- (groans) Oh.
Do you like to walk but you're limited by knee pain,
particularly if you're going up steps, it kind of hurts?
Probably arthritis or it could be something else.
- Oh, hi Brad. - Oh, hi!
- But we have five easy exercises
to help fix this knee pain.
- Now does that seem like a really cool intro?
- Do you wanna come in my house?
- No. - Oh.
- We'll be right there. We'll show you all five.
(bright music)
Alright. If you're in your fifties or older
and you've been gradually getting
more knee pain with walking,
you know it's probably arthritis, you're thinking.
There are exercises you can do to improve the situation
and sometimes even actually make it go away.
- And often as we age, if you have knee pain,
it can lead to weight gain, which is less fun yet,
and it can lead to feeling depressed.
So we want to help alleviate this knee pain
to get you moving better and feeling better.
- That's right. So we've picked out
our best five exercises to work with the knee,
get the range better, get it feeling better,
get that synovial fluid in there where it needs
so it feels as you want, and get active again.
- So first, we're going to talk about the knee mechanics
and then we're gonna talk about different standing
and walking habits you may be having causing this knee pain.
- You're a knee mechanic?
- Yes.
- (laughs) All right, we'll be right with it.
All right, I just wanted to have Sam give us a hand here
or perhaps a knee to show a little arthritic education.
Now, in the knee joint, the arthritis set
oftentimes occurs is between the femur and the tibia.
You have these two surfaces, they should be shiny and smooth
with that nice pristine cartilage on the cartilage here.
However, after time, with age,
it may be a mechanical thing maybe,
if you're a little bow-legged or outward,
you got knocked knee,
then one side gets more worn out than the other.
So that's where that's gonna happen.
But there's one spot that a lot of people aren't aware of,
is the kneecap or the patella.
Now Sam's patella is kind of screwed on there.
It has more mobility than this, but it's underneath here.
The surface is there that can also be arthritic
and that, I think is a good source of pain
going up and down stairs.
So we'll show you some stretches
that'll help work with that joint as well.
Mike, do you have anything to add to the knee?
- I think you did a good explanation, let's get into it.
- Oh, excellent. Most excellent.
Alright, for the first exercise,
we're gonna look at the knee extension.
In other words, getting the knee straight.
Oftentimes what happens over time is the knee
doesn't fully extend because of arthritic changes.
And what we need to do is work through that.
A good way to assess it is Mike's gonna show,
he's gonna demonstrate how you may do it
on a bed or a couch.
I'm gonna show how you do it on a chair
with a stool like this.
Let's say this is my sore knee,
this would be Mike's sore knee.
And if you put your two knees up together
and you straighten 'em out
and you'll see that, well,
one, the sore knee may not fully extend.
Like this one you can see fully extends all the way down.
It feels good.
That's normal, nice and straight.
This one goes down and we have an inch or more difference,
and you can just tell,
it's not going down like the other one.
Then we need to work on that
and that can be done,
and we'll show you a couple of options,
'cause you don't wanna get after it too aggressively,
you can get real sore.
Bob always tells his story about one of his patients
that got after it too aggressively.
He came back, he was a little upset,
so Bob had to calm him down.
They backed off and they got him going again.
So just a little red flag warning on that,
or caution, I should say.
All right, so what you'll do is bring it out like this.
Now, if you have a stool with wheels, it works really well.
If you're doing it on the bed,
Michael, show that,
the stool that I like to do is just go like this
and go tell it straightens and stretch.
If you get sharp pain, you're going too hard.
If you've got just a little pain, just work it.
Do five or 10 repetitions,
and if each time it feels like it's going a little better,
you're doing good.
Mike, why don't you talk about it, doing it on the bed.
- So if you're on the bed,
you're gonna be in a long sitting position like this.
If my knee is stuck here, I'm gonna focus on trying to
push the back of my knee into the bed.
If this is problematic or you can't do it as well,
you can put a pillow under your heel
to get a little more height there.
And then sometimes you can start pushing down.
Now you may not be able to get all the way to the mat,
just do what's comfortable and what doesn't feel painful.
Oftentimes when your knee is bent like this,
your hamstrings are gonna be tight,
so you're gonna feel a little pull in there.
Don't be too aggressive,
you can get a hamstring strain.
Then you're starting from ground zero all over again.
So just take it easy, go nice, low and controlled,
hold it down for a few seconds and then relax.
- That's right. So the idea,
this is probably not gonna straighten out
in the first one or two days.
As a matter of fact, the first day, I would only do it once,
see how sore you are the next day.
If it feels fine, then you can start to push a little more,
up to 10 repetitions, no more than 10.
And then you may wanna do it twice a day.
Go the next day, see how it feels.
And you may go up to three times a day,
morning, afternoon, and evening.
But that's as most as you want to go after it.
And then you may take a week or two weeks
before you actually get it where it needs to go.
It's possible that there's enough arthritic damage in there
that it may not come back.
And that's just what you have to find out.
Now, I did talk about the patella or the kneecap.
That's the next thing to assess.
And the key to this is on this.
I'm not gonna put my foot out like this
to get the knee straight.
We're not concerned about that.
We do want it as straight as it comfortably can be.
And then you're gonna completely relax the quads,
because if your quadriceps are not relaxed,
your kneecap will not move
because they're directly connected up to each other.
So Michael, show his mobilizations.
You can go right to left.
We'll get a close up here.
Now I'm completely relaxed in the quads
and if your quads are relaxed, you can, as you can see,
do it just with my fingertips.
You can use this measured method with your thumbs
and just go back five or 10 times.
You might find that one way is painful.
The other way feels okay.
Do not push into the painful range too far.
Just a little bit, work it again, same manner.
And you can go forward and backwards.
You can do some angles in there.
The whole idea is see how mobile it is,
compare it to your other knee cap
and they should be about the same.
And that can work out.
That can work out some, that's one of those things
that sometimes is a little faster to mobilize
than the whole knee with extension.
Mike, any additions?
- You will know if your knee is not relaxed,
because if I'm tightening up right now,
that kneecap is not moving.
So you have to get it to relax
and then you will start to see the movement.
And just do what is pain-free.
If it's hurting every time, don't push more into it.
Just do a nice slow, controlled pain-free motion.
- All right, well we went into detail
fairly amount with that
but it's important that you get it right
and you don't have a situation where
you're really painful the next day
and then you say bad words about Mike and I.
You know, we don't want that. - No.
- Okay, let's go to number two.
Alright, number two,
this is a pretty straightforward and simple one.
It's just being aware of your standing habits
in regards to your knee position.
Now what happens is some people,
they'll stand with their knees fully extended;
we call that end range,
all the way till it stops going.
And they stand like that, typically for,
you know, not forever, but it's long,
as they don't even realize they're at full extension.
That, after time, can really beat up the knee
and when you walk, it can cause problems.
So all's you want to do is look at your knee
and go full extension.
And if you're there and you say, "Well,
that's the way I stand all the time,"
simply a little flexion in the knee
and hold it like that
and you may find out a whole nother story
about when you're standing for long periods of time.
You can stand longer with less pain.
Mike, why don't you talk to 'em about how that feels.
- So this is going to make your muscles engage more
and take pressure off your actual joint.
So if you're having knee pain,
this is gonna put pressure on your joints,
your hip joint, your knee joint and your ankle.
This is gonna allow the quads to activate
and the glutes to activate more,
taking pressure off of that joint.
And this is how muscles are supposed to function.
It is easier to stand like this
because you're basically stacking your bones
on top of each other,
keeping in place disengaging muscles,
but you want to make those muscles work
because you're gonna have less pain there.
- Right. And just another little tip.
This is one that I know Bob talked about
with one of his patients, that works so well.
We're gonna call this soft knee.
So it's a soft knee when there's a slight bend in it,
but actually stagger your feet.
Go ahead and stagger, you know what stagger means?
- [Mike] Which stagger?
- No, that, this way.
There you go. It's always tough
working with these young guys, you know what I'm saying?
So just, and that's an option to you, just stand.
If you got a job that you're working on,
you may put your staggered left foot in front,
and after so many minutes, stagger the other direction
and then maybe a squared off stance
and just vary that position.
Taking pressure, putting it on one knee,
a bit more on the other,
and it helps rest that knee a little bit.
It's a good little strategy.
- And it's important to stagger front to back.
You don't wanna lean on one side
'cause you're probably gonna lock that knee out again.
- Right. That's another thing some people do do,
they just put all their weight on one knee,
maybe from a habit, from an injury,
from holding onto the...
- Well, you do it all on one leg when it's tired
then you switch to the other leg.
I used to do it.
- Yeah. - Then I learned better.
- What else did you used to do?
- Lots of things.
- Let's get on, we got work to do.
Okay, the next one is how to walk.
Change your walking mechanics to eliminate
or actually reduce the impact on those knees.
We call it walking with soft knees.
Mike, why don't you explain it in detail.
- So most people commonly walk with a heel strike
landing on your heel like this.
This is going to put the forces from the ground
into your ankle, then your knee, hip, back, et cetera.
It works its way up.
If you're having knee pain,
you're taking that shock directly into your joints.
So what we recommend is walking with soft knees.
It's very similar to standing.
In order to do this, you're gonna stand
and land more on your forefoot.
You could see here my heel is still elevated.
I'm kind of exaggerating,
you don't have to walk exactly like this
but this is how you will begin.
When you do this,
this activates your glutes more to fire again,
also your quads.
So you're gonna be using your muscles
versus putting all that pressure on your joints.
It's gonna lighten the load
and impact forces on that arthritic knee.
So when you walk,
you could see I'm doing a large distance heel strike.
This is a no-no.
In order to walk on your forefoot,
I'm not gonna step this far forward.
I'm gonna start taking smaller steps.
As I'm here, I could feel my glute start to activate.
If you wanna do this at home, probably not outside,
you can put your hands on your buttocks, heel strike.
I don't feel anything in my right side.
Now I'm putting my forefoot down,
as I step through, I feel my butt muscles
start to engage and activate.
So you might look a little silly
walking around town like this,
but if you wanna do it in your own home,
start practicing forefoot or soft knee walking.
Did I forget anything? - Bob used to walk around
like that in the neighborhood when he was practicing.
- He probably still does.
- (laughs) They're used to it.
- So it's a little harder to do this
if you have standard shoes as well
because you're gonna have an elevated heel.
I have flat shoes on.
If you wanna start this and you don't have any,
you can try walking barefoot in your house
if you feel safe doing that.
That's just where you can start and slowly build into it.
It feels a little different,
but over time, you get acclimated.
- That's right. And if you feel a relief from pain
when you're doing that forefoot walking,
it's even more motivation to continue.
It does take a while, I gotta admit.
- Yeah, you've been walking the same way
for however old you are. (Brad chuckles)
So, takes a while. - Right.
Well anyways, let's get on to the next one.
We're at number three, right?
- Number four is next. - Four? Oh yes.
All right, now we're gonna talk about
negotiating up and down steps.
If you have knee pain, a lot of times
people have more pain going down steps than up.
But it varies from person to person
and knee to knee actually.
So I'm gonna talk about
just changing your mechanics of walking.
If we look at my feet,
and this is how I normally walk up,
my toes normally point out a little bit.
That's normal for me.
Let's say I'm having pain on my right knee with that.
I'm gonna try two different options.
The first one is actually rotate my foot out a little bit
and see how the pain, how the pain response
is to that mechanics.
And if it feels better,
then you're gonna change your mechanics
to walking like a duck going up and down the steps.
As long as it's less painful, you're aligning the joints
so that the cartilage is actually lining up
in a more healthy manner.
You can also try pointing in a little bit.
Now for me, that's awkward
because I'm a natural retroverted hip.
So if I mean I go this way, I really feel awkward
and it probably would not do anything
for my knee pain if I had it.
But you can try it. Some people's bodies are different.
So outward and inward and then see how that works.
If your knee pain is really severe,
it doesn't matter which way you point your foot,
then the next option is, go ahead Mike,
you show him this one.
- So what you're gonna do is you're going to lead
up the stairs with your good leg.
So say my left leg is bothering me,
I'm gonna lead with the right
and then I'm just gonna step to.
I'm just gonna do one step at a time,
use the rail as you need,
leading with the good leg.
Now on the way down,
you're gonna actually lead with the bad leg,
because as you see, as I'm going down,
my good leg is supporting my weight here
as I'm going down, this leg is doing the work.
So make sure to use the rail.
Once you get here, bring this foot down.
Bad foot down, bad foot down.
So, you remember this by good people go up to heaven
and then the bad people go to the underworld,
'cause I won't say the other word.
So up with the good and down with the bad is the trick here.
- And you'll, if you get a knee replacement
or a hip replacement,
they'll tell you exactly the same thing.
So you'll be ready for that if it does get to that point.
So, very good. The idea is that you go up with the good,
down with the bad, until that knee settles down
and then get back to your normal gate
going up and down the stairs.
Alright, let's go to the last and final trick.
Alright, last but not least.
Now this option is absolutely the easiest
and the fastest way to get rid
of knee pain when you're walking.
The only thing is it's the least desirable by most people.
So if this is my right knee, and it hurts,
and every time I put weight on it...
(groans) And you try to bend, you know,
grin and bear it and act like it doesn't hurt.
While, if you're going to unload it,
you simply take one of these devices, a cane,
and it'll really take a lot of weight
off of that painful joint
and allow you to walk much smoother.
You just have to adjust the cane properly and walk properly
and it really will help, I guarantee you,
even though you may not like it.
So get a nice, fancy cane that gives you some,
you know, make you feel cool.
Anyways, that really doesn't help with a lot of people,
but it does help.
I've had people do it.
So if this is my sore knee,
what I'm going to do is use the cane in the other hand.
A lot of people get that wrong
because they watch that, what's that Dr. House, Bob?
Yeah, that guy on TV, he walks with the wrong,
the cane on the wrong side.
Painful knee on right cane in the left.
If you drop your hand down with good posture,
the handle should go right about at the crease.
It doesn't have to be exact,
but if it was up here, I would change the height.
Typically canes are adjustable.
If you have a wooden cane, you can always cut it off
and make it shorter
but you can't cut it off and make it longer.
So you gotta make sure you know it's the right length
and you are able to adjust it.
So here we are, when my right foot goes forward
the cane goes forward and we walk through,
and you simply put weight through your arm.
It takes weight off of the sore knee
and because you got a wide base,
it really makes your balance and you're much more stable.
So it's a win-win situation for pain, for your stability
and you're, you know, able to walk.
And the idea is that typically arthritis comes and it goes,
it kind of gets worse and bad.
You're gonna use this on those bad days
and do the exercises, do the range of motion exercises,
one or two of them that you'll find that help.
And then you don't need the cane all the time
just on those bad days is the goal.
So Mike, do you have anything to add
about the came from your experience?
- No, I think you did a good job explaining it.
- Okay.
- You have some practice there.
- (chuckles) Yeah.
There's a few years behind me.
Anyways, I would say,
don't let that knee pain get you all hung up.
Try all these.
Some of them won't work for you, some will,
and do the ones that work and make...
What about the comments?
They're supposed to...
- Let us know what works for your knee pain.
Comment down below.
(upbeat music)