The knee is the body part people mention most when they write to us, with the back and the hips close behind. Usually the sentence is some version of "my knees are going". Here is the thing a coach sees that a sore knee cannot: the joint you worry about is moved, steadied and protected by muscle, and the muscle is the part you can change.
A joint is only as good as what holds it
Your knee does not decide how much load it takes. The muscles at the front and back of your thigh do, by absorbing force before it reaches the joint. When those muscles are weak, more of every step, stair and squat lands on the joint itself. The same is true of the hips, which are steadied by the muscles around the backside, and of the back, which is held by a corset of muscle that runs from your ribs to your pelvis. Weak muscle means a joint doing a job it was never meant to do alone.
This is why NHS advice for osteoarthritis and for most back pain is to keep moving and to build strength, not to rest. Rest lets the muscle around the joint shrink, and the joint ends up with less protection than it started with.
What we do about it
- Knees: sit to stand, step-ups on a low step, and squats to a box, loaded a little more each week. The thigh muscles grow, and the knee takes a smaller share of every movement.
- Hips: hip hinges and glute bridges, then a light bar or kettlebell from the floor. Strong hips take the strain off both the knees below and the back above.
- Back: rows, carries and the hinge again. The back is happiest when the muscles around it are strong enough to hold it still while your arms and legs do the work.
Our seven lower-body exercises are the home version of this list.
The rule for a sore joint
Some discomfort while you train a joint that already aches is normal. A common physiotherapy rule of thumb is that an ache you would call three or four out of ten, which settles by the next morning, is acceptable; pain that climbs during the session or is worse the next day means that dose was too much, so the next session is lighter or shorter. Load is a medicine with a dose, and a coach's job is to find yours.
When to see your GP first
A joint that is hot, red or swollen, a knee that locks or gives way, pain that wakes you at night, or a sudden change after an injury all need a GP or a physiotherapist before a gym. If you have had a joint replaced, our guide to exercise after a hip or knee replacement covers the timeline.
Frequently asked questions
Will lifting weights wear my knees out faster?
Sensible strength training loads the joint gradually and builds the muscle that protects it. The NHS lists exercise as one of the most important treatments for osteoarthritis. Jumping, twisting and heavy loads before the muscle is ready are the things to avoid, and a coach avoids them for you.
My back goes if I lift anything. Should I lift at all?
Yes, taught properly and starting light. Most backs that "go" are being asked to do the lifting that the hips and legs should be doing. The hinge fixes that, and it is usually the first thing we teach.
How long before the knee feels different?
Most people notice stairs and getting out of a chair within four to six weeks of two sessions a week. The joint has not changed; the muscle around it has.
References
- NHS. Osteoarthritis. nhs.uk
- NHS. Back pain. nhs.uk
- NHS. Strength and flexibility exercises. nhs.uk
