I don’t know many people who want to get a knee replacement. Most older adult and masters athletes we see actively try to avoid it. While the common phrase of the great depression, “Use it up, wear it out, make it do, or do without” works well for clothes, it shouldn’t apply to our joints. Instead we should, “Use it, take care of it, or replace it and hope it works.” In our society, we are brutal to our knees.
According to the American Academy of Orthopaedic Surgeons, over 600,000 knee replacement surgeries are done in the US, each year. And each year the average age is getting younger and younger to the point that now 50% of those getting knee replacements are under 65 years old.
Why is this? Are we just more active than our parents or grandparents?
Could be. I would also argue that we don’t train or train properly to protect and preserve our knees.
The knee is an interesting joint, unlike the hip or shoulder which is a very stable joint because the end of the bone (the ball) fits snugly into a perfect receiving cup (the socket), because it’s main stability comes from muscles, ligaments, and tendons. There really is no bony structure to have it move well. What this means is that if you have muscle weakness or imbalances you can alter how the joint moves and can cause some unnecessary wear and tear.
What can be done to prevent or prolong getting a knee replacement?
Smart training. Our society tends to be very quad-dominant. By strengthening the other surrounding musculature, reducing imbalances, and correcting form many clients have avoided or greatly prolonged needing a replacement.
You’ve got to manage the negative factors that are causing you pain: be it neurological, arthritis or something else. This is essentially what therapy does. They find exercises that you can do in the absence of pain. Finding those can be challenging and often needs the help of a professional.
The following is my top 5 list of exercises I incorporate with those clients whose knees are already presenting some problems and they want to avoid or prolong needing to get a knee replacement.
**Important note: clients have already seen a doctor regarding their knee problem. Many have also seen a physical therapist or are currently seeing a PT. I’m not a doctor and I don’t diagnose anything.
5 Best Exercises to Avoid Knee Replacement
1- Sled Pushing
This is a great way to strengthen the quads (thigh muscles) while still being nice to the knees because the range of motion is smaller than a typical squat or lunge. It also removes the eccentric (lowering portion) of the exercise which is the one that makes you sore. Remember that time you went on a big hike? All that soreness you felt the day or two afterwards was from going downhill or the eccentric load.
2- Cable Leg Extensions
This exercise has gotten a bad rap in recent years because some believe this exercise puts too much load directly in the knee. To mitigate any issues a client may have, we once again decrease the range of motion, lighten the weight and focus on time under tension. Depending on how bad your knees are acting, if most walking, standing, stair climbing gives you problems, often taking gravity out of the picture can help strengthen those muscles while removing the joint pain.
3- Banded Bridges
This exercise hits your butt muscles (aka the glutes). While the glutes aren’t connected to your knee directly, they do play a significant role in them. Often weak glutes creates bad/faulty movements at the knee.
Also, most people don’t use the hips/glutes as they should putting more strain and stress on the knees. This variation of the classic bridge puts more load on the glutes so you feel it more. It also keeps you honest in your movement.
If you create slack in the band at any point of the exercise, you’re setting yourself up for knee pain and/or problems.
4- Leg Curls
There are several ways to do this exercise, a machine, a cable pulley, those fancy suspension straps or in your socks on a hardwood floor. The point is to strengthen the hamstring muscles (back of the thigh). Most often, this motion does not cause pain in the knee assuming appropriate load. Not only does it strengthen the back of the leg, but as it does so, it also helps stretch out the quadriceps at the same time.
5- Walking Backwards
It’s as simple as it sounds. You’ll look less conspicuous if done on a treadmill, but this can be done outside or even with some resistance. Walking is often a well-tolerated exercise with a low enough load/force that it doesn’t bother most problematic knees.
I hope you’ve enjoyed this list and found it useful. These are just a few of the exercises we use with our clients at Leverage Fitness Solutions, it all depends on the client and how they respond to a dose of an exercise. The biggest take away is train smart, work pain-free.
BONUS EXERCISE
6- Knee Circles
This one seems funky, but it’s really beneficial. We live in a 360 degree world, we rarely if ever move strictly 100% in one plane of motion. What the knee circle does it explore the full range of motion in 360 degrees that the knee can move. By challenging yourself and going into the end range of motion you end up activating what are called motor neurons. These neurons essentially tell the brain if a particular motion is ‘safe’. By going slowly at first you help train the body and brain that things are okay. We’ve seen that by doing these pain often is decreased significantly.
This is also AMAZING to do post-surgery because it helps waken up the nerves that have been damaged/cut from the surgery and helps remind your brain what your knee is capable of doing.
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