After training clients and athletes of all shapes and sizes over the years, it’s no wonder why so many of them end up with knee pain.
Many are left with the impression that they have genetically “bad knees.” Others simply assume that they will no longer be able to do the extracurricular activities that they enjoy.
However, it’s my opinion that a lot of the knee issues you see in the gym are more a result of limitations in joint mobility, coupled with structural imbalances around the joint itself.
Here are just a few of the reasons the average guy/gal has knee pain when training in the gym.
1.0 – Horrible Ankle Mobility
Remember all those sprained ankles you suffered during middle and high school sports?
I sure do.
You never really had to rehab them all that much – you simply went back out a few days or weeks later and got back in on the action. While you didn’t realize it at the time, you were slowly but surely losing ankle mobility.
(And ladies, don’t even get me started on high-heels. You won’t like what I have to say!)
Here’s the issue, though – your ankle needs mobility. Even though you may never use it under load in the weight room, you need the ability to dorsiflex your ankle, or glide your knees over your toes.
When you don’t have this requisite mobility in one joint, you look to another joint (typically above or below) to fill in the gaps. So failure to address ankle mobility needs can often lead to an increased demand for knee mobility.
This takes me directly into my next point.
1.5 – Horrible Hip Mobility
While the ankle sprains were bad, the abuse many of us put our body through every day is even worse.
It’s not the rigors of extreme training or hardcore exercise. No, this fate is much slower and more deliberate.
It’s the act of disuse that really puts a hurting on our hip mobility.
Quite simply, sitting down at a desk or driving a car all day is a sure-fire way to watch your hips stiffen up like a stone golem. All of a sudden, you’re wondering why your squat or lunge doesn’t feel quite right, and you can’t figure out the answer.
Many of the athletes/clients I work with are lacking hip extension, and/or the ability to really turn on their glutes. One of the primary culprits is the rectus femoris muscle, a two-joint hip flexor that crosses the hip and knee. A short or stiff rectus femoris not only limits hip extension, but also makes it increasingly difficult to turn on your gluteals.
With short/stiff hip flexors, we’re immediately more likely to NOT use our glutes and hamstrings to do the work. So we’re left with quad dominant movements that put more shear and compressive forces on our knees.
Taking it one step further, when you combine a quad dominant squat or lunge with poor ankle mobility, your knee is stuck in between two joints that are really pissed off and not moving well.
The result? A knee that is really pissed off.
And to think – you don’t even have a knee problem, per se. You have a hip and ankle problem!
2 – Weak Hips and Hamstrings
We discussed this briefly in our previous point, but let’s dig in a bit more here.
The hip joint is pretty magical, all things considered. It’s a ball-and-socket joint, which gives it a ton of freedom of movement in all planes of motion.
However, the hip is also extremely important when it comes to controlling motion at the knee and developing strength/power throughout the lower body. If your hips aren’t up to the task, you’re severely limiting your movement quality, as well as your performance capabilities.
If someone presents at IFAST with weak or dysfunctional hips, we’ll take a multi-pronged approach to get them up to snuff:
1 – Isolative work to improve motor control and strength in the psoas, glute max, posterior glute medius, etc.
2 – Single-leg work to activate and strengthen the stabilizing musculature within unilateral movement patterns. (This will also be covered in-depth in my soon to be released Single-Leg Solution DVD and manual).
3 – Bilateral work to strengthen the big muscles (especially glute max and the hamstrings) via compound movements.
The problem is, as an industry, we often get so caught up in using one approach that we forget how many tools we have available to us!
All of these tools have a time and place within our training programs. They key is figuring out what our client or athlete needs, and giving it to them at the appropriate time.
Which leads me directly to my final point.
3 – Poor Program Design
The final reason many people suffer from knee pain when hitting the gym is poor program design.
The first reason is obvious – we use too many machines.
And people, I’m telling you, if you think people aren’t using machines these days, you’re crazy. Go to a commercial gym and see for yourself.
I could go on and on about why machines are horrible, such as the fact that they lock everyone into a similar movement pattern, the fact that your body almost never works at one-joint while restricting motion at others, etc., but hopefully you already know most of this.
If your “trainer” has you float around from machine-to-machine while he/she counts reps, run away as fast as you can!
Another issue you’ll see is that many trainees fall victim to extremely repetitive programming. This is witnessed every Monday when every male in America feels the need to bench press and/or train “chest.”
In the case of leg training, many guys simply follow some version of this leg routine for years on end:
– Leg Extensions
– Leg Curls
Anyone see the problem(s) here?
We know that they probably have horrible mobility at their ankle and hip, so they probably don’t have the mobility to squat efficiently in the first place.
We know they probably don’t have a butt and hamstrings, so now we’re forced to squat in a quad-dominant fashion that’s really going to torque our knees.
And as if that wasn’t bad enough, to really drive the stake-through-the-heart, we finish up with single-joint, machine-based exercises that put our knees on an island.
Then, we wonder why they hurt?!?!?!?!?!
Finally, very few gym-goers that I know put a premium on building the back-side of their body. Exercises such as RDL’s, deadlifts, glute-hams, etc. are almost never seen in commercial gyms.
The result? The front side of your body is super-strong, and the back-side is super weak. Can anyone imagine why we might have a problem?
So there you have it – some of the major reasons that people who frequent commercial gyms have knee pain.
But let’s be honest here, this is only a few of the reasons.
What do you guys think? What are some more reasons why the guy or gal who hits the gym is suffering from knee pain?
Leave your thoughts and feedback below!
BTW – If you’re interested, I actually created an entire product that goes much more in-depth as to why most people have knee pain, as well as how to fix it.
If you haven’t checked it out before, it’s called Bulletproof Knees and it’s gotten many people fantastic results. I’ll provide the link below. Good luck!