But what exactly do my knees need?

September 11, 2014 9:35 AM

I've read a lot of AskMes on what people wish they had done in their 20s/30s/40s etc., and one oft-repeated bit of advice is "OMG, take care of your knees NOW!!" But what exactly does that mean?

I'm a 39 y/o woman and my knees are currently fine. I'm assuming taking care of one's knee health includes losing weight and building muscle, but I'm curious about specifics. Are there any particular strength exercises, fitness activities, sports, vitamins, supplements, and/or nutritional habits that are advisable for long-term knee health?

posted by megancita to Health & Fitness (18 answers total)

In general, foam rolling of your ITB after workouts is pretty good for just about anyone. For some people, knee health maintenance means stuff like being cautious of the surfaces you run on, and making sure you have suitable running shoes for your environment. It can mean making sure that you aren't running habitually on the same side of a graded road such that one foot is striking the ground lower than the other. It can mean making sure you have appropriate surfaces for standing if your work involves being on your feet a lot, and correctly supportive footwear. It can mean prompt medical attention and PT followups for falls that you might have shrugged off as a kid or teen.

Basically your knees take a lot of asskicking in every day life and making sure you prevent/mitigate as much of that as possible before the regular degeneration of older age sets in can be very important in the long run. It all depends on how you're built, what you do for a living, and what you do for hobbies/recreation.
posted by poffin boffin at 9:52 AM on September 11, 2014 [4 favorites]

Building and maintaining core strength will do a lot for the health of your knees. I'd work on strengthening the muscles in your butt, lower back and lower abs/pelvic floor area, because when those stabilizing areas are weak, more stress is placed on knees and feet. There are a million exercises that you can choose from on the internet, based on your preference of equipment, no equipment, gym machines, etc.

Agree with poffin boffin that your build has a lot to do with it. Some people are anatomically blessed in the knees, a lot of people aren't.
posted by sweetpotato at 9:59 AM on September 11, 2014 [3 favorites]

For me, it means using trekking poles when backpacking all the time and when hiking on complex surfaces. The number of times I have saved myself from a serious twist is basically uncountable. When I was a serious runner, it meant not ignoring pain and taking time off, doing physical therapy exercises when I needed it if I had started to mess up my knee, even if that meant that I wasn't able to perform as well in the short term. On the bike, it means making sure that my fit is dialed in, so that my knees/hips/ankles are happy during long rides.
posted by rockindata at 10:01 AM on September 11, 2014 [5 favorites]

Swim or bike instead of running on hard surfaces. Proper soled shoes or sneakers. Carry less weight. Improve the muscles around the knees. When my son tore his ACL, I did a lot of the rehab with him and my own knees felt much more stable at the end of the program.
posted by 724A at 10:16 AM on September 11, 2014

I do a lot of spinning, which is hard on my IT band and knees, so have started Pilates to work on some finer movements to counter act the tightness/grind on my IT band and knees.
posted by sweetkid at 10:20 AM on September 11, 2014

Anecdotally: I had naturally great knees (strong, sturdy, flexible) until I knocked a kneecap out of place playing soccer seven years ago. I bounced back quickly, gave up soccer but did more running and cycling, with a fair amount of yoga--even finished an Ironman!

Earlier this year I was in the gym doing a low-intensity workout, swung my leg around and my kneecap just popped out of place, scraping off a bunch of the cartilege on the back, requiring surgery and putting me athletically out of commission for months, plus a few months of physical therapy to remediate. I can run again, but not for more than a few miles and it stiffens up/gets sore randomly. I still have a few years to go before 40.

Moral of the story: injure a knee once and it makes it much easier to reinjure down the line, with increasing problems each time.
posted by psoas at 10:21 AM on September 11, 2014 [1 favorite]

Building core strength is very important, as I learned from my physical therapist when I tore my PCL a few years ago.

Also, do the PEP Program exercises (PDF link), especially before physical activity. The PEP Program was created by a team of women's sports medicine experts to prevent injury for female athletes.
posted by stompadour at 10:22 AM on September 11, 2014 [4 favorites]

I'm not yet 40 and my knees are complaining after years of sports.

I have found custom orthotics and physio therapy (to correct misalignment in my walking gait) helpful. But I will be checking back on this thread since I don't have the full answer.

Agree with core exercises - my pt said I was too flexible and don't have enough core strength, causing knees and ankles to over compensate. When he has me stand properly and balance on one foot properly, I have to use my core in order to maintain balance.
posted by St. Peepsburg at 10:23 AM on September 11, 2014

When I finished PT for my knee I knew I wasn't going to keep doing the exercises she gave me on a regular basis. So I asked whether regular yoga and strength (squats, other leg strength) would just about do it, and she agreed that it would.

I've been surprised by how much adding muscle has helped - not only is it supposed to help stabilize the joint, but I've definitely noticed it helping with balance overall.

Nthing hiking poles, too, if you hike. I was surprised by what a difference they make.
posted by ldthomps at 10:39 AM on September 11, 2014 [3 favorites]

Don't have epic falls while doing twisty things, like snowboarding.
[ouch, snap, crackle, pop]

Learn how to do squats with good form. Keep building muscle with a wide variety of exercises. Make sure you're carrying the load properly when bending and carrying. Develop and maintain good lateral strength and stability, flexibility.
posted by barnone at 11:00 AM on September 11, 2014

I asked my left knee this question and it said to avoid a lifetime of manual-transmission cars, no matter how much fun it is.
posted by Thorzdad at 11:07 AM on September 11, 2014 [5 favorites]

The evidence is that running does not not harm knees, although activities that place more intense stress on them, such as soccer and hockey, may. See Runners are not giving themselves arthritis. It seems that the standard advice that you mentioned - maintain a healthy weight, remain active, maintain or build muscle - is correct and probably sufficient.
posted by Mr.Know-it-some at 11:34 AM on September 11, 2014 [4 favorites]

If I had my runnin g days to do over, i would avoid as often as possible road running and seek softer surfaces for it...But that actually not an issue for me now. I am 85, have run one marathon, 6 half marathons, and dozens of shorter races as well as some 25 years of nearly daily running. My knees still give me no pains whatsoever. In sum: you may be ok years from now no matter what so listen and read and go with your gut feelings on this issue.
posted by Postroad at 11:37 AM on September 11, 2014 [9 favorites]

When you climb hills or stairs, keep your heels down. Don't climb on your toes, even though it feels natural if you wear heels sometimes. Your meniscuses will thank you.
posted by workerant at 1:04 PM on September 11, 2014 [2 favorites]

Building and maintaining core strength will do a lot for the health of your knees.

Yes! I might have avoided patellar tracking disorder and its pain and limitations had my fitness level not gone way down.
posted by jgirl at 2:04 PM on September 11, 2014

I have patellar tendonitis and arthritis in both knees. Part of what I did wrong was to strengthen hams and quads at the expense of adductors, abductors and glutes. Yo-yo dieting didn't help.

My physical therapy regimen included exercises for leg AND hip muscles. When I climb stairs I used to go up on my toes (not sure why, maybe I'm part sloth). Now I put my whole foot down and squeeze the glute on the side that's taking the next step. Also, regular stretching, especially for the abductors.
posted by Sheydem-tants at 2:48 PM on September 11, 2014 [2 favorites]

Everyone I know with knee problems had it start with a minor seeming injury that they didn't bother to seek medical attention for, and that they continued to walk on. So my takeaway is that "look after your knees" means Molly-coddle them if they ever start hurting.

Also, don't wear dumb shoes.
posted by lollusc at 6:46 PM on September 11, 2014

Pay attention to your stride.

If you make a lot of noise while walking around, you're thumping your knees, and that damage adds up over time. When you notice that you're thumping around, try to walk more on the balls of your feet instead of landing hard on your heels, and over time, you can change your natural stride, although this may take months or years.

Or, take a look at older folks you know. Ones who walk loudly tend to have knee replacement surgeries. Ones who walk more quietly tend to be just fine, that I've seen. Weight definitely plays into it as well.

For a bunch of runner's wonkery on this, Google for "neutral foot strike". For a longer bit, the book "Chi Walking" might nail it for you. We're all evolved to run and walk, albeit some of us do it differently than others, with different short and long term results.
posted by talldean at 10:01 AM on September 14, 2014