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Are your knees beginning to talk back to you? After years of use, achy knees could be very much in need of tender loving care. If you want to preserve the good life for them, the key is to strengthen their surrounding muscles. The lower body is home to the two major muscle groups that affect knee stability, the quadriceps and hamstrings. When those muscles become weakened and can no longer properly support the knee joint, eventually the weak muscles will give permission to the bones to grind down their protective cartilage. "When the cartilage wears down completely, you're left with bone rubbing on bone and painfully swollen joints," says Dr. Tamara Martin, an orthopedic surgeon at Brigham and Women's Hospital in Boston.
A combination of strengthening and stretching muscles that support the knee helps protect from injury but also keeps knees in good working order so that you may have pain-free days of walking, jogging, standing, going up steps or dancing the night away. Leg strength is crucial to enjoy independent living; your balance is more secure, and you are less likely to fall.
"Strong quads also protect your back when you need to bend down to lift a heavy object," said Rob Maschi, a senior physical therapist in the Sports Rehabilitation and Performance Center of the Weill Cornell-affiliated Hospital for Special Surgery in New York. "If your quads are weak, you'll tend to use your back, rather than your legs, to help you lift; instead of bending at the knees, you bend at the spine, which places your back at risk."
What and where are those muscles?
The quadriceps and hamstrings, more commonly known as the "quads" and the "hams," work together. The quadriceps are a group of four muscles located on the front of the thigh that attach to the front of the shinbone, just below the knee. They control the straightening of the knees and movement of the kneecap and are responsible for straightening your leg from the knee. The hamstrings are three muscles in the back of the thigh that attach to the back of the shinbone, just below the knee. They enable you to extend your leg straight back and to bend your knee as if you were bringing your foot toward the buttocks, and they also come into play when you are pushing against something.
Some strategies for a quads-hams workout
The goal should be to prevent injury, not create it. Keeping that in mind, do not attempt to do too much too soon. Strength needs to be developed slowly.
Avoid deep squats: They could be harmful to knees.
Give muscles a break: Try not to exercise the same muscle groups two days in a row. It is a normal process for microscopic tears to occur when you are slightly stressing the muscles, tendons and ligaments. As the tears heal, the muscles become firmer and stronger, however, they must be given time to go through the healing process. Performing knee exercises three or four times a week is sufficient.
Avoid locking knees: When you are lifting a weight, don't lock the knees or you'll place extra stress on them.
The knee vs. toe position: Do not allow knees to go beyond the toes when performing squats and lunges; keeping your weight behind your knees will reduce pressure on the knee joint.
For beginners: Start with a weight that you can lift for five repetitions, gradually increasing reps until you can perform 10 to 15 repetitions. When that becomes easy, add another set of 10 to 15 reps; after that, it is time to increase the weight, reduce the number of reps, and repeat the process.
Stretch: Always include stretching at the end of the workout and when you feel you need it during the workout. Flexible muscles are not as easily injured as are tight muscles; tightness of muscles connected to the knee can pull the knee out of alignment.
Bad knees? If you have knee issues or experience limited range of motion and are not sure what exercises are safe for you to perform, check with your doctor or physical therapist for a personalized exercise plan.
If you are 50 or older and have not been exercising, check with your physician before beginning any exercise program. Trainer Sally Anderson is happy to hear from readers but cannot respond to individual queries. She can be reached at slafit@tampabay.rr.com.
SEE THE ACCOMPANYING PHOTOS (ABOVE RIGHT) FOR THIS MONTH'S EXERCISES: Work the quadriceps and hamstrings and you'll be doing your knees a favor. Today's exercises are demonstrated by Dr. Susan Beaven, 56, a family medicine physician at Millennium Medical in St. Petersburg.Our thanks to her. -- Sally Anderson
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