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How to Grow Strong Knee Joints

[ read time ~ 6 minutes ]

I grew up in the Midwest, and my grandma had an exceptional garden. She did not rush the harvest of the corn, green beans, lettuce, radishes, or zucchini. But she did optimize their growth.

She planted marigolds near the tomato plants to discourage pests. And she fertilized with what my mom referred to as "black gold" or cow manure. (As a child, I was not impressed by its fragrance, but Uncle Marvin and Uncle Glen assured me that it “smelled like money.”)

These practices did not necessarily speed up when Grandma’s vegetables would be ready to eat, but they did improve the outcomes. Fertilizer increased the size of the produce. And the crop was more plentiful when fewer insects fed on the plants.

My grandma’s gardening wisdom also applies to healing and strengthening knee joints:

  1. Fertilize frequently.

  2. Discourage Pests.

Part 1: Knee Joint Fertilizer

Fertilizing fortifies plants. It creates an environment for them to thrive. Likewise, there are ways to help knees thrive-- methods of supporting and strengthening deep inside the knees.

The Quad Set is an exercise that improves the quality of the fluid inside of knee joints. By tightening the muscles on the front of the thighs, it thickens the joint fluid to provide better cushion and lubrication. Consistently performing Quad Sets -- completing about 10 repetitions, repeating this several times per day, and doing so over multiple weeks -- is also associated with less knee pain.

Another way to “fertilize” the knee joint is by gently moving it. Moving the knee with the right amount of pressure promotes the integrity of the surfaces inside the knee. These surfaces consist of a substance called cartilage. Cartilage covers and protects the end of bones. When cartilage is healthy, it provides a smooth, firm surface for movement to occur. When cartilage weakens, it is softer, and it’s frequently referred to as chondromalacia. (“Chondro-” is latin for cartilage, and “-malacia” means softening.)

Moving with the right amount of force strengthens cartilage by making it more firm.

But if too much force is used during movement, it will cause the cartilage to weaken. For example, if bodyweight squats cause knee pain (during the exercise or even the following day), the force on the knees is harmful. In this case, rather than strengthening the cartilage, the squats are actually weakening or softening the cartilage.

The solution requires making the exercise easier and easier until the knees do not become painful or swollen during or afterwards. In the case of squats, lying on a Variable Incline Plane allows someone to perform the squats with only a fraction of their body weight. For a demonstration, watch this.

Another way to use less body weight during a squat is to sit down and stand up from a chair using arm assistance. This does not not require equipment, but it’s also not as precise because it’s difficult to measure how much assistance the arms are providing. And in many cases of knee pain, the knees demand a decrease in pressure that requires more strength than the arms can produce.

Other methods to achieve knee motion include easy cycling and some elliptical machines, especially those that can be used while sitting. (This one is an example. Note: I have no financial interest in this model or in any of the equipment I recommend.)

Options for gentle knee motion that do not require exercise equipment include sitting in a rocking chair. By resting your feet on the floor while you rock in the chair, a gentle, lubricating motion occurs in the knees. Or many of my clients perform Sitting Sliders by using a furniture mover, a dust cloth, or something that decreases the friction under their feet to effortlessly create knee motion.

All of these forms of knee motion need to feel good or neutral to realize the benefits for the cartilage. If Sitting Sliders are uncomfortable, this video shares five options to improve them.

(For more information on this topic, read my colleague Doug Kelsey’s article How Knee Joint Cartilage Heals; watch my YouTube video How do I Get Rid of Sitting Knee Pain? ; or read my article Can You Rebuild Knee Cartilage?)

Part 2: Eliminate Knee Joint Pests

Pests damage plants. And activities that cause knee pain or swelling damage knee joints. The first step in eliminating the offending activities is identifying them.

Some will be obvious. When knee pain occurs while walking down stairs, sitting at a desk or in a car, and running, these are all aggravating activities.

But other activities are more mysterious culprits. They are difficult to identify when knees feel fine during the activity, but knee pain, and possibly swelling, occurs later.

Someone may hike without any discomfort, but wakes up the following morning with a stiff and sore knee. The initial reaction to the knee pain, when walking from the bedroom to kitchen, may be confusion: “That’s strange. I wonder why my knee is hurting. It was fine yesterday when I was hiking, and hiking is definitely harder than walking in my house.”

Since cartilage doesn’t have nerve supply, there is not an immediate message sent to the brain that the forces -- in this case, from hiking -- are more than the cartilage can withstand. The message is not delivered until hours later, or even the next day, and comes from the inflammation (i.e., irritation) of the nearby joint lining, a tissue that does have nerve supply.

Given this delay in experiencing symptoms, people tend to unknowingly continue activities that hurt their knees. The knee pain fades, they go hiking again, and their knees hurt the following day. This type of pain may become more intense over time.

Regardless of whether the activities causing knee pain are obvious or not, they must be eliminated to facilitate strengthening.

Strong knees and healthy plants are both difficult to achieve when pests are abundant-- even in the presence of good fertilizer.

To learn how some of my clients have strengthened their painful knees, read about Andrew*, Amanda*, Bill*, or Keith*.


My colleague, Doug Kelsey, PT, PhD, and I have developed Better Knees for Life, a program for people with tolerable knee pain. Better Knees for Life offers step-by-step instructions that can be performed at home with very little equipment.

What people are saying about Better Knees for Life :

"...well thought out, easy to understand and implement."

"It is almost like a computer algorithm. (That's how clear it is!)"

"BKL (Better Knees for Life) is an outstanding program -- with graded exercise programs and guidelines for advancing, and outstanding support with the Zoom sessions."

"I've already recommended BKL to 2-3 friends because of the noticeable difference in reducing pain in my left knee."

Better Knees for Life helps you get stronger, feel better and maybe best of all, feel more in control of your life.

To determine if working with me is a good fit for you to strengthen your painful knees, schedule a Strategy Session by clicking here.

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