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Thread: Any advice for "bad knees"?

  1. #1

    Any advice for "bad knees"?

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    I've been fully paleo/primal for about a month now and have been loving it. The only thing that is lacking right now for me is exercise. I'm already very fit, because I was doing a heavy lifting routine (Leangains style) all last year - until my knees started to ache so bad that I limped for a couple of weeks. I saw an ortho, got an MRI, and luckily there's no meniscal tear, but there is definitely pain in the medial meniscus in both knees, as well as the lateral on one (and some swelling there any time I'm active). I've also got chondromalacia patella (cartilage degeneration). And I'm only (just) 33. The only advice my ortho gave me was to lay off of everything for 3 months and then come back and see him (it's almost been 3 months now). I did my research, started supplementing with gelatin for the cartilage issue and started doing physical therapy exercises that I found online. Things started feeling better, I discovered hot yoga and fell in love with it, and a few weeks later, I was back to limping, despite being very careful with my alignment and completely avoiding certain poses.
    I don't buy into what the orthos and physical therapists say about squatting being bad and that we shouldn't do it. I started seeing a physical therapist, but he just did everything by the book and kept insisting that I needed to strengthen my VMO (teardrop on the quad) muscles. I've done a lot of reading about how important the hips and hip flexors are to keep the patella tracking properly (mine currently track laterally, which leads to pain after awhile), and have been working on strengthening my hips. I think I'm going in the right direction, and things start to get better - and then I start taking the stairs at work again on occasion, and maybe doing a little bit of a light run when I'm out walking the dog, and I'm back in pain again.
    I'd love to get some advice from the paleo community about this. Has anyone had similar issues with their knees and gotten back to "normal"? I feel so limited with my activity level and I HATE it. I want to go do some sprints on the beach! Since I fired my PT (which I'm still sure was a great decision), I don't have any guidance aside from what I read on the internet. So, here I am, on the internet, asking for some direction!
    I'm not sure if I should lay off the stairs and runs and things like that completely while I focus on strengthening my hips and trying to get my knees better. I had been just listening to my body, and easing up on anything that hurt at all, but I found out that some things end up not hurting until later. I really miss weighted squats, and deadlifts, and sprints, etc. (Though I've been doing body weight squats with a band just under my knees to keep them from pronating inwards, once or twice a week with out any adverse reactions.) Any advice and/or stories of personal experience with something similar would be greatly appreciated. I want to get out there and have fun!

  2. #2
    Join Date
    Oct 2011
    Edmonton Canada
    Hope your knees sort themselves.
    You might want to see a physio but take a look at [I]Athletic Body in Balance[I] by Gray Cook (I am sure there are other good books out there) but he looks at ways to assess the body either at home or a clinic and suggest ways to stretch and strengthen links. Link the web site here.
    Hope you sort it out it is very frustrating.
    Eating primal is not a diet, it is a way of life.
    Don't forget to play!

  3. #3
    Join Date
    Dec 2010
    Terranora, far north coast NSW, Australia
    Swimming. Have a look at my journal but basically I couldn't do anything due to tendon and ligament damage in my ankles which gave me very sore knees and a bad back. All exercise caused pain. I started swimming in mid August 2011 and have finally found a pain free exercise. I am up to 36 laps 3 times a week and 20-24 the other 2-3 days I go. It takes me 90-120 mins, I'm slow, but I have become much fitter and the best part is I am almost pain free now.

    Just do slow movements int he water at first, even just walking in the water is beneficial. I do aquarobics on the 'short days' at the shallow end of the pool and do my squats and stretches in the water - could never do 'em on land.

    Recommend it!
    F 58 / 170cms / SW 131.5 kgs / Current 112.4/ GW 65
    following Primal Lifestyle and swimming my way to health

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  4. #4
    Join Date
    Aug 2011
    Eden, NC
    If my knees hurt from sitting on a jet too long without moving ( and eating the wrong foods), I use fish oil. It helps relieve the inflamation. Marks fish oil pills work great with no after taste.

  5. #5
    Join Date
    Feb 2011
    Joint Health | Glucosamine | Chondroitin Sulfate | MSM | DMSO | Sock-Doc

    You should probably strengthen all the surrounding muscles as well.

  6. #6
    dado's Avatar
    dado Guest
    squatting will strengthen the muscles around the knee and you will feel so fucking good when you squat

  7. #7
    Join Date
    Nov 2011
    Hi Happy Paleo Girl,
    I have had my fair share of knee issues over the past few years. After being diagnosed with severe arthritis in both when I was 38 ( I'm now 45 ) I had key hole surgery to examine my left knee. There were about 4 things wrong in there including the degenerative wear and tear, including a couple of minor tears in the ligaments which they left alone. The months after the operation I spent building the strength up in my left knee again, to match that in my right, using controlled unilateral leg presses coupled with one legged squats. I also had to patiently increase my range of motion as well, from a few inches, to where I could get my thighs just past parallel, but it took several months. All the while however, I used slow controlled reps, which worked the muscle but didn't place unnecessary force on the joints. 3 seconds on both the concentric and eccentric, I still do something similar today for all my exercises, but go slightly quicker....( 2 seconds ). I avoid exercises that I deem are risky. Anything ballistic is now a no no. I use higher reps on my leg exercises. Recent studies have shown that any number of reps within a reasonable Time Under Tension can lead to strength and hypertrophy gains. I'd rather stick with the higher reps which I feel places less strain on the joints.
    I've moderated my cardio so that it's now either the long slow walking kind of stuff......if I feel my knees I back off....or have a rest day. Or it's short sharp stuff, intervals, keeping the volume low eg 5, 30 second intervals on the treadmill with 30 second rests, working up to 8 over a few weeks then, slightly increasing the speed ( by maybe 0.2 kph ) and coming back down to 5 reps next time. I also use short steady state sessions of 3 to 4 minutes (3 to 5 if it's the exercise bike) once I reach the upper time limit at a speed then I come back down to 3 minutes and start again at a slightly higher speed. Obviously this does not include my warm up time. It's based on a cardio protocol called GXP ( Google it ). I also alternate my cardio and long slow efforts between the treadmill, recumbent, exercise bike and elliptical. I feel this doesn't put the knees under the same stress continually, and the only higher impact one is the treadmill which is kept to a manageable limit. Once again, if the knees flare up, then I back off the Treadmill and emphasize one of the other pieces for a while. I do occasionally do 16 minute efforts ( don't ask me why it's 16....I just came to that number ) on the exercise bike, elliptical or recumbent, trying to maintain a certain pace, a threshold test if you will. I don't do this on the treadmill. I used to, but no longer want to risk it, and as I don't run races like I used to ( my PB for 10K was about 34 and a half minutes in my 20's ) I don't see the need to. The only reason I do it on the other 3 pieces is due to curiosity, and as I said it is only occasionally.
    My knees have had their ups and downs but up till now ( Touch wood ) I have kept my problems under control and managed to remain active.
    I think you have to do a bit of the same self experimentation. Test things out, tentatively, keep a training log, make relevant notes, I do and find this focusses my mind on looking for what works and what doesn't. Keep things that do, drop things that don't. Specific advice is hard to give because people's knee issues, causes and effects can be different. I do one legged squats still....but even though I bought "Convict Conditioning" I would never work to the final step of placing my knee under load for full range pistol. I'll leave that to the people with healthy knees. My desire to be able to do that feat is tempered by my wish to still want to be walking unaided in my old age.
    Hope that this is of help. Good luck with your knees. Please keep us informed of your progress.
    Last edited by UK Guy; 01-27-2012 at 07:18 AM.

  8. #8
    Join Date
    Oct 2010
    Waterloo, Iowa
    what footwear are you using? I had chronic knee pain before i switched to minimalist shoes.

  9. #9
    Join Date
    Mar 2010
    Perth, Australia
    WOW I have exactly the same problem and was told I could swim which i hate. I am an active gym goer and cried for days after hearing this. I rested my lower half for a month (ie no squatting or lunges, did some biking and upper body stuff) and then thought stuff this. I know what aggrevates my knees and that is bodypump (repetitive squats and lunges and a fast pace) and running, yet strangely enough I can do bodyrock workouts which have alot of burpees and and plyo stuff but because its intense short workouts it doesn't seem to bother my knees. They still hurt a bit with walking up stairs so must be that type of movement, but I can still do squats and lunges just not really heavy ones. I think it was the bodypump that was really aggrevating them and the heavyish squatting. I'm just amazed I can jump and skip rope and bodyrock and they feel fine!

  10. #10
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    Quote Originally Posted by stewie97 View Post
    what footwear are you using? I had chronic knee pain before i switched to minimalist shoes.
    All last year I was using New Balance running or cross trainer shoes with orthotic supports in them (the ones from the Good Feet store, which were supposed to help relieve some of the pain from a toe joint issue that I have).
    I actually JUST picked up a pair of Vibram's yesterday and have been wearing them around the house all day. I love the way they feel. I'm generally barefoot at home, so I don't think it will be too difficult of a transition for me. I see they even have some basic black/gray styles with a bit of leather which I could probably get away with wearing in the office.
    I've also just converted to a stand-up workstation, which while I can feel a bit of knee pain after too much time spent standing, I think will be beneficial in the long run with helping me to strengthen my hips and hip flexors, etc.

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