Last week I had a new client in studio who was concerned about her knees, she’d just come back from the doctor who told her recent MRI showed her knee was pretty much worn out, and she’d most likely need a knee replacement. The doc recommended she work with an Exercise Physiologist, but she was unsure;
“How can I exercise on my knee when its so sore.”
We sat down and had a bit of a chat about her knee pain. The buildup of her knee pain took a few years, after a fall at work where she tore some cartilage in her knee. She had pretty much accepted the fact that she was going to get a knee replacement, because dodgy knees are in her family.
She’d also stopped going to the gym because it hurt too much too squat, when i asked did she get any advice on it she admitted she thought it wouldn’t help, so left it.
So we spent some time talking about ways we can exercise safely, even when theres “dodgy worn out knee”. She was surprised to learn that exercises is really effective in helping folks manage joint pain, if it’s done in the right way.
The key to exercising when you have joint pain is to first understand the nature of the pain, whats actually causing the problem, it could be:
Mechanical – incorrect or poor movement quality, exercise technique, postural loading
Structural – there may me some anatomical uniqueness in your joint which can cause the spaces between the joints to be smaller, or create impingement
Traumatic – perhaps you were playing netball, landed awkwardly and twisted your knee
Inflammatory – you may have an autoimmune response like Rhamatoid Arthritis which cause joint pain
To find out what’s causing your pain try touching base with a Physiotherapist, Exercise Physiologist, Chiropractor, and Osteopath.
As a guideline I would recommend touching base with one of the four allied health professionals as they spend 4-6 years at university training to work specifically with musculoskeletal conditions.
Of course a visit to your doctor is always a great idea if you are unsure who to see.
Once you have a clear idea of what’s causing your joint pain we can then start to craft an exercise program that suits your specific needs. Everyone requires a slightly different approach due to the inherent individuality of the human experience.
I can see 10 clients who all have clinically similar knee pain, but each person will have an exercise program design for them, based on their exercise experience, pain levels, mobility, flexibility, strength, capacity to do the exercises and ability to practice at home or in the studio
Starting an exercise program when you are in pain can be pretty daunting, theres alot of fear wrapped up in thoughts of pain, and causing further problems. These are totally legitimate concerns, particularly when moving the wrong way can trigger pain.
For example, if we return to the client I mentioned at the beginning when we look at her ability to stand up out of a chair, whats we cal a sit to stand, she was having a lot of pain in standing. After spending some time on her technique we were able to make a big shift in the pain she was experiencing.
In terms of exercise coaching it was pretty simple technique adjustment, but if you didn’t know, you don’t know. Its often the case, simple correction can make HUGE changes in someone’s movement experience.
Once you are comfortable with exercise, understand what good pain should feel like (yep, its a thing) and what bad pain feels like (the yuk kind), and understand a little more about what pain is, why its there, and how it works then you’ll b e surprised at how much better you start to feel, simply because know you have more understanding, and that gives you control
A big shift when you are in pain is understanding that it need not control your life. For many thats a total game changer
Moving forward it all about layering the right exercise progressions, which may include little things like adding extra repetitions, sets or rest periods. We can also look at moving from exercises that are low intensity, easy to perform, to harder intensity , more complex to perform.
This may look like starting with a chair squat, moving to goblet squat, and eventually a KB rack squat with press
How we layer in the progression is the Art and science of exercise prescriptions, and take years of experience to understand the nuances of human behaviour, Movement in conjunction with what the current research recommends as a best practice.
Its a real blend of experience and structured movement therapy
Its a collaborative approach, coaching and instruction with lots of practice, repetition and feedback
Its a process, a systematic approach of rebuilding movement and tissue health
And it what i love to help people to do