I have what you might call bad knees, although you might not know it to look at me.

I can also run, jump and hold xu bu all without any knee pain.

At this point you might be thinking “how do you have bad knees then?”. Surely if it is anything, bad knees means pain when doing movements that put stress on the knee? Let me explain why I have have bad knees, how I manage to train almost every day without any issues and most importantly, how you can too.

My History of Knee Problems

I have a congenital issue with my knees; the groove in the femur is not as deep as it should be, and the ridge on the back of the knee cap not as big. This increases the mobility of the knee cap and can potentially lead to dislocation. I went completely unaware and unaffected by this until a knee injury playing rugby in my teens started a downward spiral. At first one knee was the problem, then over time as the other leg sought to compensate, that knee started having issues too. Some periods were better than others, but at its worst, my knees would hurt from any extended period of walking, they would give way unexpectedly and at times my right knee would stiffen up and feel as if the only way to release it would be to click my knee joint by moving it in the wrong direction!

Despite all this I decided to start training Kung Fu, definitely in one of my better periods. My knee certainly affected my training, sometimes I would miss training, or not be able to do as much I would like because of my knees. A few years in I went through a particularly bad period, which was affecting my work, and I got sent to a physiotherapist. It was here that I learned about my knee issues, and that the prescribed treatment of rest, which I’d received from multiple doctors over the years, was in fact the exact opposite of what I should be doing. I don’t blame the doctors, a GP can’t be an expert in everything, but this encounter with a physiotherapist completely changed my view on my knees and how to treat them. Rather than training Kung Fu less, I needed to be training more.

Now, many years on, I still have bad knees; if I stop training for a few weeks they will start to ache as I walk up hills. Now I know what the problem and treatment is though, and I don’t let it get beyond that point.

How to Combat Knee Pain

The Basics

Let me first make it clear that I’m not claiming that what I describe below will fix everyone’s knee problems; there are far too many different types of issues out there. However, I know that it can help, I’ve used it to help others before and I know a number of people who have had to deal with knee issues which have been different from mine.

A lot of joint pain issues develop from muscle weakness, tightness or imbalance. This needn’t be directly related to the joint you are having issues with. It could equally be caused by something further along the kinetic chain. Weak shoulders can lead to RSI in the wrists, weak glutes can lead to extra strain on the knee etc.

The first thing to bear in mind is that if you have had an injury, make sure you do rest up. The usual rest, elevation and ice will help the initial recovery. Don’t go doing intense exercise on something which hasn’t had a chance to heal. When you do first start getting back into training, I highly recommend some form of support, to make the start of the process a little easier on your body. I generally go for K tape, as it offers more freedom of movement than a bulky support, and I’ve found it more effective than neoprene supports. This is especially important when we are talking about fixing knee pain; we want that full range of motion available to us.

From here we start slow, and build our way up to the more difficult exercises. The first thing which you want to make sure you are doing regularly is stretching you quadriceps, hips and glutes. A major source of pain and injury can be tightness in the surrounding muscles, so we want to eliminate the possibility of that. I recommend stretching at least three times a week, ideally every day, just for a minute each muscle. If you’re unsure about the best way to stretch these, you can find some guidance here: (1) Stretching for flexibility, mobility and injury prevention - YouTube

Next we want to work on the stabilising muscles in the knee joint. A great way to do this is to stand on some cushion or pillows with one leg; just enough so that you are a little unstable and can only just feel the floor. From here throw a ball or some rolled up socks against the wall and try to catch it whilst staying on one leg. The upper body movement will affect your balance, forcing your stabilisation muscles to work extra hard. Do this for a few minutes on each leg every day.

Another great way to build up these muscles is to walk backwards. We train our legs to move forwards every day, but being able to take the strain in backwards motions is important too. To do this just periodically incorporate a few minutes of backwards walking into your day. Once you are comfortable with this, you can even up the intensity to include some backwards running.

Now we want to work on the strength of the major muscles around the knee. At this point we need to start slow and work our way up, don’t jump into the enxt exercise until you are comfortable with the latest one you have incorporated.

Strength Exercises

The first exercises to incorporate come as a group of five and you are going to do them three times a week. Start slow with each of them and slowly build up the difficulty as you get stronger. You should be able to do them without any pain if you start gently. If you do experience some pain ease off, make the exercise easier, maybe do slightly fewer repetitions to begin with.

Tibialis Raises (25 repetitions)- Stand with your back to a wall, lean back so that your upper back touches it and step your feet away, keeping a straight body line. The further your feet are from the wall, the harder the exercise is, so start quite close and work your way out a little further with each session. Starting with your feet flat on the floor, lift your toes up towards your shins, using your heels as the pivot point. This will seem easy at first, but you will soon feel it! This exercise will strengthen the front of your lower leg and help to protect your knee as it moves into greater ranges of motion.

Bent Leg Calf Raises (25 repetitions)- Stand facing a wall, with your hands placed on it for balance and bend your legs slightly. The more you bend your legs, the harder this exercise becomes, so start with a very gentle bend, knees still behind your toes. As you get stronger you will want to start moving the knee over and eventually beyond your toes. Once your knees are in position, make sure that your hips are in line with your knees, you want your thighs to be vertical, not sloping backwards. From here perform slow calf raises, keeping that straight vertical line between your knees and hips.

Patrick Step (10/15/20/25 repetitions each side)- This exercise is a bit more difficult. The first two you should be able to start pain free, but this one may cause you issues. Because of that I recommend you start with fewer repetitions, and work your way up each week. Stand side on to a wall, place your hand on it for balance and lift the nearest foot off of the floor, keeping your leg straight. The higher you lift the foot the harder the exercise becomes, so keep it quite low to begin with. Bend your other leg, keeping your body upright, until the heel of your lifted foot touches the ground and then come back up again. Once you have done all of your reps, repeat on the other side.

Clam Shells (25 repetitions each side)- Lie on your side, slide your knees towards your chest, bending your legs to about 90 degrees. Next, open up your hips, keeping your feet touching. Your upper most knee should reach up into the sky. Try to engage your hips and glutes to open as far as you can and then close again. This will strengthen your outer glutes, which can be very important for stabilising the leg.

Glute Raises (25 repetitions)- Lie on your back, place your feet flat on the floor, with your legs bent. Squeezing your glutes, lift your hips up towards the sky. Try to get a straight line along your thighs and torso. Keep the hips engaged all the way up, pause, and then drop back down. This will strengthen the main part of your glutes.

Eventually you will be able to do tibialis raises quite far out from the wall, your knees will be past your toes in the calf raises, and you will be getting a full leg bend in the Patrick steps. If you can do all of this without pain, it is time to start incorporating other exercises.

Next Steps- Kung Fu

The first thing I would introduce next is a Patrick step with a resistance band. Loop the band around the back of your knee and anchor it to something in front of you. Adjust the tightness so that you are getting some resistance as you straighten your leg. This will help to further strengthen the muscles around the knee.

Now comes the hard work and the real Kung Fu. To really strengthen your legs, glutes and the muscles around your knee, xu bu is the perfect position. It is also quite demanding, which is why we are leaving it until last. Trying this too early could exacerbate your knee pain. If you are training Kung Fu anyway, and need to do xu bu, I recommend doing a very high version until your knees are strong enough to take it. If you are unsure on how to do xu bu properly, you can watch this video: https://youtu.be/E0jJhMek7DA

You might notice that this is incorporating some of the elements we have already looked at. The knees go over or even beyond the toes as we drop down, we shift our weight backwards a little and we lift our torso up, forcing us to engage our glutes to maintain balance.

To train your xu bu you have a few options. Many people just hold it, and whilst this is a great way to build up your leg strength, to really work on the knees and to make sure that we are working our way down into the lower depths we need to incorporate some other exercises. I would do these in addition to your other exercises.

Xu Bu Drop (10 repetitions each leg)- Start by standing, all of your weight on one leg, and then slowly drop down as low as you can go. Pause and then come up. As time goes on try to get lower and lower. Once you are getting your thigh close to parallel with the floor, of you hit a block and you can’t get any lower, start increasing the number of reps.

Xu Bu Chair Sit Ups (10 repetitions each leg)- Sit down on a chair, position your feet as if you were in xu bu; one close to the chair, one further away. Lean forward and using the slight momentum that gives you sit up off of the chair, all of your weight going on to one leg. Pause and then sit down slowly. Start with quite a high chair, and slowly work down to a lower one, until you are sitting up into a position where your thigh is nearly parallel to the ground. This will work the most difficult range of motion, when your knee is around 90 degrees. Getting into this position from standing can be very difficult, but by reducing the amount of motion required, and using a bit of momentum, we can get into it and work this range sooner than we otherwise might, thereby strengthening our knees to be ready for this position when we can drop down into it.

Conclusions

So, that is my recommended way to fight knee pain. As I said near the beginning of this post, this won’t work for everyone, it does depend on the cause of your pain, but for many of us, weak muscles, imbalances, strains and tightness are a major factor. Give these exercises a go, start slow, build up making the exercises harder, adding in the newer exercises and increasing the number of reps as you find you can confidently perform them.

If things start to really hurt, ease off, take a few days to recover, then get back to it with a little less intensity. Listen to your body! If you ache, that’s fine, your muscles will probably be sore from the work, but sharp pains are definitely bad. You may find that you have to work through some joint ache to get the initial strength, but try to recognise the difference of a joint that isn’t used to the work you are putting it through and a joint that is being damaged, I really don’t want you to be exercising through the pain.

I hope you find this regime useful, and although it will take a little while, it should be a big help to a lot of you. I’d love to hear how you get on.

Stay fit,

Damien