Let's face it, many of us regardless of our best efforts suffer from the occasional ache and pain. But just because you are feeling some pain doesn't mean that you have to shut it down and spend the next 3 months doing nothing but clam shells and hip flexor stretches.
We see a highly active population here and constantly have to dance the line of what can the patient continue doing, what needs modification, and what must they discontinue doing.
What we can tell you from our experience is that it's rare that somebody has to stop being active all together. There are two reasons why I am an advocate for this: 1) They won't listen to this advice, and 2) the advice is flat out wrong. If a patient can remain active, let them.
So at this point I know you are thinking; "if I do have pain, what is okay to do?"
Keep in mind, just because we can find ways to train around an injury, doesn't mean you don't have an injury. This is still something that should be checked out by the appropriate medical provider ("cough, cough, Perfect Stride, cough") and taken care of.
The first rule of thumb I will share with you is if it hurts, stop doing it. You may be snickering right now thinking, "no kidding, that's common sense." And I completely agree with you, except not many people use their common sense.
Okay, now once you follow that one simple rule and removed all painful stimuli, all other exercises are fair game.
Outside of the obvious (doing upper body exercises), let's talk about how we can modify lower body exercises so you can continue to have success remaining active.
If you have pain with flexing (bending) your knees, it can be for a multitude of reasons that are out of the scope of this article. What this post can help you with is learning how to modify lower body exercises, like squats and lunges, to help decrease the stress on the knee.
This leads us to a second rule of thumb, or rather just a simple fact: The further your knee travels forward, the more stress is applied to the knee. Therefore, by making your tibia's as vertical as possible, you will be able to decrease the load placed on the front of knee.
Give these options a try.
1) Box Squat
I am using a dowel here, you can too. But that can be replaced by a straight bar, or even kettlebells.
- Place the bar in the "low bar" position by pinning the barbell tightly against the ‘shelf’ of your mid back, just below your shoulder muscles (posterior deltoids).
- Sit back as far as you can until the box touches you. Sitting back allows the tibia's to get more vertical.
- Drive your feet through the floor to return to the standing position.
2) Reverse Lunges
We are holding a kettlebell here, but you can substitute this for a barbell or a dumbbell(s).
- Hold a weight in the goblet position, rack position, or at your side.
- Take a step back, keeping the glute engaged.
- Focus on maintaining a vertical tibia with the lead leg.
- Make sure your hip, knee, and toes all stack on top of each other.
- Drive your leg through the floor to stand up.
3) Hip Hinge/Deadlifts
For most people with anterior knee pain, hinging or deadlifting should be okay as it requires more hip movement and less knee motion. So have fun trying different types of deadlifts.
Here we are demonstrating the RDL, but this could be substituted for kettlebell swings, conventional deadlifts, sumo deadlifts, single leg deadlifts etc...
- Grab a kettlebell in each hand (could be dumbbells or a barbell).
- Drive your hips backwards as far as you can while maintaining a slight bend in the knee, and weight through your midfoot.
- At the bottom, drive your feet through the floor to return to the top.
To recap: pain should not stop you from being active. You just need to be smarter with training, avoid painful stimuli, and seek treatment from the appropriate medical providers.
If you aren't sure where to turn or what to do - shoot us an e-mail, we can set up a virtual consult today!