Paul Landini is a personal trainer, health educator, and regular contributor to The Globe and Mail. This is part of his guide to protecting and strengthening common pain points, such as your hips, shoulders, knees and back.

Knee pain is one of the most common ailments among adults over 45, which makes sense when you consider how hard our legs work every day.

The knee is the largest joint in the body; it’s a complex structure involving the femur (thigh bone), tibia (shin bone) and patella (kneecap), all supported by an intricate network of ligaments, tendons and cartilage.

Improve your shoulder mobility with these three movements

Try these three daily exercises to keep your hips happy and healthy

Outside of structural damage to the joint itself, knee pain is often caused by issues relating to the hips and ankles.

By focusing on improving hip and quadriceps strength, enhancing both hip and ankle mobility, and refining balance and proprioception, we can build a strong foundation for the knees and alleviate persistent pain.


Box squat

What it does: A variation on an old classic, the Box Squat is designed to improve squatting technique while emphasizing the muscles that form the posterior chain (your back, butt, hamstrings and calves). Strengthening these muscles keeps the knees happy and healthy.

Difficulty: Beginner

How to do it: Stand with a box, bench, chair or any other elevated platform a few inches behind you. Initiate the squat by pushing your hips back while bending your knees until your butt lightly taps the platform. Now push through your midfoot and heel and stand back up to the starting position with your chest high. Perform 2-3 sets of 8-12 reps.

What to focus on: Sit back in a controlled and somewhat slow manner. Avoid sitting directly on your platform as you will lose tension in the targeted muscles. Keep your heels flat to the floor and your knees aligned with your toes.

Modification: Beginners should start with bodyweight squats to a platform that allows for a 90-degree bend at the knees. Once you’re comfortable with the technique, add some weight. A single kettlebell or dumbbell held “goblet” style is a great option. A lower platform will also increase the challenge.


Split stance knee bend + knee shift

What it does: Almost like a plank for your legs, this exercise builds resilience directly in the knees by strengthening the muscles, ligaments and tendons that act directly on the joint.

Difficulty: Beginner

How to do it: Begin in a split stance, one foot forward and one foot back. The big toe, baby toe and heel of the lead foot should be planted firmly, the heel of your rear foot elevated slightly.

Bend the lead knee and push it as far forward to the toes as possible while keeping the heel planted. Your weight should be shifted almost entirely to the lead leg. While holding this position, slowly pull the knee side to side for 30 seconds. Repeat on the opposite leg.

What to focus on: Slow, controlled movement is essential. Make sure the knee stays centred as it travels toward the toes. Keep your hips squared and levelled; don’t let them rotate to the side, don’t let your butt drop to the floor.

Modification: If staying balanced is a challenge, use a prop for support. You can increase the intensity of the movement by lifting your lead heel as you drive the knee forward. Another way to up the challenge – close your eyes.


Scales

What it does: These deceptively challenging exercises strengthen the entire leg, from hip to heel, while also training balance, body control and proprioception.

Difficulty: Beginner to advanced

How to do it: There are two main variations of the Scales: the Front Scale and the Back Scale. For the Front Scale, stand on one leg while extending the opposite leg straight forward, lifted as high as possible while maintaining a strong, upright posture. For the Back Scale, rather than extending the leg forward, reach it backwards and lift it high while hinging forward at the hips, creating a straight line from your head through your back and into your elevated leg. Aim to hold these positions for 15-30 seconds on each leg.

What to focus on: For both variations, your grounded leg must be fully extended and locked out at the knee. Avoid rounding your back or lifting your chest – keep your spine long and in a neutral position. Reach your arms out to the side to assist with balance.

Modification: The higher you lift the elevated leg, the more your balance will be challenged; if you’re just starting out, only lift your leg a little bit, gradually increasing the height as your balance improves. Another way to make this movement more manageable is to bend the knee of the elevated leg so it’s at around a 90-degree angle.

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