6 Reasons Why You Could Be Experiencing Knee Pain This Winter
“Winter is Here”…and Your Joints Know It! Does Cold Weather Really Cause Knee Pain?
While there is ongoing debate on whether the weather effects joint pain, Harvard Health Publishing (June 2019) of Harvard Medical School, reported on a study presented by the Rheumatology Advisor, that there is a correlation between joint pain and cold weather.
Since we mere mortals have absolutely no control over the weather, what can we do about it?
Fortunately for the billions of people suffering from knee pain specifically and joint pain generally, there are a great many things you can do.
The first thing you can do is lose weight. When you are walking, your heel will land with a force of 1.1-1.5 g’s (g’s = Force of Gravity).
Therefore, at the moment of impact, your heel will feel a force of up to 150% of your body weight.
The knee, however, has a different structure and feels a force of 400% of your body weight.
As a result, losing just 10 pounds, can take 40 pounds off of your knee.
You probably already know that weight loss, fat loss, and weight management have been a popular topic in many of my previous FitBit articles, as well as the many, many Benefits to Losing Weight.
You also know that exercise is a primary modality to my weight loss recommendations, but what do you do when your knees hurt too much to exercise?
If you have knee pain, it can hurt to walk, even at the 1.1-1.5 g’s.
Just the thought of jogging (4.4 g’s) can cause your knees to ache. And running (7.7g’s) brings you nightmares filled with excruciating knee pain.
Therefore, you should consider non-impact exercise like biking, rowing, swimming, or other exercise modes that keep the stress off your knees.
You also need the correct exercise prescription that includes the required IFPA Components of Fitness.
The IFPA Components of Fitness needed to correct most knees pain are:
Body Composition – specifically losing fat and building muscle
Strength – strong muscles support joints and bones
Flexibility – you need a functional ROM around every joint
Symmetry – imbalances in strength/flexibility can cause joint disorder
Before we get to how we correct the joint dysfunctions that causes your knee pain, let us first consider some actions you can take to alleviate knee pain before exercise.
While it is not well understood why cold weather causes knee pain, I will provide you some of my favorite theories.
From these theories, you can take some actions I recommend that may provide some relief…at least sufficient relief, that will enable you to begin the exercise activities, with the hope that these activities will provide you with more sustained relief.
Theory #1 – Cold Weather is going to affect your joints, particularly the joints of your extremities to a much greater extent than other tissues in your body.
Because most tissues in your body are continuously fed by your blood circulatory system, which starts from the left ventricle of your heart that maintains a temperature of 98.6 degrees Fahrenheit (37 degrees Celsius).
Unfortunately, your joints do not receive as much blood flow and parts of the knee capsule, i.e.: meniscus, bursas, ligaments, etc, receive none at all and instead receive nutrients through synovial fluids.
It seems a logical assumption that these synovial fluids, like all synovial fluids in the extremities, will cool faster and have more of a challenge to get warmed-up.
Part of the reason for a Warm-Up before exercise or any athletic or physical activity, is to warm-up these synovial fluids.
Keeping this theory in mind, you should try to keep your knees (and other joints) warm. And before you begin any exercise or other activity involving the knees, do a gradual and thorough Warm-Up.
They were not referring to needing another person helping to pull you up, but the need to use your arms to get up from sitting in a chair.
You should have sufficient leg strength to go from sitting to standing using only your leg strength.
If you cannot, that may be your indicator that your leg muscles are badly atrophied and cannot support your knees adequately. This may be a factor in your leg pain.
Recommendation: Strengthen Your Legs.
Theory #3 – Lack of Symmetry.
You must build your muscles around your knee. Muscles left and right, above and below, front and back, must be symmetrical in strength.
You may never want to build the size and symmetry of a competitive Bodybuilder, but without symmetry in muscular strength, and to some extent muscular endurance, the asymmetrical pull of strong muscles that are not adequately equalized by the opposite side muscles, leads to many knee and other joint dysfunctions.
One common knee dysfunction is caused by muscles on one side of the knee being hypertonic (overly strong and overly tight) and the opposite side being weak and stretched.
This asymmetry can easily pull the patella out of it’s Trochlear Groove.
The Trochlear Groove is a very narrow channel in the knee, that keeps your knees on track during all movement around the knee. Even a slight misalignment of the patella out of the Trochlear Groove can cause impingement and excruciating pain.
Either asymmetrical strength or flexibility can cause this and other dysfunctions, but normally, the strong side is the “tight” side and likewise, the weak side is the “stretched” side.
Therefore, your exercise prescription will typically require strengthening the weak side and stretching the strong/tight side.
Recommendation: consult with a physical therapist or IFPA Certified Medical Fitness Specialist to get a customized exercise prescription.
Theory #4 – Cold muscles will make your hypertonic muscles tighten.
If one side of your knee capsule has an asymmetrical pull caused by hypertonic muscles, you can reasonably suspect the colder muscles will get even tighter….Tight enough to be the Proverbial “Straw that Breaks the Camels Back” and lead to the patella being pulled out of your knee’s Trochlear Groove as described above.
Recommendation: Keep your knees warm, before, during, and after exercise and physical activity.
Exception: if you have known knee dysfunction or pain, then follow the PRICE Prescription detailed in your IFPA Personal Training Textbook or IFPA Sports Medicine Textbook.
Theory #5 – Retrain your Gait.
Inevitably, when you feel any pain from your waist down, it will probably result in a change in your gait.
One of the most confusing things to diagnose about joint pains is determining the first initial cause of your knee dysfunction. A thorough Injury History is essential to pinpointing the origin of the problem.
Your knee dysfunction may be the result of an ankle or foot injury that happened years before, that caused you to change your gait to take pressure off your initial injury, in order to alleviate the pain.
Your “limping” could cause a permanent change in your gait, that could lead to knee or other joint dysfunctions along your kinetic chain.
Recommendation: Sit down and focus on writing a complete and thorough Injury History focusing on the cause of the injury, extent, intensity, and duration of pain/injury. Then follow the advice in (#4) above and see a physical therapist. Afterwards, see a Gait Expert to correct any changes in your gait.
Theory #6 – Get the correct shoes.
Walking shoes can help, but you must get the correct shoes.
Recommendation: See a good podiatrist/shoe specialist, to get the correct shoe for your condition.
Exercise Prescription for the Treatment, Care, and prevention of Knee Joint Dysfunction
Strength Training: 3 Days/Week of a full body strength training program including legs and core training.
Flexibility Training: at least once/day, preferably 3-4 times/day if you have the time and want fast results. Remember: Flexibility Training lasts about 4 hours before muscles begin to return to their previous length, so every 4 hours is ideal.
Symmetry: IFPA Personal Fitness Trainers should refer to their Personal Fitness Training Textbooks, specifically the Symmetry Chart, to develop the strength of all the body’s muscle groups in symmetry.
Since the knee pain is one of the top reasons people visit their doctor, an IFPA Certified Personal Trainer can build a successful personal training business on this one issue alone!
However, my strongest recommendation is for all IFPA Certified Personal Trainers to require their clients to see their doctors FIRST in order to determine the extent and type of damage that has been done.
There will be different treatments required, even among the 3 most common causes of knee pain:
Chronic Degenerative Meniscal Tears
In many cases, the doctor’s early treatment to lessen the patients’ pain may be required before the patient can begin a personal training session.
IFPA Certified Personal Trainers can help many people with knee pain and dysfunction, but working with your personal training clients’ doctors will make you far more effective and much safer.
Never forget IFPA Personal Training Rule #1: DO NO HARM!
Dr. Jim Bell