The Secret To Keeping Your Knees Healthy For Sport

As I discussed in my previous post about my own journey with knee rehab, knee pain can undoubtedly attenuate with proper management. However, many of us have been exposed to misinformation about best practices for improving our knee health. Putting it explicitly, anyone who has attempted to perform a squat has likely been told to prevent their knees from traveling over their toes. Thus, I’ve seen people limit their depth numerous times in order to prevent this from happening when, in all honesty, it is not only normal, but simply impossible to perform a full squat deeper than parallel without doing so. Putting the gym aside, we sometimes sit with our feet tucked under us, have to stand from low sofas or toilets, etc.---all requiring our knees to be over our toes. It is normal!

The trouble comes when we’re experiencing pain and the easy, theoretical culprit would be allowing this to happen when, the simple answer, is that our knee has been placed under more strain than it was capable of handling and now it is sensitive. It is that simple. What isn’t simple is knowing for sure if our knees will be more sensitive, how much activity is too much or if a weakness somewhere else is contributing to overloading the knee.

The solution, you might be wondering? Progressive overload. Since the beginning of time, our bodies adapt to stress. Our muscles, tendon, bones, etc. all get stronger as we load them more and more. The resistance will come if a certain movement or load produces unsafe levels of pain, but using pain as a guide and not a mechanism of fear, we can modify activity to find a safe place to train. 

As we saw in my last post, I started without letting my knee travel over my toes, but gradually loaded my knee with assistance from holding onto a wall. Then, as it felt better, I increased the weight and decreased reps. Now, I’m purposely performing single leg squats that force my knee to travel over my toes. Why? 1. My knee goes over my toes multiple times a day during my capoeira training so it’s inevitable going to happen. Thus, why fight it and instead, why not train it? 2. Preparation for anything. If I travel to Europe again (as certain as certain can be), I’ll definitely be in seats that are not made for my large thighs and placing my knees in a near fully bent position. 

Let me make this super simple: 

If you have pain with your knees going over your toes:

1. Determine if this is being exacerbated due to a motor control issues (poor stability in your hip/ankle)

2. If so, address those deficits. 

3. If not, train in a modified range of motion until it feels more comfortable (e.g box squats, split squats to 60 degrees only)

4. Increase training load (e.g. hold a kettlebell, increase weight on the bar)

5. Allow your knee to train in deeper ranges of knee bending (e.g. front squats, forward lunges, pistol squats)

This may not necessarily follow a linear progression as something could increase pain sensitivity along the way---insert lengthy, challenging hike with a friend, perhaps. It helps to have someone like a physical therapist or strength coach to help guide you as training variables always need to change to meet your body’s capacity to perform on any given day. 

So next time someone calls you out for your knees travelling too far over your toes, you will be ready to chirp back--constructively!