The New York Times had an article this past week on using squats for ‘aging knees.’ http://well.blogs.nytimes.com/2013/01/25/ask-well-squats-for-aging-knees/
The article has some good tips but it is incomplete and can’t address most of the issues that a good fitness professional can. This is a great opportunity to show some of the things that trainers can give you that you can’t find in print.
In this article a reader wrote in and said “I’m in my late 60’s and I take part in dancing, weightlifting, and yoga. All this makes me feel good, gives me plenty of energy and helps me control my weight. But my knees hurt enough to make me wonder how long I can keep up with the workouts. Do you have any suggestions.”
The response says that the individual is already doing many things right, particularly with regards to being conscious of their weight as carrying extra pounds puts added pressure on knees. Also weight training is important because “sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee…” The article thus goes on to suggest that the person perform squats because, contrary to popular belief, squatting when done correctly safely strengthens the legs which is good for the knees. This is all true, and yet it is very incomplete.
First and foremost, this article doesnt’ (and obviously can’t) ask any questions. I wrote in another article that one of the most important things a trainer can do is remove Iimiting factors from a persons fitness routine. That philosophy guides my very first reaction to this article which is: why does this person have knee pain? They are active and managing their weight but, contrary to the statement in the text, that doesn’t mean the person is doing things right. In fact, I believe quite the opposite. If you are exercising and watching your weight and you are still in pain then something is wrong. This leaves me with a lot of questions. For example:
– How much exercise are you doing? You mentioned three forms already. While you are trying to get all that in are you giving your body enough recovery?
– What kind of dance are you participating in? Dance is certainly exercise but it is not necessarily easy on your body. Are you spending a lot of time up on your toes putting pressure through your knees?
– What does weight training mean? Are there exercises in your routine that might be causing knee pain?
It is important to ask these questions and ascertain if there is a root cause of the troubles that needs to be eliminated before prescribing a solution. In this fitness culture, people are often beating themselves up more than they realize and addressing that goes a long way to reducing pain.
On the other hand it’s entirely possible that this person is doing all their activities just fine and that a little leg strength is really all that is missing. In that case I think doing some squats is a fine suggestion. Of course, I have one or two comments about that suggestion.
Number one, squatting is hard. They describe more or less what it should look like but this is a akin to writing down how to swing a golf club and sending people out on the course – it’s not going to be a pretty round. More than that, many people’s bodies simply are not ready to squat due to a variety of mobility, strength, and neurological deficits that have to be managed first. So if you’d like to start squatting as a remedy for some issues, you really need some good coaching. This individual may indeed benefit from squats, but I am willing to bet they aren’t able to do it yet.
Also, using the squat to strengthen the muscles “at the front and back of the thighs” is flawed and this flaw leads to a mistake in their directions. They instruct the person to “bend your legs until your thighs are almost, but not completely, parallel to the ground.” Squatting like that would definitely emphasize the muscles around the thigh but the problem is, these aren’t the only muscles that are vital to the knee. The glutes, in particular Maximus and Medius, also stabilize the knee because they attach to the femur and the IT band. Considering that most people spend an inordinate amount of time sitting in a chair, what muscles do you think are the most numb and inactive? With this in mind what really needs to happen is the legs need to be at least parallel and if possible, a little lower than parallel because it is in this range of motion that they will get the most glute activation. Again, most people have a very hard time getting that low and will need a lot of work and coaching to get there. This may be a reason why so many exercisers who do plenty of squats still end up with knee pain.
I could continue, but those are the main points for now. Let me say I enjoy reading fitness blogs, health articles, the occasional fitness magazine, and in particular the Health section of the New York Times. I also love the enthusiasm and the excitement around health and fitness that comes from these sources. However, I hope that these comments will also serve to show that these sources are limited, incomplete, and can be misleading. Fitness professionals are out there and what they do, which really only works live and in person, is teach people the complexities that articles cannot. Without this, any remedies or recommendations you find in print are pretty much a shot in the dark.