1. Exercise & Proper Time to Recover
Weak muscles and stiffness are two of the leading causes of knee injuries. So while exercise is important for keeping your knees healthy, you also need to rest enough and give your body time to heal. Some people will need to take a break from most exercise or several weeks to heal a damaged knee, or at least limit high-impact activities for a period of time. Before trying more drastic treatments, see if taking a few days off from your usual exercise helps. Plan to decrease your mileage/length of workout when you return.
To protect yourself from injury, always warm up lightly and stretch before exercise. Before engaging in running, biking or another knee-bending exercise, walk a quarter- to a half-mile. After your exercise, be sure to stretch again and then to give yourself enough time to recover properly, at least 1–2 days (especially after intense workouts).
Doing low-impact exercises is best for people with chronic knee pain or conditions that affect the joints. Examples of low impact workouts include:
- water aerobics
- brisk walking
- elliptical training
On the other hand, these activities can negatively impact the knees and should be avoided if you’re having knee issues:
- intense biking
- activities that involve repetitive movements of the legs
- high-impact sports
2. Physical Therapy (Stretching & Exercising the Knees)
If you’ve experienced loss of flexibility and weakness in your knees, or other limitations that affect your ability to move, it’s a good idea to work with a physical therapist, trainer or coach who can help you with conditioning and recovery. A therapist (such as a neurokinetic therapist) can help you gradually build strength in your lower body and also work on achieving proper form to reduce your risk for future injuries. Having a gait analysis done can be beneficial for correcting pronation problems and other postural issues.
Performing exercises that help strengthen the quadriceps, hamstrings, lower back and hips can all support the knees. In addition to building strength and stretching, work on balance and stability exercises helps to train the muscles in your legs to all work together. This can reduce the risk for falling and developing compensations that take a toll on the knees. Your therapist might also recommend using both cold and hot treatments to ease pain and support healing after exercising your knee, such as ice packs or a hot bottle applied to the painful area.
3. Good Footwear, Insoles & If Needed, a Knee Brace
In general, people with knee pain should try to avoid wearing sandals, flip flops, crocks, boat shoes, high heels and boots. These types of shoes are not very supportive and can aggravate back, knee or hip pain.
If you’re having knee pain when exercising and suspect your shoes might be contributing to the problem, it’s helpful to visit a running store to speak with a specialist about your specific stance, stride and needs. You can have a free, simple test done on your feet that will identify which types of shoes are best for correcting your posture. You can also visit a podiatrist (a doctor that specializes in treating foot-related problems) for custom insoles.
Superfeet insoles, an over-the-counter insole option that can be purchased online, are recommended by certain doctors, including Dr. Ron Torrance. These insoles are pretty sturdy and provide support for the knees, unlike some over-the-counter insoles that are cushiony but not as stable. Soft insoles are not always as helpful for some people because they don’t help with stabilizing the ankles or knees, which can further aggravate knee pain.
4. Foam Rolling
Foam rolling is very beneficial for breaking up adhesions in the legs that can contribute to knee pain. Dr. Torrance recommends foam rolling the quadriceps and IT bands to help with knee pain relief, especially if you’re a runner or avid exerciser. You can also use a foam roller on other muscles that support the knees, especially the gluteus maximus (the largest muscle in the buttocks) and the tensor fasciae latae (a muscle that runs along the outer edge of the hip).
You can try both soft or hard foam rollers, but some people with pain find that using a soft roller is more manageable. While rolling, if you find a place that really hurts, take a couple minutes to sit there and let tension in the the muscle start to ease up. This will feel uncomfortable at first but should gradually go away as you loosen up the tight area.
- To foam roll your quads — Place your foam roller on the floor and lie on your stomach with the front of one thigh over the foam roller and the other leg on the floor for support. Roll the entire front of the thigh from the top of the hip to the top of the knee cap in an up and down motion. Do this for about 2 minutes, ideally every day.
- To foam roll your IT band — Place your foam roller on the floor. Take a side position with the outside of the thigh over the foam roller and your other leg in front for support. Roll the entire outside of your leg from your pelvis to your knee in an up and down motion. Maintain your abs tight and proper low back posture during the exercise. Do this for about 2 minutes each day.
- To foam roll your hamstrings — Place the back of one thigh over the foam roller and the other leg on the floor for support. Roll the entire back of your thigh from the bottom of the buttock to your knee in an up and down motion. Do this for about 2 minutes each day.
- To foam roll your adductors — Lie on your stomach with the inside of one thigh over the foam roller and your other leg straight on the floor for support. Roll the entire inside of your thigh from your groin to your knee in a side to side motion for about 2 minutes.
5. Eating an Anti-Inflammatory Diet
Eating a nutrient-dense diet is important for overall joint health for a few reasons: it helps you to maintain a healthy weight (which decreases strain on your joints), reduces inflammation, improves recovery from exercise and lowers the chances you’ll develop a condition like arthritis or osteoporosis.
- Consume plenty of fruits and vegetables, especially those high in vitamin C, sulfur and antioxidants like leafy greens, carrots, peppers, berries, onions, broccoli, garlic, asparagus and cabbage.
- Get omega-3 fatty acids from wild-caught fish, especially benefit-packed salmon. Other food protein sources include grass-fed meat, pasture-raised poultry, fish like sardines or mackerel, fermented dairy products, and eggs.
- Include healthy fats in your diet like coconut oil, olive oil, ghee, grass-fed butter, avocado, nuts and seeds.
- Drink bone broth or use protein powder from bone broth.
- Add antioxidant-packed herbs and spices to your meals.
- Limit or avoid excess sugar, hydrogenated oils (soybean oil, cottonseed oil, even canola oil), processed/refined grains, flour products, synthetic additives, processed meats and fast food.
6. Anti-Inflammatory Supplements
Certain herbs and supplements can help to reduce inflammation and support recovery from injuries or degenernative diseases. Some of the best supplements for knee pain include:
- Glucosamine and chondroitin
- Bone broth, or bone broth protein
- Collagen protein
- Omega-3 fatty acids