that affects millions of people in the United States. According to a study published in American Family Physician, “Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually.”. There are many reasons why one could be suffering from knee pain and it can happen at any age.
The Knee Joint
The knee is the largest joint in the body. It allows your leg to bend and straighten by connecting the upper leg bone (femur) to the two lower leg bones (the tibia and fibula). There are two pieces of cartilage (the medial and lateral meniscus) that sit and act as cushions between these bones. (There is also additional cartilage that covers the long bones that is different than the meniscus.) Numerous ligaments act as stabilizers in your knee and tendons connect the bones to the muscles. Your kneecap (patella) sits on the front of your knee and moves up and down when you bend and straighten your knee
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Two groups of muscles are the main support to the knees. One are the hamstrings, which are the muscles on the back of the thigh. They run from the hip to just below the knee and work to bend the knee. The other are the quadriceps, which are the four muscles on front of the thigh that run from the hip to the knee and straighten the knee from a bent position. Your hip muscles can also affect your knee, as they control the way your knee moves and work together with the other muscles connected to your knee.
What Are Some Causes of Knee Pain?
A common cause of knee pain can be from an imbalance in the strength around the knee. For example, “Runner’s Knee” (patellofemoral pain syndrome) is pain right behind and around the knee cap. Runner’s knee isn’t a structural problem (like a torn meniscus), the issue lies in how your muscles function. It is most often a result of abnormal mechanics caused by muscle weakness and/or tightness in the legs or core that forces the patella to bump against the femoral groove causing pain. Often our quadriceps are stronger than the hip muscles and/or hamstrings. Strength training for the posterior hip muscles, like the gluteus medius will help correct this incorrect movement of the kneecap. Tight muscles can also be a cause of misalignment. Static stretching after exercise and foam rolling can help relieve tight muscles.
This doesn’t just happen in runners. Many people have an imbalance in the strength around the knee which causes the knee to be unstable. This can be caused by our sedentary lifestyles. When we spend the majority of the time sitting, our hips, glutes and hamstrings are tight and not as strong as our quadriceps.
Hip or foot pain can change the way you walk. This altered gait can place more stress on your knee joint. In some cases this can cause knee pain. Identifying the cause of the hip or foot pain is important to realign your gait and subsequently ease the additional joint pain. Sometimes a pair of shoes can change your posture and walk. Making sure your shoes have the support you need is important to prevent any injuries or ease existing pain.
Excess body weight can also put a lot of pressure on the knees. A study showed that each pound of weight loss can reduce the load on the knee joint by 4 pounds. Lose 10 pounds, and that’s 40 fewer pounds per step that your knees must support. Less pressure means less wear and tear on the knees.
Inflammation is another cause of knee pain and can be due to a variety of reasons. Being overweight may increase inflammation in the body that can lead to joint pain. Losing weight, a healthy diet, reduction of stress and good sleep are all things that can reduce this inflammatory response. Inflammation is also a symptom of arthritis.
There are many different types of arthritis. The three types that most often occur in your knees are Osteoarthritis, Rheumatoid Arthritis and Post-Injury Arthritis. Osteoarthritis is a progressive condition that slowly wears away joint cartilage. Rheumatoid arthritis is an inflammatory condition that can strike at any age. Another type of arthritis can develop following an injury to the knee.
Knee injuries can include torn meniscus or ruptured ligaments, inflamed tendons or torn cartilage. Injuries can be caused by many different reasons; including sports injuries, falls or other accidents.
Should You Exercise with Knee Pain?
Now that you have a bigger picture of how it all works together, it should make sense that having strong muscles and bones to support the knees can help, and may eliminate or prevent pain. By building strong muscles, you can reduce knee pain and stress and help your knee joint better absorb shock. Strengthening exercises involve developing stronger muscles in your quadriceps, hips, and hamstring. Having strong muscles in place can take some of the pressure off your knees.
A common misconception is that exercises can harm your knee joints by placing excess pressure on them, especially in high impact activities such as running or high impact exercises. A study in the National Institutes of Health shows that arthritis in the knees is not more common in those that run. A report by the American College of Sports Medicine (ACSM) provides strong evidence that exercise is, in fact, good for the knees. The findings concluded that exercise actually helps improve the cartilage in between joints instead of breaking it down.
Keeping moving with low impact activities and strength training will help arthritis pain. Swimming, water aerobics, stationary bicycles and low impact aerobics are all good examples of low impact activities appropriate for those with arthritis. Movement is lotion for the joints.
Example Exercises
Here are a few exercises to help strengthen the muscles that support the knee. I would recommend starting with 10 repetitions of each. Only increase that number when you can perform them easily, without pain or difficultly. Complete a 5 minute warm up, a walk or stationary bike, prior to completing these exercises.
Lateral Band Walks
Place a resistance band around your ankles. Come into a half-squat position, with core tight and glutes engaged. Without letting your knees cave in, and keeping your weight in your heels, step out sideways with one foot, and slowly follow with the other foot. (You can add a second resistance band above your knee for additional challenge.)
Forward/Backward Band Walks
Place a resistance band around your ankles. Come into a half-squat position, with core tight and glutes engaged. Step forward at a 45-degree angle with one foot, and follow with other foot. Repeat on the other side.
For backward, take a step backwards at a 45-degree angle.
Wall Squats
Stand up straight with your back to a wall and your feet parallel, about two feet away from the wall, spread hip-width. Slide down the wall slowly until you are just about in a sitting position. Hold that position for up to 10 seconds and then slowly slide back up. Don't allow your knees to overextend in front of your toes.
Hamstring Curls
Lie flat on your stomach. Slowly bring your heels as close to your butt as you can, and hold that position for a few seconds then release and extend your legs. You can also do this exercise standing while you hold onto a chair and lift one leg at a time.
Hip Raise or Bridge
Lay on your back on the floor. Bend knees keeping feet on the floor. Heels should be close to the butt. Pushing off with the heels, squeeze your gluteal muscles and lift the hips towards the ceiling and slowly lower your hips back to the floor rolling your spine down one vertebrae at a time.
Calf Raises
Simply stand with your heels hanging over the edge of a stair and rise up onto your toes to perform calf raises.
There are many ways to strengthen the muscles that support the knee. Exercise selection depends on your fitness level and your specific knee issue. Consulting with a physician, physical therapist or personal trainer can help determine what is appropriate for you. The best thing you can do for existing knee pain, and to prevent knee pain, is to strengthen the muscles that support your knee and keep them flexible. Don’t let knee pain keep you sidelined, keep moving!
Topics: LivRite News
Healthy habits include anything you do to benefit your physical, mental or emotional well-being. They help create a healthy life. If you are not used to living a healthy lifestyle, these habits can be difficult to develop.
Change is hard! However, if you are ready to commit to improving your health, creating healthier habits is possible and will greatly benefit you in the long run.
Why a habit? Habits free us from decision making and from relying on self-control. According to researchers at Duke University, habits account for about 40 percent of our behaviors on any given day.
Once something is a habit, it becomes almost automatic and you do it without thinking. A habit is formed through a habit loop consisting of a cue, an activity and a reward. Something cues you to complete a certain activity like a location or time of day.
When that activity is complete your brain releases chemicals (like dopamine) that signal pleasure. Because of the reward, your habit loop is reinforced. This reward can feel like stress relief or happiness or another benefit that feels good to you at that moment.
Your brain will want to complete that activity again next time it is cued so you will receive the reward. This works for all habits, healthy ones and bad.
For example, say whenever you get ready for bed (cue), you brush your teeth (activity), which results in clean feeling teeth that makes you feel good (reward).
Or a bad habit, whenever you drive to work (cue) you stop by Starbucks and get a Venti Mocha Frappuccino (activity) on your way in and you are rewarded by that rush of sugar (reward).
Do you have some unhealthy habits you want to break? Think of the habit loop.
A habit starts with a cue. Because bad habits serve you in some way, it’s very difficult to simply eliminate them. Instead, the activity you would like to stop needs to be replaced by a new habit that provides a similar benefit or reward.
Let’s say you want to quit smoking. What cues you to smoke? Identify your triggers and replace the bad habit with a healthier one whenever that cue comes up that will elicit a reward/similar benefit.
If you normally go outside on your work breaks (cue) for a cigarette, ask a coworker to go for a walk with you instead. Or, if possible, remove those cues that make you want to smoke. Another example, if you would like to stop snacking in the evening after dinner, think of what cues you to do so.
If it is sitting and watching tv, switch the mindless munching to knitting or doodling. Or remove the cue of watching tv by meeting up with a friend instead or talk on the phone. Cut out as many cues as possible. If you can’t remove the trigger, replace the unwanted activity with a healthier option.
James Clear said, “When you learn to transform your habits, you can transform your life.”
Here are three more ways to create and keep whatever healthy habits you want to start.
- Add a healthier behavior to an existing habit. You brush your teeth every day right? It’s automatic (because it is a habit!). Try adding an action you want to make a habit at the same time as one of your existing habits.
For example, if you want to eat more vegetables you don’t have to necessarily completely change your normal eats. If you normally make eggs for your breakfast start adding spinach to them to get more vegetables.
Or if you need to drink more water, add filling your water bottles for the next day to the time you normally brush your teeth before bed. Put your water bottle right next to your tooth brush so you will remember. Then your water bottles are ready to go the next morning. Pretty soon when you go to brush your teeth, filling your water bottles will just be part of the routine. Do you drive by the gym on your way home from work? Make it a new stop on your usual drive home. Before you know it, going to the gym after work will be automatic.
- Start Slow. You wouldn’t go out and run a marathon if you’ve never run a mile. Make small changes (a few or even just one at a time) and slowly add more from there. This goes for anything, including both exercise and nutrition. It is important to make SMART goals. (Check out my post about SMART goals here!) The R stands for realistic. Setting small, measurable, realistic and time measured goals will help you reach a bigger milestone and keep you motivated along the way. If you are new to exercise, a SMART goal, or habit to start, may be to go to the gym twice this week. Or to take a walk for 20 minutes three times this week.
It can be easier to make changes to your nutrition slowly as well. Eating healthfully should be lifelong, not just for 21 or 30 days. A SMART goal to start eating better could be to cook at home three nights this week if you usually go out or get take out every night.
Or pack your own lunch if you normally go out. If you drink soda, replace it with water or unsweetened tea. As you get used to these changes and they become habit, you can add more.
- Pause, don’t stop. In her book “Better Than Before”, Gretchen Rubin says restarting is harder than starting. If you derail from your new exercise routine or healthier eating, take a step back and pause. Don’t think all is lost because you missed a few days of your new habits. You didn’t stop, you just paused and are able to start right back up where you left off. This happens to everyone and it will to you as well. So plan for it and know what you will do when you do get off track. Building healthier routines is not all or nothing, and missing a week or workouts or one weekend of unhealthy eats doesn’t make you a failure. It makes you human and you can start right back where you left off.
Not sure what kind of healthy habits to adopt? Here are a few things that might be a good fit in your daily routine. You don’t have to do all of these suggestions, some of them you might already be doing, plus it’s better that you don’t try too many new things at once. As we already discussed, start small and pick one or two things to turn into a new habit then build from there!
- Drink More Water – Track your water intake with an app like My Fitness Pal. Drinking one full glass of water before every meal is a great start and a great habit to implement!
- Walk during every break you have at work or aim walk for 2-5 minutes every hour
- Strength train two times a week
- Take the stairs instead of the elevator whenever possible
- Turn off all electronic devices at least an hour before bed
- Keep a Sleep Schedule – go to bed and wake up at the same time each day
- Be Mindful – Stay in the present moment, whatever you are doing. This could be meditation or simply focusing on the task at hand. Pay attention to your breathing and all the sensations you are experiencing.
Change can be hard. Be patient, give yourself some grace and keep reminders around of why you want to create this healthier life.
“Habits are the invisible architecture of daily life. We repeat about 40 percent of our behavior almost daily, so our habits shape our existence, and our future. If we change our habits, we change our lives.”
― Gretchen Rubin, Better Than Before: Mastering the Habits of Our Everyday Lives
Topics: LivRite News
Want to lose weight? What’s more important, diet or exercise?
Looking to lose some weight? Should you start exercising or should you change your diet? Can you change the number on the scale with just one or the other or do you have to do both?
I’ve heard from individuals who have lost weight by altering their nutrition and not working out at all.
I’ve also met with people who after starting exercising, slimmed down without changing their eating habits.
I even have spoken with some individuals who made changes to both their diet and exercise routine and didn’t lose anything.
So what should you do?
Weight Loss Basics
Let’s start by reviewing the basics of weight loss. To lose weight you must have a calorie deficit, that is you must be burning more calories each day than you are taking in with food and beverages.
Of course, this simple equation can become very complicated with issues like insulin resistance, unbalanced hormones, lack of sleep and other medical conditions. We won’t get into those situations here.
If you feel you have any medical conditions inhibiting your weight loss, please contact your doctor. However, even without medical reasons making weight loss even more difficult, while a simple equation, creating a calorie deficit and losing weight isn’t easy to do! But it is possible with patience and dedication.
How do you know how many calories you need each day? Your body needs a certain number of calories to maintain your normal bodily functions. That number is your resting metabolic rate (RMR) and it is different for everyone.
There are online calculators to determine your RMR or you can use an app like My Fitness Pal to figure it out for you. The calculator or app will ask you about your activity level.
Your RMR will be multiplied by your activity level; sedentary, lightly active, moderately active or very active. That will give you the number of calories you should be taking in each day.
Subtract 500 calories from that number to give you an updated number of daily calories to put you on track to lose a pound a week.
Studies show it takes a 3,500 calorie deficit in a week to lose a pound, which breaks down to 500 calories a day.
When you have your number of calories to take in each day, keep track of your food and drink intake for at least a few days to ensure you are staying near to your goal. There are many free apps on the market that can help you track your food and can also add in your physical activity.
The calories you burn exercising can be added back to the number of calories you can take in that day and still be on track to lose.
For example, say I should be taking in 1,500 calories daily to lose around a pound a week.
If I run for 30 minutes and burn 200 calories (calorie burn is different for everyone and depends on your height, weight, age, gender and exertion level) then I could eat 1,700 calories that day and still be within my goal for the day.
By making any necessary changes to your nutrition, as well as ensuring you are exercising, you will achieve weight loss faster and in a healthier way. Plus you will be healthier overall!
Here are 5 tips to maximize both diet and exercise for fat loss.
1. HIIT and FIIT
These are important acronyms when it comes to ensuring you are getting the biggest calorie burn from your workouts. HIIT, High Intensity Interval Training, will burn more calories than steady state cardio (like running or walking at the same pace for a period of time).
Plus, with HIIT workouts, your body continues to burn calories hours after your workout as it recovers. This is called excess post-exercise oxygen consumption or EPOC.
EPOC can elevate your RMR up to 38 hours after very high intensity exercise. This number of EPOC boost varies based on the intensity of your workout, your genetics, current fitness level and muscle mass.
Your body will get used to any stimulus you provide it with so what was very difficult a few months ago seems easier now and requires less calories to do. That’s where FIIT comes in.
FIIT stands for frequency, intensity, time and type. By changing either how often you exercise or the number of sets you preform, the intensity of your workout, how long you complete your exercises or how often you work out or the type of your workout, your body will be challenged in a new way and will burn more calories than it would have with your prior workout it was used to.
For example, if you usually do the same five exercises with dumbbells three sets of twelve repetitions, switch to machines that work the same muscle groups or change it to four sets of ten reps with dumbbells.
Change it up! Try a new class, get out your bike, do something different to move your body.
2. Use Weights
More muscle means more calories burned. A pound of muscle burns six calories per day, versus a pound of fat burns which only two calories per day. This increases your RMR and metabolism, which means you will be burning more calories every day even while at rest. A pound of muscle also takes up considerably less space than a pound of fat, so it is not only healthier and burning more calories, it is making you look leaner too.
If you are new to strength training, take a look at our exercise library for instructional videos and instructions.
3. Prioritize Clean Eating
Limit added sugar, focus on lean protein, healthy fats and whole carbs from fruits, vegetables and whole grains.
All calories are not created equal. If you are eating processed foods and other foods with mainly sugar, saturated fats and salt, you will develop consistent cravings and never feel satisfied.
Processed carbs like white flour and foods that are high in sugar or artificial sweeteners will cause your blood sugar to rise sharply but then will crash leaving you hungry again and craving more in an hour or two.
You will feel more satisfied when you are eating lots of foods rich in fiber like legumes (dried beans, lentils), veggies (Brussels sprouts, broccoli, spinach squash, sweet potatoes) and fruit (apples, berries, oranges, pears).
Fiber helps improve blood sugar control, helps lower cholesterol and reduces your risk of chronic diseases like diabetes, colorectal cancer and heart disease as well as keeping you feeling full longer.
Replace processed carbs like white bread, bagels, muffins or donuts for breakfast with high-protein foods like eggs, or Greek yogurt mixed with chia seeds and berries.
For lunch and dinner focus on lean proteins like fish, chicken, turkey, beans, lentils and veggies.
There are many diet trends out there that are not always sustainable and some are not healthy. No gimmicks are necessary if you are eating a well-balanced diet that is within your calorie limits and prioritizes lean proteins, vegetables and whole grains.
If you have questions about a certain diet plan or way of eating, please contact your doctor or a registered dietitian.
4. Watch Liquid Calories
Alcohol, Juice, Coffee Drinks (not just black coffee) can be huge calorie bombs and provide no nutritional value. For example, a Grande Mocha Frappuccino is 410 calories. Imagine your calorie goal for the day is 1,500.
That Frappuccino is over a quarter of your daily intake and doesn’t provide you with much nutritional value. Plus it will probably leave you with a sugar crash in an hour and wanting more. Stick with water, black coffee or unsweetened tea.
5. Make Sure You Are Eating Enough
If you want to lose weight, you may think you need to eat less. Which might be true, but make sure you are eating enough and not starving yourself. Literally.
Extreme calorie restriction can result in amino acids/proteins being used for energy (instead of carbs or fat), meaning muscle loss instead of building lean muscle during a workout.
This would actually reduce your RMR. In other words, slow your metabolism. In general, no one should be consuming less than 1,200 calories per day.
Making sure your nutrition is where it should be is very important to weight loss as well as your overall health. Exercise has many benefits beyond weight loss, but also assists in weight loss by adding to your calorie expenditure.
The key to successful weight loss is a commitment to making lifelong healthy changes in both your diet and exercise habits.
Want a partner in your weight loss journey or don’t know where to start? Schedule a complimentary fitness assessment with a LivRite Personal Trainer to discuss how they can put a plan together for you and work with you to reach your goals!
Topics: LivRite News
It is finally spring here in the Midwest! The warmer weather, flowers starting to bloom and trees starting to bud can bring about lots of motivation to get moving and start fresh.
Don’t stop at spring cleaning your house, think about a spring clean for your health too!
Whether you kept up your workouts all winter, are still working hard on your resolution to get fit or are just starting out on your fitness journey, now is a great time to refresh your workout regiment.
It doesn’t have to be a complete deep clean, you can make small adjustments that will add up to big benefits.
Make A Schedule
This is especially helpful for those just starting out or getting back into a routine.
Each Sunday look at your calendar and plan your workouts. Be realistic, if you have taken a break from exercise most of the winter, don’t say you will workout an hour six days a week.
Start out with something more like a 30 minute session on three non-consecutive days.
Put your workouts on the calendar along with all of your other important appointments. And don’t cancel those appointments!
Check Your Gear
Spring is a great time to clean out your closet as you are transitioning from a winter to a spring/summer wardrobe.
Don’t forget your workout clothes and shoes! Recycle, reuse or donate any old worn out workout clothes and shoes.
Ladies, don’t forget your sports bras too. A typical bra has a lifespan of about six months depending on how often you wear it.
Running shoes last between 4-6 months depending on how many miles you put on them.
Now might be the time to go into a running store and get fitted for new kicks.
New workout clothes can be motivating and other gear (like your shoes) can help prevent injury.
Change Your Workout
If you have been doing the same workout for months, it might be time to switch it up.
Not only can the same old routine become boring, your body gets used to the stimulus which can prevent you from progressing.
There are many ways to change your training, like the number of sets or reps you perform, changing exercises or even changing your training schedule completely.
Altering the frequency, intensity, time or type of your workout will get your body and muscles challenged again.
Tidy Up Your Thoughts
Instead of creating goals based purely on weight loss, think about how you feel.
If counting calories has become a drag, think about your portion sizes instead. Dreading your workout?
Chances are you need to find a workout you enjoy. Check out different classes or work with a trainer to get new ideas on what type of exercise you will look forward to (or at least not dread!).
Take the opportunity with this new season to look at your workout routine and see if any of these tips will help you get energized about your health and wellness!
If you haven’t already, sign up for a free fitness assessment and talk with a trainer about how to spring clean your workouts and get ready for spring and summer.
Topics: LivRite News
How to engage your core! What does that even mean?
Have you ever heard a trainer or group exercise instructor say “engage your core” or “tighten your abs”? Some might cue you to pull your navel to your spine. These are all ways to remind you to tighten your abdominal muscles while performing certain exercises so you can reap the most benefit from the moves as well as reduce your risk of injury. But how do you do it? What does it even mean?
First, a quick look at what makes up your abdominal muscles (abs) which are a big part of your core. Everyone has four layers of abs. The deepest layer is called the transversus abdominis (TVA). The TVA wraps around your waist to connect the ribcage to the pelvis. On top of the TVA are the internal and external obliques which criss-cross your torso. Last but not least, the top layer is your rectus abdominis which are the muscles that form that often discussed six-pack. When all four of these ab muscles are braced together, working with the muscles that line your spine, you have what is called an engaged core. Keep in mind, your core also includes your glute muscles and adductor muscles in your hips along with your lower back and abs.
Why do you want to engage your core? Engaging your core during your workout helps reduce the risk of injury, especially injuries of the lower back. For example, think about completing shoulder presses. As your shoulders get tired you may start arching your lower back which puts a dangerous strain on your spine and the muscles around it. By zipping up your abs and squeezing your glutes, your spine is more protected and you can move your shoulders through a safer range of motion.
Practice engaging your core while doing my fast ab circuit!
Also, engaging your core when performing abdominal exercises especially, ensures your abs are doing the work instead of recruiting other muscles to take over. This will make those moves more effective. Since your core is the basis of almost every movement we make in our day to day lives, it is important to keep it strong.
So how do you engage your core? Your abs should be tight and pulling in but you should be able to breathe and move normally. It is NOT sucking in your stomach and holding your breath. You can practice engaging your core at any time by feeling your ribs expand to the sides while you inhale, then as you exhale contract and zip up your abs, thinking about pulling your navel up and in toward your spine. Keep breathing normally while you continue to hold your abs in.
Keeping your core engaged properly while exercising will help keep your core strong and reduce your risk of injury not only while working out, but also in your day to day activities.
Look for more great core exercises? Check out our staffs favorite ab workouts!
Topics: LivRite News