Suffering from knee pain during squats, odds are that the pain is occurring due to a muscular imbalance. This blog post will be focusing specifically on exercises to help knee pain with the end goal of altering your neuromuscular activation, therefore altering the mechanics/functionality in the body. Knee pain could be occurring for many different reasons, including but not limited to, lateral patellar tracking, patellar tendonitis, over pronation of the feet, asymmetry of the core, muscular imbalances between hip adductors (groin) and hip abductors (glutes), runner's knee or ITB syndrome and the list goes on. Women are prone to these types of dysfunctions due to their wider hips made for childbearing.
Listed below are exercises ranging from basic to more advanced to help with squat mechanics fixing these imbalances.
1. Clams: great for lateral hip strength to help with the knees staying wide during squats. laying on your side, knees bent at 90 degrees, with hips, knees and feet stacked on top of each other. Keeping your hips and feet from moving, lift your top knee up as high as you can without opening your hips up (do not lean the top hip back)
2. VMO SLR: great for inner quad strength to help patellar tracking. Laying flat on your back with the right leg straight and foot pointed out on a 45 degree angle, squeeze right quadriceps (push back of knee into ground) and lift your leg 30 degrees off the ground. Try both sides. Should feel muscles activating on inner right thigh. If too easy, add a five-ten second hold to the exercise.
3. Toe grips: great to help build intrinsic muscles of the feet to help with flat feet (over pronation during squats, leading to pressure on inner knee). Standing straight, imagine there is a rope attached to your head and pulling you straight up. Feel yourself get taller? Good. Feet should be hip width apart, pressing your feet into the ground, imaging pulling your belly button into your spine and slowly fall forward inch by inch. Most important part is that your hips and shoulders stay in line. Eventually, you should be far enough forward that you feel your toes gripping in order to keep you from falling. Do not fall so far forward that your heels come off of the ground. Slow and controlled. Stay in the position where you feel you might actually fall forward and to where your heels are still on the ground and wanting to come off. Hold as long as you can.
4. Clock work: great overall functional movement. This movement is meant to focus on hip hinging, balance via single leg stance work, and hypertrophy of the gluteus medius in the planted leg. Begin the exercise by transferring body weight onto one leg. That leg is going to remain soft (do not hyper extend or flex). Keeping spine neutral, reach the opposite leg straight backwards to six o’clock and tap your toes to the ground. As that leg reaches backwards, hip hinge and bring the chest forward keeping spine neutral. Make sure to be digging first toe into ground to create the transverse arch in the planted foot. Also, pushing the planted knee laterally (outwards) in order to aid in activation of gluteus medius and minimus. Next, complete the same movement but instead of reaching your foot straight backwards to six o’clock, go to seven o’clock. For added difficulty try 8 and 9 o’clock.
5. Reverse cross lunge: this exercise is to help build inner quad strength, lateral hip strength (glute medius) and in turn help with patellar tracking and an imbalance between the hip abductors and adductors. Very similar to the clock work except keeping foot planted at 8 o’clock and lunging down and back. Hip hinging and keep your chest straight. Keep majority of weight in front leg, push front knee laterally, and keep front knee behind toes. This is a stationary lunge so keep feet in same position for entire set.
6. Lateral isometric squats: This exercise is a favourite of mine for functionality. Great for intrinsic muscles of the feet to rebuild your arch, knee pain, glute activation and in turn, may help back pain too. Starting with feet fairly wide (wider than hip width), place majority of body weight onto right leg by shifting that way. Hip hinge slightly. Shins are going to remain vertical, chest is open, squeeze shoulder blades together, and push that right knee wide. The trick with this is to allow your hips to drop down and keep that knee/shin from moving forward. Now push the right big toe into the ground and feel your transverse arch in your right foot activate even more.
For more information or if you have any questions please feel free to contact me, Meagan Davis at Meagan@crossfitinsight.com to book an appointment! We can complete a functional assessment and then we can move forward by helping you fix the dysfunctional/imbalanced mechanics.