Butt it's just not only about the knees!


Competing for first place with the hip and back, knees are right up there in the complaint department for pain and sensitivity.

It’s not like they robbed a bank or did something wrong. It’s more like you have!

The problem is that it’s rarely just one thing that led your knees to the state they are in. Therefore, the fix is rarely just as simple as one thing to get you out of the state you are in and on the road to healthier knees!


How did they get so bad?

It’s the combination of factors that have you complaining.

Injury history; athletic history; too much or too little or activities; degenerative arthritis; obesity; poor core and gluteal strength; imbalances that lead to poor gait patterns; and then there’s AGE!

We’re tougher on our bodies than we were made to be! Although having a knee replacement may be an option your doctor has suggested for you, I suggest you should be doing everything possible now to ensure the best outcome whether you choose to have surgery or not. Surgery seems like an easy fix, but it doesn’t always produce the result you were looking for.


Perhaps you have Osteoarthritis?

Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints. In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65.

One in two adults will develop symptoms of knee OA during their lives.

Although osteoarthritis (OA) was long believed to be caused by the “wear and tear” of joints over time, scientists now view it as a disease of the joint. Here are some of the factors that contribute to the development of OA:


Various genetic traits can make a person more likely to develop OA. One possibility is a rare defect in the body’s production of collagen, the protein that makes up cartilage. This abnormality can cause osteoarthritis to occur as early as age 20. Other inherited traits may result in slight defects in the way the bones fit together so that cartilage wears away faster than usual. Researchers have found that a gene called FAAH, previously linked to increased pain sensitivity, is higher in people with knee OA than in people who don’t have the disease.


Being overweight puts additional pressure on hips and knees. Many years of carrying extra pounds can cause the cartilage that cushions joints to break down faster. Research has shown there is a link between being overweight and having an increased risk of osteoarthritis in the hands. These studies suggest that excess fat tissue produces inflammatory chemicals (cytokines) that can damage the joints.

Injury and overuse:

Repetitive movements or injuries to joints (such as a fracture, surgery or ligament tears) can lead to osteoarthritis. Some athletes, for example, repeatedly damage joints, tendons, and ligaments, which can speed cartilage breakdown. Certain careers that require standing for long periods of time, repetitive bending, heavy lifting or other movements can also make cartilage wear away more quickly. An imbalance or weakness of the muscles supporting a joint can also lead to altered movement and eventual cartilage breakdown in joints.

Other causes of osteoarthritis:

Several other factors may contribute to osteoarthritis. These factors include bone and joint disorders like rheumatoid arthritis, certain metabolic disorders such as hemochromatosis, which causes the body to absorb too much iron, or acromegaly, which causes the body to make too much growth hormone. -1

How age affects your knees

We often have a change in gait parameters such as stride time and length, swing time and stride width as we age and typically lose strength. It’s the imbalances, incorrect and non-symmetrical wearing patterns that lead to injury. The research has shown us that the muscles acting on the knee are strongly correlated to gait performance and that increasing strength of knee flexion and extension, as well as hip flexion and extension, will improve gait characteristics.



In her book, Alignment Matters, author Katy Bowman reports on the results of MRI’s of 236 adults ages 45 – 55. It showed that those in the high activity group (large quantities of movement, high impact or repetitive motion) had knee damage three times more severe than the couch potatoes!

Excessive mileage and impact forces from overuse are contributing to the increasing levels of osteoarthritis, knee surgeries, and knee replacements. Do not read this as an excuse to stay on the Lazy – Boy, but as one of the many reasons why training smart is so important. Quality movements with safe appropriate loads and progressions are what you want your training to consist of. Listening to your body and modifying your program appropriately are key to improvement here.

Bowman reminds us that “movement” is a physical requirement to physiological function and “exercise” is a modern creation designed to help us improve our health. Exercise doesn’t alway contain good movement and therein lies a problem. If you’re looking to blame the knees because of poor movement and exercise quality you have to look at much more than the knee itself. Improving the knee pain is one thing but correcting the underlying problem that got you there in the first place will involve assessing the mobility, strength, and mechanics of everything above and below the knees. This may be a matter of trial and error, working with movements to improve the quality and re-train a healthier pattern. We don’t have looking glasses so patience and consistency are the keys to improving function.

I love the simplicity of the article by Erica Suter, a soccer and strength coach from Baltimore, “5 Reasons You Have Bad Knees,” because despite the frankness it holds a lot of truths in my opinion!

  1. Your butt isn’t big enough.
  2. You are training your core wrong.
  3. You have pelvic and hip asymmetry.
  4. You are not conditioned.
  5. You don’t do enough balance and single leg training.

The answers you seek to improve your knee health are all here:

  1. Get a bigger butt.
  2. Train your core with current exercise methods.
  3. Have an assessment and seek professionals to facilitate balancing yourself out.
  4. Get conditioned! This means movement, mobility, stability, and STRENGTH! Move well…Move often!
  5. Squatting, lunging, hinging, and balancing in both a single leg and double stance!

Remember that knee issues develop from a combination of factors, one being AGE! So use the advice above to keep on track, get on track, and improve your track record!

Get those knees out of the bad house!