I read this on a quick plane trip to Boston, and it had some decent points. It is of course very very hard, if not impossible, to diagnose knee problems without an extensive in-person evaluation wth an O.S, D.O, or P.T. And even then, as in my case, it can be impossible to determine a true root cause.

At any rate, Johnson has years of experience in treating knee problems, and has found four main areas that patients can work on to improve the pain level of knees and increase knee functionality:

1. Strength
2. Flexibility
3. Proprioception
4. Endurance

He gives simple exercises for each one — sometimes too simple depending on where you are with your knee and treatment and pain level. For example, on Strength, he uses the very simple “quad press” in which you lie or sit mostly reclined, and press down with extended leg onto a towel. Hold for a few seconds, release, and repeat up to 30 times. Johnson does site research that clearly shows such a simple exercise will increase quad strength over time, so it is a good exercise. But is it enough? That of course depends on where you are…

For flexibility, he lists the tried and true quad stretch, which is one I still use all the time, to try to give my knee cavity more space. I also supplement this with Yoga’s Hero pose. But I think other stretches, beyond just the quad, may be called for depending on your root cause of knee pain. For example, I have a tight ITB (just one of several bio-mechanical problems I have!), so ITB stretches are also part of my routine.

Proprioception is the abilty of your mind to know where and how your leg is placed. Standing on one leg and balancing is the exercise he uses to improve this ability. And if you can do that, try closing your eyes and counting to 30! I have been doing this one for a while, and I do believe it is beneficial. I also supplement it with Yoga’s Tree position. In Tree, you can look at a point in front of you (easier), or look at your finger tips (harder!)

The final item is endurance, and he suggests walking. Walking on a road, on a treadmill, in the water, wherever. I agree with this and have been walking more, though I do miss running. (I am running once or twice a week, up to 30 minutes, but I am so slow compared to before!)

I would add to both strength and endurance by stating that an Electro-stim unit such as the Compex or Globus are beneficial. I just realized I never blogged on my Compex unit, so I will try to do that soon. Briefly, the compex allows me to work on muscle strength and endurance without joint movement. For me, many of the strength exercises proscribed by my PT would irritate my knee. So I’ve been running the strength program on my quads and hams to build up the supporting muscles of the knee, in an effort to help solve some of my knee issues. I have not used the endurance program that often, but I have, and do believe it does help with muscular endurance as well.

Overall this is a quick read, and if you have been dealing with knee pain for some time, and have been trying to solve the problem by working with doctors, PT’s, or on you own, there probably isn’t that much new information here. But it does not hurt to read it, and perhaps incorporate some of his suggestions into your daily routine if you have strayed from any of them.