Sean McCawley, Fit for Life in Napa Valley: Consistent practice for strong knees

"Are the first few minutes of getting out of bed just absolute hell?" my friend Kaus asked me while we were enjoying one of Model Bakery's finest English muffins, which had been toasted and smothered in strawberry jam. Kaus and I take leisurely walks every few weeks, discussing our hobbies, traveling adventures, and current events. I especially enjoy Kaus's thoughts about my professional growth as a business owner and leader among my fellow coaches. He's perpetually fascinated to see our fitness center grow not only as a business but as a culture with more clients, staff, and a presence in Napa's community.

Regarding Kaus' comments about his situation of taking a tour through the underworld first thing in the morning, he happens to be about a decade older than me. Unfortunately, injuries and events in his life have produced musculoskeletal injuries to his joints. Sometimes, his neck, shoulders, lower back, and knees emit pain and soreness throughout the day. He mentioned that he feels like he got shot out of a cannon off a mountaintop first thing in the morning. Therefore, advice on improving his physical well-being is a hot topic when we take our "walk-and-talk" adventures to our favorite eateries.

Joint pain appears in various presentations. Arthritis, osteoporosis, or the atrophy of muscles and connective tissue surrounding joints and bones following the recovery of a substantial injury are just a few examples of suboptimal occurrences influencing the disruption of connective tissue. Bone-on-bone contact and degeneration of cartilage around the articular surface in which joints rub together, pinched nerves, or deconditioned muscles are usual suspects that produce joint pain. For Kaus, it is no surprise he feels this way in the morning when you hear about his former athletic career as a professional biker training for the Olympics. Decades of competitive performance produced shoulder, lower back, and knee pain.

It's challenging for me to relate fully to Kaus' musculoskeletal pain he experiences in the morning because I haven't been on this earth as long as him. He's a decade older than me and has endured 10 years more stress than me. However, I understand that strengthening muscles surrounding critically important joints mitigates pain and increases human performance. Knee joints are among the most common areas that experience discomfort due to overuse and joint degradation. Therefore, knee strengthening and injury prevention concepts can't be overstated. A simple and effective tactic we use with our personal training clients is consistently practicing exercises targeting muscle connective points around the knee joint.

Areas hindered by knee joint pain can occur in the front, back, sides, and within the knee. For individuals experiencing advanced joint pain due to lack of cartilage or weakened tendons and ligaments, shifting knees throughout bending and straightening the knee, lateral movement, and stepping movements can create uncomfortable, loose, and shifty bone movement. As a solution to strengthen those areas, it's essential to identify the muscular attachments that protect areas of the knee prone to loose and shifty joint movements. The hamstrings and hip adductors are two common muscles that act as brackets to hold the knee joint tighter.

The hamstrings originate from the bottom of the hip bone, beneath the butt cheek, and attach below the knee on the back of the shin. Optimizing strength in the hamstring assists in limiting the anterior gliding of the knee and aids in bringing the leg backward throughout walking movements. The hip adductors originate from the groin region of the inner thigh and attach to the inner portion of the knee. Muscular endurance and enhanced structural integrity of hip adductors prevent the knee from shifting past its normal range of motion medially and laterally. Now that we know these muscles are essential to knee strength and mitigating pain, we must identify tactics to apply productive muscular stress via exercise consistently. Below are two exercises we conduct with our personal training clients for one set every during each training session:

Side Laying Hip Adduction: Position yourself on your side with your feet stacked on each other and cross your top leg over to the front of your body, where your top foot should rest flat on the ground. Keeping the bottom foot flexed toward the body and the knee extended, lift the bottom leg until a brief muscular sensation is experienced in the inner thigh region. Repeat this movement for five to 10 repetitions.

Supine Isometric Hip Extension: While flat on your back and your knees bent, press your feet into the ground and lift the hips upward until a brief muscular sensation is experienced in the hamstrings and glutes. Once your hips are extended upward, hold this position utilizing your glutes and hamstrings to stabilize the hips in an extended position for 10 to 30 seconds.

We perform these exercises at the beginning of every training session to induce muscular adaptation and optimize muscular strength and intramuscular endurance.

While it's true that we might feel a few sensations of pain in the morning due to the onset of joint damage throughout life, these symptoms can decrease, and we can feel better. We can reduce sensations of soreness in the morning by consistently practicing simple and effective knee-strengthening routines two to three times a week to reinforce knee health.

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Sean McCawley, the founder and owner of Napa Tenacious Fitness in Napa, welcomes questions and comments. Reach him at 707-287-2727, , or visit the website napatenaciousfitness.com .

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