Transform Your ‘Bad Knees’: Expert Strategies for Pain Relief, Improved Movement, and Strength

We all know somebody in our lives who have talked about their “bad knees”. It could be a parent, grandparent, coworker, or friend that has a long history of knee issues. Their knees stop them from doing all kinds of things in life, or they do something and then are paying for it later. It could be something as simple as running around with the kids or taking too many stairs that really sets off their knees and has them in all sorts of pain. There is also a good chance they have seen a Physiotherapist, Exercise Physiologist or even a Specialist, who has told them they have something very wrong with their knees which makes it feel like there is nothing that can be done aside from just learning to live with it. Some of you reading this right now may be relating to all of this because you might be that person in someone else’s life! 

This idea of having “bad knees” comes from our knees being simultaneously one of the simplest but one of the most complicated joints in the body. Our knees are designed to primarily work in one dimension, flexion and extension. They are capable of moving in all directions, but they mostly work to bend and straighten the leg, through things like walking, taking stairs, and lifting. Now take a second to think about just how much you use your knees in your day-to-day life. How many different activities were you able to think of and just how much are you doing those throughout the day? It’s quite a lot, right?

As you can see, our knees move in quite a simple way, however, with as much as we use them all day, every day, they can be quite complicated to manage when it comes to knee pain as we must use them. Despite this, there is plenty we can do to manage and improve your knees, regardless of how “bad” you might think they are.

There is very much a misconception that “having the knees of an 80-year-old” excludes you from things like running, jumping, or playing sport ever again. It does, however, require some good therapy and management to get to the point where your knees may be able to handle what you want out of them.

This is where good Physiotherapists and Exercise Physiologists come into the equation. Our primary role as clinicians is to reduce pain and swelling, while also improving movement patterns and improving strength. There is a lot to this statement though, so let’s break this down.

1. Reducing pain and/or swelling:

First and foremost, reducing initial pain and swelling is key as this underpins our ability to move well. This is incredibly important, as pain and swelling are both drivers of muscle inhibition, which can negatively affect the knee by causing even more pain and swelling through poor loading. This can become quite a vicious cycle and it is our job to break this cycle so we can get function back!

Managing pain and swelling is quite broad however, so a thorough assessment to determine what could be driving the pain at the knee that is a result of other areas of the body is key! For example, a tight hip may be directly affecting the knee by tightening up the ITB, having a flow on affect to the knee. Apart from this, education around how to correctly modify load or manage pain/swelling is very important. There might be reasons as to why the knee is so sore that someone who lives with the pain every day, may not be fully aware of and it is our job to help determine those.

3. Improving movement patterns

Coming off the point above, pain and swelling can cause more than just muscle inhibition. Have you ever noticed that when someone has a sore joint, they walk with a limp? Now have you ever seen someone who may not necessarily be in pain but still walk unusually?

Our bodies are great at finding ways to offload areas that are painful, but they’re also great at making certain movement habit, even if it is no longer beneficial to us. Some movement patterns, like limping, are also potentially negative in how it affects our uninjured leg, as it can lead to overload injuries. A big part of our role is then working to correct the habits that have set in, so we are able to get back to more regular and effective movement.

3. Improving strength

The final step to all of this is improving strength to a level which allows the knee to tolerate what load you want to put through your knee. With pain and swelling causing muscle inhibition and resulting in poor movement patterns, a long enough period of this can result in a general loss of strength, meaning that any activity now results in a relatively higher level of work as your peak level of strength is now reduced.

Building that strength up in key in maintaining good movement patterns and tolerating the loads placed on the knee. Progressively improving strength also means progressively exposing the joint to more and more load, building up tolerance so that returning to something like sport is a very genuine possibility. 

The most important thing to the three points you just read is CONSISTENCY! Keeping up with rehab regularly and continuing to exercise even after finishing the rehab journey is the most important part about maintaining healthy knees.

Despite what you might think, even the worst knees are capable of great things under the right guidance and exercise. You will not make your knees worse if you’re exercising them well!