ONCE WE SORT THROUGH THE MYTHS, WE FIND THERE ARE SIMPLE EXERCISES THAT IMPROVE THE STRENGTH AND FLEXIBILITY OF KNEES AND HIPS.
Knee and hip problems are fairly common among middle-aged and older individuals, and the effects go far beyond difficulty walking. When the joints that affect mobility have pain (including arthritis) or other dysfunction, those individuals will reduce and alter their physical activity.
Which starts a domino effect. The inactivity that results leads to a gradual but steady degeneration and additional health problems. Circulation suffers, the individuals usually gain weight and they tend to get less vitamin D owing to a lifestyle that is more indoors than out. Skin, hair and teeth health eventually suffer as much as the heart and brain functions.
It isn’t always necessary. Research and textbook knowledge of joint health tell us a focused approach to stretching and strengthening muscles around the joints can reverse some knee and hip issues.
Note that there are many causes of hip and knee problems — and a doctor’s diagnosis is always recommended — but one need not accept it lying down (on an operating table). There are simple exercises for strength and flexibility that improve the functioning of both joints and often have an ancillary benefit of reducing lower back problems in the process.
But first, a couple of research studies show there is a big myth around knee and hip health, which needs to be debunked.
That myth is that habitual long-distance running ruins your knees. While it might intuitively seem logical that all that pounding on pavement would have such an effect, here is what two studies have shown:
- Researchers at Stanford University (E. Chakravarty et al. “Long Distance Running and Knee Osteoarthritis, a Prospective Study,” American Journal of Preventive Medicine, 2008) looked at 45 long-distance runners and 53 healthy nonrunners from 1984 on through 2002. The study used radiographic observation (X-rays), and its findings were opposite the assumption that running causes osteoarthritis (the wear-and-tear form of arthritis). As they aged, about 20 percent of the runners developed arthritis, while 32 percent of the nonrunners got it. In other words, running is not a universal cure, but there is a greater tendency for nonrunners to suffer arthritis.
- A second, smaller study was conducted on eight marathon runners who competed in the 1997 Vienna Marathon (W. W. Krampla et al., Danube Hospital, “Changes on Magnetic Resonance Tomography in the Knee Joints of Marathon Runners: A 10-Year Longitudinal Study,” Skeletal Radiology, 2008). Ten years after that marathon, seven of the eight runners were still running. The one who dropped out had severe deterioration of the internal structures of the knee joint, while a second individual who was still running had progressive arthritic changes (indications of arthritis that would get worse over time).
Neither of these studies provides a definitive reason why running might actually strengthen knees. They were actually looking to find out the opposite. From the researchers’ conclusions, it appears that activity, including that which involves repetitive shocking hits that happen during running, is not detrimental to knee strength.
Imbalances — including while sitting and exercising — are what hurt
So what is it that leads to knee and hip problems? Short of injury or degenerative diseases (such as an internal infection), the real culprit might be what you’re doing right now: sitting. That means being in a seated position a lot, as we do at desks and in vehicles and while watching television. It tends to tighten up our bodies in that position, such that standing and walking become labored activities.
Additionally, you can cause strain and pain in either hips or knees when you exercise without balance, that is, exercising one side of the body while neglecting the opposite side. For example, runners sometimes overdevelop their quadriceps and underdevelop their hamstrings, particularly if they run only on flat courses or in treadmill settings.
To understand this, it helps to think about how the muscles and tendons that make up your body are similar to rubber bands. They come in different thicknesses and lengths; for example, compare the small muscles in the hands versus the much larger muscles and connective tendon tissue in the gluteus maximus, your backside.
If you chronically hold a position for long, extended periods of time — such as while sitting for eight or more hours each day — those bands of muscle and tendon tend to form and tighten to that position. When that happens, the muscles that stabilize the hips, the hip flexors, are tight in the front and elongated in the back. The hamstring muscles (behind the upper leg) also tighten while the quadriceps (thigh muscles) elongate.
Open up the hips
I spoke with exercise physiologist Tim Allegretti, the director of training at Go Performance Fitness in Chicago, about the types of exercises that should address these two factors, imbalanced strength and inflexibility. “You can’t strengthen joints per se,” he says. “You have to strengthen, and usually lengthen, the muscles and tendons around the joints.”
Allegretti offers a solution to the sitting problem, which is to stretch in an opposite direction. He says to get up from your desk, stand up straight and raise your hands toward the ceiling, stretching as high as possible. Then with your eyes fixed on your hands, arch backward as far as possible. Feel the stretching going on in the abdominal region and the front part of your hips?
Taking that stretch one step further, adopt a “tandem position,” with one foot planted three to four feet behind the other and both feet pointed straight ahead. Clasp the hands overhead, stretching the arms straight upward, then hinge the legs slightly forward from the ankles while you pull your arms and hands back behind the head. The hip flexors of the back leg should get a good stretch here — in a position quite the opposite from a desk chair or car seat.
Strengthen around the knees
Knees suffer from their own imbalances, particularly those muscles and tendons that support them: hamstrings, quads and the hip stabilizers (flexors), and to some extent the calves and tibia (shin) muscles.
The exercises targeting these muscles needn’t involve heavy weights. In fact, the novice strength trainee should never approach any exercise with much more than his or her body weight, at least at the beginning. A good example would be to lie flat on the floor, with a medicine ball positioned approximately where your left knee would be. Raise the left leg, bend the knee and place the left foot on top of the medicine ball, then press down on that left foot to raise your tailbone off the floor. After one or two reps, you will feel significant work occurring in the hamstrings. Repeat as many as ten reps per leg; then alternate with an exercise that works the quadriceps.
YouTube and other fitness video Web sites offer many good examples of how to strengthen this family of muscles around the knee, but they are too extensive to go into here. If at all possible, it’s highly advisable to work with a qualified fitness trainer at developing and perfecting your form. Be clear with the trainer about your goals.
A final note: If you are beginning to worry about the strength and functionality of your hips and knees, these instructions might work for you. If you are coming off an injury or surgical treatment, see a physical therapist and physician.