Knee Pain Prevention During Exercise

January 31, 2017


As an Orthopedic Surgeon, one of my best achievements is being able to help someone avoid needing surgery. Most people will experience knee pain at some point in their lives. You will be especially prone to knee problems if you have a genetic predisposition to knee problems, a previous knee injury, a high impact job or sports history or are overweight and deconditioned. We all want to be in good shape but sometimes our training routine can cause knee injury and pain. Here are some suggestions to keep your knees healthy.


1. Have reasonable fitness goals and a safe exercise plan.


Exercise is the best medicine but it can also have side effects. It is imperative to start a new exercise program slowly. With inactivity, it took time for your body to weaken. Expect that it may take one month of exercise for every year of inactivity, to just begin to feel conditioned.  During this time your knees are vulnerable to overuse injury. Keep your intensity low and increase to moderate slowly especially if you are overweight. If you are a seasoned fitness participant with an established routine, be careful with sudden changes, this is how many tendons and joints can be injured or overused.


2. Understand knee joint impact 


I often see patients that run on the treadmill for an hour in the morning, are on their feet all day at work and then come home and go for a three-mile walk. This can lead to a knee joint overuse condition.  When it comes to having healthy knees it is better to be the “tortoise” and not the “hare”.


One pound of extra body weight puts four pounds of excess pressure on your knee. An impact exercise program may be doing damage to your knee. You may need to stick with biking, swimming, elliptical or seated zumba to minimize impact stress to your knee. If you are overweight or had previous knee problems be careful with exercise classes with a lot of impact or programs such as cross-fit or P-90X. Wearing a well-padded shoe is essential.  An exercise mat may be very helpful for someone with chronic recurrent knee pain.  If you are overweight and have had prior knee problems you should see an orthopedic knee specialist before you get started with an exercise program.


3. Leg strengthening exercises and flexibility is essential.


Many of my patients end up with a knee problem because they had been doing too much cardio training with joint impact without keeping their leg muscles strong. The leg muscle strength you need to support and protect your knees can only be obtained from resistance leg training. Most patients and fitness instructors think that a forward lunge is the best strength builder for the leg.  In fact, for some knees this is a potentially damaging exercise. 


Lack of a stretching routine combined with aging, leads to tighter and more vulnerable muscles and tendons. This causes abnormal biomechanics resulting in a higher chance of knee joint injury and pain.  If you are starting to have knee pain with a new exercise program you should have an evaluation by an orthopedic knee specialist and work with an experienced physical therapist to safely get you started with a program. 


4. Better safe than sorry!


It is much easier to prevent knee pain than to cure it.  Every day I see young patients with knee degeneration that could have been prevented or at least decreased.  Don’t ignore the warning sign of knee pain. The old saying “no pain, no gain” should be replaced with “ if you have knee pain, refrain, until you are retrained.” Be aware of the warning signs of knee problems such as pain, tightness or swelling.  Get an evaluation by an experienced orthopedic knee specialist and you may save yourself from needing a serious knee surgery. 






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