March 26, 2023 • 21 mins
Knee injuries are no joke, whether you've suffered an accident or they're "falling apart" with age. But have you been doing something, or rather NOT been doing something, this whole time that's set yourself up for failure? Tune in and find out.
Show Notes:
6:18 - CDC: Adults with arthritis aged 65 and older - https://www.cdc.gov/arthritis/communications/features/4things.htm#:~:text=Among%20adults%20aged%2065%20and,having%20been%20diagnosed%20with%20arthritis.
6:31 - Why is Osteoarthritis an Age-Related Disease? - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818253/#R3
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
welcome to primady where we find simple
techniques to help address modern
problems for our primitive bodies my
name is Andrew pafford and I'm a health
and wellness professional with over a
decade of experience helping Olympic
level athletes desk jockeys and seniors
achieving their goals and improving
their quality of life
for our topic today I wanted to discuss
knee health
(00:21):
topic is a very broad overreaching topic
that can have many causes however the
vast majority of us are guilty of one
big thing that can pile on to the Myriad
of other reasons that can cause knee
issues and we'll discuss what those are
and how this big faux pas contributes to
each I won't do what many do and save
the big reveal for the end because I
(00:42):
don't like stringing people along and
I'm just not that patient the big No-No
I'm talking about is motion or in this
case lack thereof
simple beautiful god-given motion of the
knee this does come with a subtle caveat
but yes moving the knee joint plays a
huge role in knee health
to elaborate on the mechanisms with
which we can better utilize to ensure
(01:03):
knee Health we'll touch base on the
anatomy of the knee different way
different ways our knees tend to go bad
and how proper full motion of the knee
can be utilized to help keep our knees
healthy and working
first and foremost rudimentary
explanation of the knee the top of your
shin bone the tibia is actually a
(01:23):
plateau that has two grooves for the
bottom of your thigh bone the femur to
rest and move on
in kinesi talk we call this articulation
when two bones tend to move together
on the plateau of the tibia you have
rubbery discs called meniscus to provide
cushion for the femur and to protect the
(01:43):
top of the tibia equally
the part of the femur that meets the
tibia known as the epicondials are also
covered in cartilage this protects the
articulating surface of the femur and
prevents undue friction imagine rubbing
two smooth surfaces together versus
rubbing two rough surfaces together
smooth surfaces will last a lot longer
(02:05):
because there's a lot less surface
friction going on to do damage
finally your knee has a handful of
ligaments that help hold it in place so
that the femur does not slip off its
plateau and voila a horribly reductive
description of the knee now
all the fun and terrible ways that knees
like to go bad
first and foremost we have a torn
(02:26):
meniscus
but this guy I've been known to tear and
typically in creative ways it can be as
sexy as being tackled from the side
while playing football or something as
mundane as stepping off a curb by
accident
what what does the damage is what's
known as Shear Force think exactly like
a pair of scissors or shears you have
two forces in this case the blades
(02:48):
coming from two opposite trajectories
we'll apply this to the bad curb step
metaphor
when you suddenly slip off a curb your
body weight
is what is causing you to fall to Earth
currency gravity your foot hits the
ground first so reactive forces are now
coming up
(03:09):
but the rest of you is still falling
since you likely slipped to your side
your femur is being pulled just slightly
to the side so your femur is being
driven down and to the side and your
tibia which is hit the ground is being
driven slightly in and up with this
Shear Force that's now happening the
meniscus was not designed to handle
(03:30):
horses side to side rather forward and
back or subtle grinding motions at a
normal knee range of motion entails as
such structures give and boom important
meniscus
second way injuries tend to happen to
the knee is ligament tears the handful
ligaments that I mentioned that hold the
knee in place those two are susceptible
to Shear forces I'm sure anyone who's
(03:51):
watched or played football or as we
called it America soccer
has heard of or seen someone tear their
ACL or MCL those are shorthands for
anterior cruciate ligament and medial
collateral ligament well same science as
the meniscus tears those ligaments are
meant to resist forces along the lines
of their fibers not across the fibers
(04:12):
and since Shear forces mean going
against the grain well then things tear
now the Third Way is actually kind of
the same but the mechanism is in two
different ways so we'll call the third
and fourth way
the Third Way is technically an active
way to get a knee injury
however it's a little more what we would
say Insidious meaning there's no obvious
(04:34):
sign or there's no clear action that
initiated the injury when you step off
the curb funny and your knee goes out
you know it was stepping off the curb
this is you wake up one morning and
suddenly your knee is angry at you you
don't know why that's what we mean by
Insidious this first type of
degeneration we'll call Active
degeneration this is particularly for my
(04:56):
over trainers and one trick pony
athletes for example if you've been a
runner most of your life
but now that you've hit your 30s 40s or
50s and you're starting to feel the
ravages of time on your knees well it
might have been your training all along
but my training hasn't changed you
exclaimed correct it hasn't
but you have as we age things tend to
(05:19):
slow down we're still quite capable of
getting the job done however we need a
little more time to do things like allow
our tissues to recover our metabolism is
not as fast as it used to be and that
includes tissue repair
this means you aren't going to bounce
back as fast from those long runs yet
you're still going out and putting miles
on those knees so when you're training
(05:40):
outpaces your maintenance you can expect
to start getting some aches and pains
along the way
this can also result in a possible torn
meniscus if allowed to go on long enough
but typically you'll see arthritis and
possible degeneration in the articular
cartilage of the femur that we talked
about before
so now finally for the fourth cause
we'll have what all the passive
degeneration this is for my homies in
(06:03):
their golden years when you get to enjoy
retirement and find yourself on your run
more than ever you aren't going to do
anything terrible to your knees but your
knees still feel terrible what gives
this is good old arthritis you feel
sitting in and you're not alone
according to the CDC one in two adults
means 50 percent of adults age 65 and
(06:26):
older report being diagnosed with
arthritis
further in another study that involved
480 adults who reported having knee pain
50 percent had Imaging to show that they
indeed had arthritis
suffice to say knee pain and arthritis
are quite prevalent in a population that
very much likely isn't picking up soccer
games on the weekends well we have great
(06:49):
news we can stop all that with adequate
movement
all right I already gave up the big
reveal but how can move and address all
these problems that seem to be widely
varying mechanisms of injury
well let's talk movement and a little
bit more important Anatomy that I left
out that will play a huge factor in how
the knee can stay healthy as I mentioned
(07:10):
earlier we give a very reductive
description
but I also have that one huge piece of
anatomy for our purposes today called
The Joint capsule
The Joint capsule is very much what it
sounds like a bag made of connective
tissue that encapsulates the joint you
see in addition to the meniscus and
cartilage to reduce friction your knee
cap your knee joint capsule is filled
(07:33):
with fluid called synovium synovium
provides two crucial functions first is
lubrication
think of this as the grease to your ball
bearings things roll and function well
enough but a little grease makes them
roll a lot smoother and last a lot
longer
the second function which is arguably
(07:53):
just as critical if not more so is that
the synovium is responsible for
nourishment of the articulating surfaces
I didn't mention this earlier but
connective tissue is known pretty
universally to have poor circulation
the tissue is non-contractile meaning it
doesn't Flex or relax so it doesn't
(08:13):
really have much in the way of energy
needs so it doesn't get a lot of
circulation
what this also means however is that
when it sustains damage it's also slow
to repair to further complicate the
system the knee joint moves
this is not a good space to have blood
vessels running as they would get
pinched damaged and crushed from the
(08:34):
normal functioning of the knee
so how else is a knee joint supposed to
get nutrition
The Joint capsule and synovial fluid are
quite unique The Joint capsule is highly
vascular vascularized so all the blood
vessels in a sense surround the knee
joint courtesy of the capsule but don't
go into it fluid carries nutrition and
(08:55):
metabolic waste along with being the
lube
this means when the fluid gets near the
surface of the joint capsule it
exchanges whatever metabolic waste it's
carrying for nutrition
and when the fluid makes its way back
from the surface of the capsule down
into the knee joint it exchanges that
nutrition it's carrying with the
articulating surface cells and picks up
(09:17):
metabolic waste that those cells of the
meniscus ligaments cartilage and Bone
naturally produced by doing their
business this in essence is how the
cells in the knee survive
this is pretty much a critical piece of
information we'll need for the tail end
of our segment now
let's talk about how movement can be a
Saving Grace for each of our
(09:38):
aforementioned scenarios
firstly there's probably little you're
going to be able to do to resist getting
hurt when someone tabletops you in a
contact sport or you suffer an acute
injury like an MMA kick to the knee or
someone skiing into you however
in the scenario with stepping off the
curb funny a couple factors are taken
into play
one is the health of the joint
(09:59):
remember we said that was a great way to
Shear the meniscus
if the meniscus has been compromised
over time due to lack of nutrition
it only makes sense that it's integrity
and thus function would be compromised
leading it to provide less resistance
and make it more susceptible to injury
so that synovium I just got done
describing let's double back a second
(10:20):
and discuss how that system can go wrong
visualize if you will a small balloon
filled with fluid but with your knee
inside and femur and tibia sticking out
of it you pretty much have the capsule
visualized now we talked about how
nutrition and metabolite transfer but
one point we didn't talk about was what
makes the whole system work is motion
(10:42):
motion is what causes the fluid to
circulate
and run its grocery route if you will
without motion the fluid becomes
stagnant
the fluid is stagnant it cannot transfer
the nutrition from the surface
or metabolite away from the tissues in
essence the bone and tissues on the
(11:03):
inside begin to starve and sit in their
own metaphorical poop I don't know many
creatures or organisms that thrive in a
condition like this and your knee is no
exception
so what begins to happen well your
tissues begin to slowly die
suffice to say they will not be so good
at performing their job very well or
resisting forces so when you're now
(11:25):
performing your normal day-to-day
function and receiving those injuries
they don't heal because they're not
getting nutrition and arthritis begins
to collect
because inflammation is a necessary part
of the healing process but without any
nutrition to carry the healing process
forward it stays stuck in the
inflammation mode
so now events that might have been
(11:46):
unfortunate stumbles have the
possibility of becoming acute injuries
this lays the groundwork for not only
our active injuries but even our
Insidious degenerative ones at face
value it makes sense that being
sedentary and not moving much would lead
to poor circulation within the knee and
thus a slow march to arthritis and
degenerative knee joints active
(12:06):
degeneration is not that simple
for our one-trick ponies I'll use
runners in this example because they are
famously notorious for it
repetitive motion injuries occur only
when a small part of the joint sees all
of the action
and with something like running the knee
itself does not need to bend very far so
what range of motion it is getting pales
(12:28):
into comparison to something like doing
a full squat
since the same surfaces of the knee are
always in contact the synovial fluid
cannot get in there to re-lubricate or
swap nutrition and metabolites coupled
with the stress of being load-bearing
and slowly wearing away
from a lot of volume it becomes a recipe
for a slow deterioration of the
(12:50):
articulating surfaces of the knee
as for our ligaments
some exist inside the capsule some
outside but they all fall under one very
special law in our body called Davis's
law
not a postulate or a theory mind you but
a law in science is pretty absolute
Davis's law states that soft tissues
(13:12):
model along lines of forces translation
if I take a healthy tissue and I pulled
a bunch say from north to south
as
it continues along its life cycle it
will lay down more tissue during its
remodeling steps to resist forces
specifically from north to south
(13:33):
further soft tissues and ligaments do
get stronger with training albeit about
three times slower than muscle does
courtesy of the type of tissue and
lesser amount of circulation compared to
its contractile brethren this means that
with appropriate consistent loading it
is possible to strengthen ligaments and
tendons now if I'm sedentary
(13:55):
how am I loading that connective tissue
and the answer to that 100 million
dollar question is you aren't so I'll
use the phrase if you don't use it you
lose it
now that we've given some mechanism
behind how poor movement or poor
movement Choice can lead to recipes for
failure let's discuss how to be
(14:16):
successful
first and foremost improving your range
of motion I won't pretend like the
majority of our population can drop into
a proper full Squad at will most of us
actually shouldn't
at our current stage in life given that
there likely exists a myriad of
complicating factors that might actually
lead you to getting injured so what's a
deconditioned human to do for starters
(14:37):
you need to begin by identifying the
hurdles that are keeping you from
getting into a full squat
before getting into some at-home tips
I'll begin by prefacing with this these
suggestions are not meant to be
all-encompassing and by no means replace
a careful eye of a certified trainer or
physio if you have a pre-existing
condition that might make any of the
following problematic you should consult
(14:58):
with an appropriate physician first
with that said the first step is to
Simply sit down or lie back on the couch
or bed
hug your knee while trying to bring your
heels to your butt using your hands if
you have to to give them a big hug
what Sensations jump out at you you have
pain in the knee around the knee above
the knee inside or medially outside or
(15:21):
laterally
second what does that sensation feel
like is it a sharp shooting pain does it
feel like electricity does it just feel
tight
typically in middle age to younger
populations most knee pain is brought
about by previous injury muscle tension
or muscle imbalances possibly scar
tissue from the injuries muscle tension
(15:42):
slash imbalances slash Scar Tissue can
be felt around the knee from which the
muscles and or tendons run
injuries can leave behind Scar Tissue
which can do the same unless of course
it was an internal knee injury like a
meniscus care or ligament tear if this
is the case starting with some good soft
tissue work like foam rolling trigger
(16:03):
point and all the like can help reduce
tension pulling on the knee and the
tendons preventing it from accessing its
full range of motion if appropriately
identified and addressed you can see
marked improvements in pain reduction
and range of motion with maybe a five to
ten minute bout of soft tissue work if
it was truly a muscular problem
(16:24):
for our middle age to older population
you might feel what I would describe as
a diffuse pressure or a deep stretch
coming from within or sort of spread
throughout the knee no one particular
spot but just kind of in a general area
this sensation can be indicative of the
knee capsule itself losing its
elasticity over time from neglect this
(16:47):
will take a bit more time and diligence
to overcome capsules don't tighten
overnight so they won't loosen overnight
either
if they're going to bounce back you're
going to need to give it time and
attention doing this knee-high drill
throughout the day potentially more on
one knee if you have only the one knee
problem we'll gradually reintroduce and
(17:08):
encourage range of motion at the joint
and capsule the very least you'll be
opening the knee joint more and exposing
some of the surfaces to allow the
synovial fluid to do its job
it should go without saying that a
strong case for arthritis in the knee is
the inflammation is indicative of the
body trying to heal damaged tissues if
(17:28):
there's damage the body will need
nutrition and without adequate synovial
fluid circulation those arthritic
tissues inside the knee won't be getting
much help
my recommendation would be doing about
three to five hugs in about or a moment
in time
anywhere from three to five times a day
especially if you're already seated this
(17:50):
is something you can do at rest
the lying knee hug is a respectable
movement because we're able to create
passive unloaded knee flexion with which
you are 100 in control of the motion and
potential stretch and whatever
accompanying Sensations it also allows
us to isolate the knee joint without
having to worry about other factors
(18:10):
impeding our emotion like ankle or hip
mobility
it seems silly but having a simple safe
reproducible movement
can have profound impact on the knee
functioning with understandable
mechanisms that a large majority of the
population can utilize
is about as low hanging a fruit as
anyone could ask for in terms of
(18:31):
improving the health in terms of
progression
for those that are a bit more athletic
we would then turn our attention to
quite quickly assessing how to get into
that squat specifically the Deep squat
if you are able to employ a deep squat
during your day-to-day you will be by
far better equipped to help Stave off
injury and degeneration than your
(18:52):
average couch potato we'll probably need
to dedicate an entire episode to
correctly performing a deep squat but
for time's sake the Deep squat utilizes
the full range of motion of the knees
loads the knee completely and throughout
to keep the ligaments and tendons in use
to prevent atrophy
and it is simply insanely handy to use
on a day-to-day basis the funny thing
(19:13):
about functional fitness is you don't
realize how functional a movement is
until you have it in your tool belt I'm
sure there's a large contingent of
people out there who'd love to argue
I've made it X number of years without
ever having been able to squat all the
way down and I can tell you from getting
pots out of the back of my kitchen
cabinets lifting my children helping put
on their shoes being able to squat when
no chair is available for my son's
(19:34):
karate class and gardening the squat has
been insanely functional at least for me
and my wife as always I'll leave you
with the tldr for today knee injuries
can happen catastrophically or
insidiously and can create an injury
through a number of different mechanisms
many knees are inured or set up to be
(19:55):
injured through our own neglect of their
design needs motion is essential for
knee health and it is through motion
that we can make sure tissues stay
nourished and range of motion is not
compromised as we in the training
industry like to say motion is lotion
the knee hug is an incredibly low risk
movement that does not take any
equipment training space or much time to
(20:17):
execute this can also be somewhat of an
indicator of how healthy New York knees
are and potentially shed light on any
problems that may be lurking if you can
perform a full knee hug with no pain
stretch or pressure I would encourage
you to look into incorporating full
squats in your day-to-day
it does require so many other things to
(20:37):
perform but being able to do a full
squat is a Hallmark of keeping these
healthy that concludes our topic on knee
health and at-home movements for the
knee
as always we would love to hear your
questions comments feedback and requests
from you so please send those thoughts
to info
primedy.org and as always strength comes
(20:58):
in many forms from within and without so
be strong to be useful until next time
welcome to primady where we find simple
techniques to help address modern
problems for our primitive bodies my
name is Andrew pafford and I'm a health
and wellness professional with over a
decade of experience helping Olympic
level athletes desk jockeys and seniors
achieving their goals and improving
their quality of life
for our topic today I wanted to discuss
knee health
(00:21):
topic is a very broad overreaching topic
that can have many causes however the
vast majority of us are guilty of one
big thing that can pile on to the Myriad
of other reasons that can cause knee
issues and we'll discuss what those are
and how this big faux pas contributes to
each I won't do what many do and save
the big reveal for the end because I
(00:42):
don't like stringing people along and
I'm just not that patient the big No-No
I'm talking about is motion or in this
case lack thereof
simple beautiful god-given motion of the
knee this does come with a subtle caveat
but yes moving the knee joint plays a
huge role in knee health
to elaborate on the mechanisms with
which we can better utilize to ensure
(01:03):
knee Health we'll touch base on the
anatomy of the knee different way
different ways our knees tend to go bad
and how proper full motion of the knee
can be utilized to help keep our knees
healthy and working
first and foremost rudimentary
explanation of the knee the top of your
shin bone the tibia is actually a
(01:23):
plateau that has two grooves for the
bottom of your thigh bone the femur to
rest and move on
in kinesi talk we call this articulation
when two bones tend to move together
on the plateau of the tibia you have
rubbery discs called meniscus to provide
cushion for the femur and to protect the
(01:43):
top of the tibia equally
the part of the femur that meets the
tibia known as the epicondials are also
covered in cartilage this protects the
articulating surface of the femur and
prevents undue friction imagine rubbing
two smooth surfaces together versus
rubbing two rough surfaces together
smooth surfaces will last a lot longer
(02:05):
because there's a lot less surface
friction going on to do damage
finally your knee has a handful of
ligaments that help hold it in place so
that the femur does not slip off its
plateau and voila a horribly reductive
description of the knee now
all the fun and terrible ways that knees
like to go bad
first and foremost we have a torn
(02:26):
meniscus
but this guy I've been known to tear and
typically in creative ways it can be as
sexy as being tackled from the side
while playing football or something as
mundane as stepping off a curb by
accident
what what does the damage is what's
known as Shear Force think exactly like
a pair of scissors or shears you have
two forces in this case the blades
(02:48):
coming from two opposite trajectories
we'll apply this to the bad curb step
metaphor
when you suddenly slip off a curb your
body weight
is what is causing you to fall to Earth
currency gravity your foot hits the
ground first so reactive forces are now
coming up
(03:09):
but the rest of you is still falling
since you likely slipped to your side
your femur is being pulled just slightly
to the side so your femur is being
driven down and to the side and your
tibia which is hit the ground is being
driven slightly in and up with this
Shear Force that's now happening the
meniscus was not designed to handle
(03:30):
horses side to side rather forward and
back or subtle grinding motions at a
normal knee range of motion entails as
such structures give and boom important
meniscus
second way injuries tend to happen to
the knee is ligament tears the handful
ligaments that I mentioned that hold the
knee in place those two are susceptible
to Shear forces I'm sure anyone who's
(03:51):
watched or played football or as we
called it America soccer
has heard of or seen someone tear their
ACL or MCL those are shorthands for
anterior cruciate ligament and medial
collateral ligament well same science as
the meniscus tears those ligaments are
meant to resist forces along the lines
of their fibers not across the fibers
(04:12):
and since Shear forces mean going
against the grain well then things tear
now the Third Way is actually kind of
the same but the mechanism is in two
different ways so we'll call the third
and fourth way
the Third Way is technically an active
way to get a knee injury
however it's a little more what we would
say Insidious meaning there's no obvious
(04:34):
sign or there's no clear action that
initiated the injury when you step off
the curb funny and your knee goes out
you know it was stepping off the curb
this is you wake up one morning and
suddenly your knee is angry at you you
don't know why that's what we mean by
Insidious this first type of
degeneration we'll call Active
degeneration this is particularly for my
(04:56):
over trainers and one trick pony
athletes for example if you've been a
runner most of your life
but now that you've hit your 30s 40s or
50s and you're starting to feel the
ravages of time on your knees well it
might have been your training all along
but my training hasn't changed you
exclaimed correct it hasn't
but you have as we age things tend to
(05:19):
slow down we're still quite capable of
getting the job done however we need a
little more time to do things like allow
our tissues to recover our metabolism is
not as fast as it used to be and that
includes tissue repair
this means you aren't going to bounce
back as fast from those long runs yet
you're still going out and putting miles
on those knees so when you're training
(05:40):
outpaces your maintenance you can expect
to start getting some aches and pains
along the way
this can also result in a possible torn
meniscus if allowed to go on long enough
but typically you'll see arthritis and
possible degeneration in the articular
cartilage of the femur that we talked
about before
so now finally for the fourth cause
we'll have what all the passive
degeneration this is for my homies in
(06:03):
their golden years when you get to enjoy
retirement and find yourself on your run
more than ever you aren't going to do
anything terrible to your knees but your
knees still feel terrible what gives
this is good old arthritis you feel
sitting in and you're not alone
according to the CDC one in two adults
means 50 percent of adults age 65 and
(06:26):
older report being diagnosed with
arthritis
further in another study that involved
480 adults who reported having knee pain
50 percent had Imaging to show that they
indeed had arthritis
suffice to say knee pain and arthritis
are quite prevalent in a population that
very much likely isn't picking up soccer
games on the weekends well we have great
(06:49):
news we can stop all that with adequate
movement
all right I already gave up the big
reveal but how can move and address all
these problems that seem to be widely
varying mechanisms of injury
well let's talk movement and a little
bit more important Anatomy that I left
out that will play a huge factor in how
the knee can stay healthy as I mentioned
(07:10):
earlier we give a very reductive
description
but I also have that one huge piece of
anatomy for our purposes today called
The Joint capsule
The Joint capsule is very much what it
sounds like a bag made of connective
tissue that encapsulates the joint you
see in addition to the meniscus and
cartilage to reduce friction your knee
cap your knee joint capsule is filled
(07:33):
with fluid called synovium synovium
provides two crucial functions first is
lubrication
think of this as the grease to your ball
bearings things roll and function well
enough but a little grease makes them
roll a lot smoother and last a lot
longer
the second function which is arguably
(07:53):
just as critical if not more so is that
the synovium is responsible for
nourishment of the articulating surfaces
I didn't mention this earlier but
connective tissue is known pretty
universally to have poor circulation
the tissue is non-contractile meaning it
doesn't Flex or relax so it doesn't
(08:13):
really have much in the way of energy
needs so it doesn't get a lot of
circulation
what this also means however is that
when it sustains damage it's also slow
to repair to further complicate the
system the knee joint moves
this is not a good space to have blood
vessels running as they would get
pinched damaged and crushed from the
(08:34):
normal functioning of the knee
so how else is a knee joint supposed to
get nutrition
The Joint capsule and synovial fluid are
quite unique The Joint capsule is highly
vascular vascularized so all the blood
vessels in a sense surround the knee
joint courtesy of the capsule but don't
go into it fluid carries nutrition and
(08:55):
metabolic waste along with being the
lube
this means when the fluid gets near the
surface of the joint capsule it
exchanges whatever metabolic waste it's
carrying for nutrition
and when the fluid makes its way back
from the surface of the capsule down
into the knee joint it exchanges that
nutrition it's carrying with the
articulating surface cells and picks up
(09:17):
metabolic waste that those cells of the
meniscus ligaments cartilage and Bone
naturally produced by doing their
business this in essence is how the
cells in the knee survive
this is pretty much a critical piece of
information we'll need for the tail end
of our segment now
let's talk about how movement can be a
Saving Grace for each of our
(09:38):
aforementioned scenarios
firstly there's probably little you're
going to be able to do to resist getting
hurt when someone tabletops you in a
contact sport or you suffer an acute
injury like an MMA kick to the knee or
someone skiing into you however
in the scenario with stepping off the
curb funny a couple factors are taken
into play
one is the health of the joint
(09:59):
remember we said that was a great way to
Shear the meniscus
if the meniscus has been compromised
over time due to lack of nutrition
it only makes sense that it's integrity
and thus function would be compromised
leading it to provide less resistance
and make it more susceptible to injury
so that synovium I just got done
describing let's double back a second
(10:20):
and discuss how that system can go wrong
visualize if you will a small balloon
filled with fluid but with your knee
inside and femur and tibia sticking out
of it you pretty much have the capsule
visualized now we talked about how
nutrition and metabolite transfer but
one point we didn't talk about was what
makes the whole system work is motion
(10:42):
motion is what causes the fluid to
circulate
and run its grocery route if you will
without motion the fluid becomes
stagnant
the fluid is stagnant it cannot transfer
the nutrition from the surface
or metabolite away from the tissues in
essence the bone and tissues on the
(11:03):
inside begin to starve and sit in their
own metaphorical poop I don't know many
creatures or organisms that thrive in a
condition like this and your knee is no
exception
so what begins to happen well your
tissues begin to slowly die
suffice to say they will not be so good
at performing their job very well or
resisting forces so when you're now
(11:25):
performing your normal day-to-day
function and receiving those injuries
they don't heal because they're not
getting nutrition and arthritis begins
to collect
because inflammation is a necessary part
of the healing process but without any
nutrition to carry the healing process
forward it stays stuck in the
inflammation mode
so now events that might have been
(11:46):
unfortunate stumbles have the
possibility of becoming acute injuries
this lays the groundwork for not only
our active injuries but even our
Insidious degenerative ones at face
value it makes sense that being
sedentary and not moving much would lead
to poor circulation within the knee and
thus a slow march to arthritis and
degenerative knee joints active
(12:06):
degeneration is not that simple
for our one-trick ponies I'll use
runners in this example because they are
famously notorious for it
repetitive motion injuries occur only
when a small part of the joint sees all
of the action
and with something like running the knee
itself does not need to bend very far so
what range of motion it is getting pales
(12:28):
into comparison to something like doing
a full squat
since the same surfaces of the knee are
always in contact the synovial fluid
cannot get in there to re-lubricate or
swap nutrition and metabolites coupled
with the stress of being load-bearing
and slowly wearing away
from a lot of volume it becomes a recipe
for a slow deterioration of the
(12:50):
articulating surfaces of the knee
as for our ligaments
some exist inside the capsule some
outside but they all fall under one very
special law in our body called Davis's
law
not a postulate or a theory mind you but
a law in science is pretty absolute
Davis's law states that soft tissues
(13:12):
model along lines of forces translation
if I take a healthy tissue and I pulled
a bunch say from north to south
as
it continues along its life cycle it
will lay down more tissue during its
remodeling steps to resist forces
specifically from north to south
(13:33):
further soft tissues and ligaments do
get stronger with training albeit about
three times slower than muscle does
courtesy of the type of tissue and
lesser amount of circulation compared to
its contractile brethren this means that
with appropriate consistent loading it
is possible to strengthen ligaments and
tendons now if I'm sedentary
(13:55):
how am I loading that connective tissue
and the answer to that 100 million
dollar question is you aren't so I'll
use the phrase if you don't use it you
lose it
now that we've given some mechanism
behind how poor movement or poor
movement Choice can lead to recipes for
failure let's discuss how to be
(14:16):
successful
first and foremost improving your range
of motion I won't pretend like the
majority of our population can drop into
a proper full Squad at will most of us
actually shouldn't
at our current stage in life given that
there likely exists a myriad of
complicating factors that might actually
lead you to getting injured so what's a
deconditioned human to do for starters
(14:37):
you need to begin by identifying the
hurdles that are keeping you from
getting into a full squat
before getting into some at-home tips
I'll begin by prefacing with this these
suggestions are not meant to be
all-encompassing and by no means replace
a careful eye of a certified trainer or
physio if you have a pre-existing
condition that might make any of the
following problematic you should consult
(14:58):
with an appropriate physician first
with that said the first step is to
Simply sit down or lie back on the couch
or bed
hug your knee while trying to bring your
heels to your butt using your hands if
you have to to give them a big hug
what Sensations jump out at you you have
pain in the knee around the knee above
the knee inside or medially outside or
(15:21):
laterally
second what does that sensation feel
like is it a sharp shooting pain does it
feel like electricity does it just feel
tight
typically in middle age to younger
populations most knee pain is brought
about by previous injury muscle tension
or muscle imbalances possibly scar
tissue from the injuries muscle tension
(15:42):
slash imbalances slash Scar Tissue can
be felt around the knee from which the
muscles and or tendons run
injuries can leave behind Scar Tissue
which can do the same unless of course
it was an internal knee injury like a
meniscus care or ligament tear if this
is the case starting with some good soft
tissue work like foam rolling trigger
(16:03):
point and all the like can help reduce
tension pulling on the knee and the
tendons preventing it from accessing its
full range of motion if appropriately
identified and addressed you can see
marked improvements in pain reduction
and range of motion with maybe a five to
ten minute bout of soft tissue work if
it was truly a muscular problem
(16:24):
for our middle age to older population
you might feel what I would describe as
a diffuse pressure or a deep stretch
coming from within or sort of spread
throughout the knee no one particular
spot but just kind of in a general area
this sensation can be indicative of the
knee capsule itself losing its
elasticity over time from neglect this
(16:47):
will take a bit more time and diligence
to overcome capsules don't tighten
overnight so they won't loosen overnight
either
if they're going to bounce back you're
going to need to give it time and
attention doing this knee-high drill
throughout the day potentially more on
one knee if you have only the one knee
problem we'll gradually reintroduce and
(17:08):
encourage range of motion at the joint
and capsule the very least you'll be
opening the knee joint more and exposing
some of the surfaces to allow the
synovial fluid to do its job
it should go without saying that a
strong case for arthritis in the knee is
the inflammation is indicative of the
body trying to heal damaged tissues if
(17:28):
there's damage the body will need
nutrition and without adequate synovial
fluid circulation those arthritic
tissues inside the knee won't be getting
much help
my recommendation would be doing about
three to five hugs in about or a moment
in time
anywhere from three to five times a day
especially if you're already seated this
(17:50):
is something you can do at rest
the lying knee hug is a respectable
movement because we're able to create
passive unloaded knee flexion with which
you are 100 in control of the motion and
potential stretch and whatever
accompanying Sensations it also allows
us to isolate the knee joint without
having to worry about other factors
(18:10):
impeding our emotion like ankle or hip
mobility
it seems silly but having a simple safe
reproducible movement
can have profound impact on the knee
functioning with understandable
mechanisms that a large majority of the
population can utilize
is about as low hanging a fruit as
anyone could ask for in terms of
(18:31):
improving the health in terms of
progression
for those that are a bit more athletic
we would then turn our attention to
quite quickly assessing how to get into
that squat specifically the Deep squat
if you are able to employ a deep squat
during your day-to-day you will be by
far better equipped to help Stave off
injury and degeneration than your
(18:52):
average couch potato we'll probably need
to dedicate an entire episode to
correctly performing a deep squat but
for time's sake the Deep squat utilizes
the full range of motion of the knees
loads the knee completely and throughout
to keep the ligaments and tendons in use
to prevent atrophy
and it is simply insanely handy to use
on a day-to-day basis the funny thing
(19:13):
about functional fitness is you don't
realize how functional a movement is
until you have it in your tool belt I'm
sure there's a large contingent of
people out there who'd love to argue
I've made it X number of years without
ever having been able to squat all the
way down and I can tell you from getting
pots out of the back of my kitchen
cabinets lifting my children helping put
on their shoes being able to squat when
no chair is available for my son's
(19:34):
karate class and gardening the squat has
been insanely functional at least for me
and my wife as always I'll leave you
with the tldr for today knee injuries
can happen catastrophically or
insidiously and can create an injury
through a number of different mechanisms
many knees are inured or set up to be
(19:55):
injured through our own neglect of their
design needs motion is essential for
knee health and it is through motion
that we can make sure tissues stay
nourished and range of motion is not
compromised as we in the training
industry like to say motion is lotion
the knee hug is an incredibly low risk
movement that does not take any
equipment training space or much time to
(20:17):
execute this can also be somewhat of an
indicator of how healthy New York knees
are and potentially shed light on any
problems that may be lurking if you can
perform a full knee hug with no pain
stretch or pressure I would encourage
you to look into incorporating full
squats in your day-to-day
it does require so many other things to
(20:37):
perform but being able to do a full
squat is a Hallmark of keeping these
healthy that concludes our topic on knee
health and at-home movements for the
knee
as always we would love to hear your
questions comments feedback and requests
from you so please send those thoughts
to info
primedy.org and as always strength comes
(20:58):
in many forms from within and without so
be strong to be useful until next time
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