Worrisome Knee Feelings...

[Asclepius]

So, my knees have never been a problem (at least I think), save for maybe feeling a bit weak after doing heavy squats. Once I started doing the GB WODs though, my knees have felt... peculiar. Once in a while I will possibly feel dull pain, but mostly they just feel maybe a bit stiff and/or slightly uncomfortable? I am not really familiar with the feeling, so I don't really know how to describe it. I noticed it after I did SLS for the first time during a WOD, if that is any token.

I also noticed that I am slightly knock-kneed, and am doing things to remedy this as outlined in Pain Free (mostly hip flexor exercises). I'm not sure if this is part of the problem or not.

Anyway, is this something I should be worried about, or am I being worried for no reason? Are these just feelings of my knees adapting to new stress and getting stronger?

[Longshanks]

I'd be careful of any joint pain to be honest. Its never a good thing. Maybe just stick to negatives for a cycle and see if it eases off. Giving your joints a bit of breathing space every now and then is always a good idea. You'll probably even come back to SLS's next cycle a bit stronger.

Also if you were doing them too quickly this can be bad for you. From my experience, if you can't do them at tempo, in a controlled manner. You shouldn't be doing them.

[Joshua Naterman]

From what I have been learning recently, the most likely explanation is weakness in hip abductors and external rotators. To correct this, use BW two leg squats with a band stretched around the knees. Your legs will literally be inside of an elastic loop. Bungee cords are a great cheap solution for this purpose if you don't have elastic bands around.

So you step inside your look, which should be just big enough for the knees to be about one inch apart before the band stretches. Now get into a proper squat stance, with your feet shoulder width apart. You will have to use your glute medius, TFL, and a few other small hip muscles to keep your knees over your toes. Proceed to do squats this way! You should find that this forces you to activate your hips in a way that you have forgotten how to do due to double leg squatting for so long. This is an easy and effective way to re-awaken your hips, which is going to fix most knee problems.

Pain free will help re-educate your adductors and flexors while this helps re-educate your abductors. and external rotators, which actually include gluteus maximus as well as medius and minimus. 1-2 sets of NOT FAILURE in each warm up should be enough to produce noticeable results in a few weeks. You may be horribly sore for the first week if you do too much, this WILL be new to your body. It's a good staple to have in your warm ups, just to ensure you never lose that hip activation. It may also be a good idea to do this as actual strength work with your weighted squats as well, and slowly add more resistance to the bands until you notice that your SLS are not causing problems. You should use SLS as a diagnostic tool for now, and when they feel better you can start transitioning them into your strength program.

I do not know of any concrete or even relative ratios for band tension, but I would expect that you would want to be able to do this with a fairly moderate tension level, like 60 lbs or so eventually.

[Cole Dano]

SLS can stress the knees more than squats. I had some every short lived issues at first i didn't do them until the pain went away, and have had no problems since.

I'm a big nut for Hindu Squats, and they can help prehab the knee for SLS. Other wise you can de-load the SLS in many ways, foot on a block, hold on to a rope etc so the knees take less stress and you work on your form.

[Asclepius]

Thanks for the responses everyone. Slizzardman, I had a feeling that my apparently weak hip flexors were part of the problem. Double-leg barbell squatting for a long time resulted in me sometimes having me knees sway inwards while squatting up with a heavy load, which is obviously due to weaknesses in this area (and possibly even caused the slightly kocked-knees that I now have). I will get a pack of bands to work on this and will continue to do the hip extensor and external rotator e-cises in Pain Free as well.

Interestingly enough, after I did the dynamic leg WOD 110128 two days ago, my knees actually feel fine. Not sure why though (maybe due to all of the double-leg stuff being done?).

[Quick Start Test Smith]

I agree one-hundred percent with Slizzardman, but I also recommend you keep an eye on Dr. Kelly Starret at Mobility WOD (http://mobilitywod.blogspot.com/). He's got daily videos on all things rehab, prehab, movement prep, etc. It's a great resource!

[Asclepius]

Thanks Patrick for the info.

I think I pinpointed the part of my knee where I feel the most discomfort, which is right below the patella at the front of the knee. It feels like it is literally right below the patella, like between the patella and the tibia.

Does this help/change anything?

[Joshua Naterman]

Nope, 3 of the 4 quads as well as quite a few lower leg muscles all attach in that area and can refer pain there, in addition to the hip muscles I mentioned. With most people, the greatest benefit will come from self soft tissue mobilization (foam rolling, self graston, self ART, etc) along with retraining the muscles to be active.

If anything, it reinforces what we are saying.

Patrick is right, mobility wod is a fabulous resource and well worth the 10 minutes a day or so.

Edit: You meant to say hip abductors. The flexors are what bring your knee towards your chest!

[Asclepius]

Patrick is right, mobility wod is a fabulous resource and well worth the 10 minutes a day or so.

Edit: You meant to say hip abductors. The flexors are what bring your knee towards your chest!

Are there specific mobility WODs for knees or should I just be doing them every day with whatever the WOD is?

Also, I'm pretty sure I did mean flexors. That is what Pain Free is having me do anyway. My knees are internally rotating, and for that they provide gluteal contractions (which I'm guessing are hip abductors?), sitting heel raises (using hip flexors, not calves), isolated hip flexor lifts, and supine groin stretch (I don't get a lot of benefit from this last one as I am apparently pretty loose there already).

[Joshua Naterman]

gluteus maximus is an external rotator as well as a hip extensor. If your knees go in during squats you either have a loss of activation or a lack of strength in the abductors and external rotators of the hips. Of course these will occur together, but it seems like the activation is actually a much bigger (or perhaps more of a root) problem than strength because once you reactivate the muscles they are working and are building up strength again. Specific strength work helps up to a certain point, after which you jsut want to maintain activation. The last thing you'd want to do is to create an imbalance where you have too MUCH external rotation, even though that seems to not be a problem that athletes have. You just want structural balance.

Pain free will be focusing on re-educating your body to use the hip flexors like rectus femoris and the psoas group instead of the internal rotators and/or adductors like sartorius for locomotion (walking and running and such) for sure, but that is again an activation issue more than a strength issue. The squatting thing is sometimes a bit different because your hip flexors will be working, it is just a lack of external rotator and abductor activity that is allowing the knee to move inwards. The gluteal contractions help, but it is not as specific as the knee-band squat. There's a lot more going on in the hip than just quads, hams and glutes!

I believe that part of the reason dynamic days seem to help is that when you are moving explosively the body does activate more muscles, especially when landing. This temporary activation work may be making you feel better until your body down-regulates again due to a lack of consistent stimulus. I will admit this last bit is a bit of an educated guess, but I believe it is a good one.