In this episode Sal, Adam & Justin cover what you need to know to correct knee pain.

   The guy’s worst knee injuries. (1:33)  The myth of overuse. (2:41)  Understanding the root cause of knee pain and how it operates. (3:48)  Defining acute pain vs chronic pain. (7:19)  How the ankle and hip relate to knee pain. (11:59)  Why everyone should squat. (16:46)  The guy’s success rates with clients with knee pain. (18:50)  Why the unlearning process is VERY important. (23:00)  The importance of getting stronger and expanding your mobility education. (24:51)  The BEST knee-protecting movements. (28:37)  The BEST mobility exercises for the ankles and hips. (33:46)    Related Links/Products Mentioned
  Limited time offer exclusively for Mind Pump Listeners ONLY: 50% off the Stress, Mood & Metabolism At-Home Lab Test + Health Coaching Call - Reserve yours today here  July Promotion:  MAPS Starter  |  MAPS Starter Bundle  50% off! **Code JULY50 at checkout** Knee Pain in Adults and Adolescents: The Initial Evaluation Are ACL Tears Really More Common in Women? Mind Pump #1382: Why Everyone Should Squat Improve Your Deadlift with a Single Leg Romanian Deadlift Focus Session The BEST Beginner Lower Body Exercise (LUNGE VARIATIONS) with Sal Di Stefano The Only Way You Should Be Doing Bulgarian Split Squats! (BUTT GROWTH) How To Do The Sled Push The RIGHT Way! (AVOID MISTAKES!) – Mind Pump TV Short Foot Exercise & Foot Activation with Dr Emily Splichal Activate Your Glutes with Tube Walking – Mind Pump TV MAPS Prime Pro Webinar Ask Mind Pump Mind Pump Podcast – YouTube Mind Pump Free Resources

If you want to pump your body and expand your mind, there's only 1 place to go.

With your hosts, Sal DiStefano, Adam Schafer, and Justin Andrews.

You just found the most downloaded fitness, health, and entertainment podcast.

In today's episode, we talk about knee pain, how to make it go away, and how to prevent it.

So we know you're gonna love this episode.

Now it's brought to you by 1 of our sponsors, Dr.

Steven Cabral and his Functional Medicine team.

And right now, they're giving our listeners 50% off the stress, mood, and metabolism test at home lab test.

So with this, they test for things like testosterone, your thyroid, your inflammatory markers, cortisol, Lots of things in this test to find how your body is dealing with its metabolism, your moods, stress.

By the way, this comes with a health coaching call.

So if you're interested, go to stephencabral.com forward slash MP.

That's Stephen, S-T-E-P-H-E-N and then cabral, C-A-B-R-A-L.com forward slash MP.

We're also running a sale right now on some workout programs.

Our beginner workout program, MAPS Starter is 50% off.

And then we have a bundle that includes MAPS Anabolic and MAPS Prime.

If you're interested, go to mapsfitnessproducts.com and then use the code July50 for that discount.

Knee pain is 1 of the most common types of pain that people report.

In today's episode, we're gonna talk about how to fix knee pain, better yet, how to prevent it from ever happening in the first place.

I mean I had I didn't have surgery but I did strain and then slightly tear my MCL, but okay yeah, no cool story.

I had a dislocated kneecap, that's about it.

Mine, 13 years old, playing at a park, playing volleyball with the family.

And I landed weird and my kneecap went out to the side.

It wasn't even like a good play or anything.

We were both going up for a rebound and I leg planted and my leg was straight and he landed on it and just

So what's interesting is I looked up the statistics for how many people report knee pain.

So it's definitely 1 of the most common ones.

And a lot of the, a majority of that is not the kind that we're explaining where you hurt yourself and then it hurts until it heals.

It's like, yeah, it's like I hurt my knee, but that was 10 years ago.

And there's this myth out there that it's overuse, that people will hear that.

It's an overuse, oh, it's because you're using your knees too much.

Here's something that kind of flies in the face of that.

Reported knee pain has gone up 65% in the last 2 decades.

So, and I don't think people are moving more.

They're moving less and yet you're getting more, uh, reported knee pain.

So that right there shows you that it's not because,

well, I mean, I would make the case that that's exactly why it's going.

You know, this, obviously this conversation is, it's spurred from the, you know, this, we just had a caller not that long ago who brought up prime pro and this is not the first time this has happened.

We've actually had this had multiple times where someone has purchased our maps prime pro program, which goes over all the major joints in the body and the mobility movements to it.

And people go, why is there nothing for the knee?

Like, and we normally address it in a short version, uh, when it gets asked, but you know, it's like, you know what, Maybe we should do an episode explaining since this has happened so many times where people don't quite understand why there's not these mobility drills for the knee.

We're not isolating just the knee, like we're looking elsewhere.

Right, yet everybody correlates knee pain as a major issue, So where, okay, what do I do about it?

And very few people understand where it stems from or

Now this, although it's true that oftentimes Joint pain is the result of other things happening in the body, so that that joint ends up operating over time in a way that's not optimal.

With the knee, it's almost always true because the knee is pretty basic in comparison to the joints that are closest to it, the hip and the ankle.

And so this is why, and we're going to talk about this in today's episode, hip and ankle issues are what tend to cause most of the knee pain.

Because if you look at the knee, first off, yes, you need to have strong muscles that support the knee.

So your hamstrings, your quads, or should I say strong stable muscles, right?

Those all should be pretty strong because that helps support the knee.

But the knee is pretty basic in the sense that it really only flexes and extends.

That means you can bend your knee or you can extend your knee.

There are ligaments attached to the knee that prevent it from really doing anything else or that keep it stable.

So like you have like the ACL, PCL that keep it from sliding apart.

You have lateral ligaments like the MCL, LCL that keep it from bending sideways.

The meniscus, which is a shock absorber that prevents it really from twisting too much.

All those things, all those ligaments and cartilage is there to keep the knee kind of stable so that it can.

Trying to keep it in place and it's optimal track.

And then to add a little bit more complexity, you have the kneecap, which kind of floats on top of the femur, the big bone of the leg, and it kind of glides.

If you take a kneecap off and look at it, underneath it, there's cartilage, and it kind of slides over a groove every time you bend and extend your knee.

And if it's not operating optimally, if some ligaments are having to do more work than they're supposed to in terms of supporting, or if the meniscus is constantly being strained because there's stuff going on with the ankle or the hip, or if the kneecap is tracking too hard to the left or the right, then you start to develop chronic problems.

And you can see the issue in the knee oftentimes.

So a doctor can go in and be like, oh, inflammation here in the meniscus, or there's a slight tear, or you have patella chondromalacia, which is underneath the patella where it's all kind of chewed up.

That is, yes, that's 1 of the reasons why the pain is there, but the root issue is that the knee is not operating optimally.

And Again, it has a lot more, most of the time, to do with the hip and the ankle.

I'm glad you went that direction because I also think that there's a bunch of people that get lost in this conversation that don't understand that they fall in the category of this chronic pain because they got diagnosed from a doctor.

They go in and they're told they have tendinitis right bursitis.

They have arthritis and so they think oh This is this isn't something that I could have solved.

This is not something I could have fixed It's like I just got a bad bad draw the cards

I'm getting older and so it's like that but that falls in the category of chronic pain.

In fact, before we had done the episode, I just wanted to see what Google and chat GBT said for like the 10 most common reasons for pain.

And like every single 1 of them were all these, you know, bursitis, the arthritis, the tendinitis, and all the patellar stuff.

Everything is all things that are related to poor movement or weakness in those other joints that then end up causing that.

And so I remember talking to, I would tell clients like when they come in and they, oh, I have really bad knees.

And then I'd say, oh, well, you know, we need to address hip mobility and ankle mobility and strengthen those areas.

My doctor says that I have tendonitis or I have bursitis or I have arthritis and I shouldn't do squatting and I shouldn't do these things.

And I was always trying to overcome that diagnosis from the doctor because it made people believe that they have this thing that they're forever gonna be plagued with and there wasn't something that we can do to address it and potentially eliminate it completely.

Because a lot of people don't understand that just because you get diagnosed with those things doesn't mean that you're stuck with it for the rest of

Yeah, first, okay, we have to differentiate something because common does not mean normal.

So knee pain is common, but that doesn't mean it's normal.

You're not supposed to have chronic pain in your joints.

Your body is very well equipped at regenerating, at lubricating, and at moving, at tamping down inflammation when it needs to, producing inflammation when it needs to.

So it's really good at these things, but if things are moving in suboptimal ways over time and you're overcoming your body's ability to heal and recover and lubricate, then you start to develop these chronic issues.

And yes, the pain is coming from the fact that you have swelling underneath your kneecap, but that's not what caused the swelling to begin with.

So it'd be like wearing 1 shoe with a 5 inch rise, and then you're walking around and then your back hurts.

And so the doctor's like, oh, the back pain, I can see where it's coming from.

But they never address the fact that you're wearing 1 shoe that's so much higher than the other, right?

So yes, you can look at a knee joint and you can see tendonitis and inflammation and cartilage that doesn't look right and all that stuff.

And yeah, pain's coming from that, but there's a root reason as to why that's there in the first place.

And it's because that knee is not operating the way it should.

It's doing more than it should, or it's compensating for the joint surrounding it.

Which is also why what ends up happening a lot of times is people end up taking cortisone shots and it's 1 of the worst things that you can do because it ends up masking what's really going on.

And you get this temporary fix, and I get it because it feels like magical right after you do that, right?

You get that shot, and all of a sudden it nails down all that inflammation.

So the pain goes away, and you feel like, oh my God, I feel so amazing.

And then what, a month, 2, 3 months go by, and then you have to go do that again.

I think, oh, this is just gonna be part of my routine as I go and get these cortisone shots all the time.

And it's like, dude, what's going on is that you're not addressing the root cause.

It's causing the inflammation, and we can get to that and fix that.

Yeah, In fact, if you look at the data on cortisone shots, oftentimes, majority of the time, what they do is actually accelerate the degeneration of the joint and they cause worse problems later on.

1 is it's really hammering inflammation down.

You need some inflammation for your body to heal.

Inflammation is literally your body trying to heal itself.

That's why if you cut yourself, you get some reds and some swelling because it's sending things to heal.

So if you tamp it down completely, it really stopped the healing process.

Pain's gone, but now there's no healing process going on.

But then 2, now that the pain's gone, you don't have a signal telling you that you're moving wrong.

So you just move wrong more so, walk more, squat more in bad ways.

And so you see the acceleration of joint issues as a result.

It improves your quality of life in the short term, but in the long term, it's not great.

You gotta figure out what the hell the root issue is.

So to give an example of kind of what we're talking about.

So, you know, cause people are like, well, how's the ankle and the hip relate to the knee?

When you do a full squat, if you're standing and you're doing a full squat, your hip has to bend, your knee has to bend, and your ankles have to bend.

So let's look at the ankles for a second.

Now, if my ankle is tight or my foot is weak or I lack mobility in it and I'm trying to squat more and I'm pushing myself down to squat more, what'll happen is my feet, as I'm squatting, will start to turn out to compensate.

That twisting that's happening in the body, my hip can handle that no problem.

So I'm squatting while my knees are twisting out and what's preventing my knees from twisting apart?

if I squat enough times that way, I'm gonna strain my meniscus, I'm gonna have inflammation there, maybe a tear.

Of course, the doctor will go in there and say, oh, we could trim your meniscus, make you feel better.

But then you keep squatting, never figure out what's going on.

Where In that case, if I had just worked on my ankle mobility, now when I squat, my knee wouldn't have to rotate out.

But because the knee doesn't rotate and that rotating is happening under load, well, now we're causing problems.

But again, if you look at the ankle itself, it can bend laterally, it can flex and extend, it can rotate to a degree, and then the foot itself has some movement, then the hip is also a very mobile joint in comparison to the knee.

So if the hip and the ankle aren't able to stabilize and do what they're supposed to do, then what happens is the ligaments and the cartilage in the knee all of a sudden start to support things.

You don't want ligaments and cartilage to do the support.

So imagine if you're holding a weight here with your elbow bent and your bicep tense.

Now imagine if you extend your elbow all the way, so you put your elbow at the end of a table and then put a weight on it, and your elbow, it's like an arm lock, right?

And your elbow's now supporting the weight, how bad that would be for the joint.

So that's kind of what happens to the knee over time when those things aren't functioning the way they should

well I mean that's in terms of like my actual injury when I was playing football It was because of the surface so it was normally, you know You have a little bit more give and your foot can kind of move and slide you know on a type of like a grass surface versus like this, this was like a very thin AstroTurf.

Like I was basically on like a really sticky kind of like AstroTurf that's almost like.

But I was wearing like regular shoes, AstroTurf shoes.

And so like, I wasn't used to cutting with those.

I go to cut this way and my whole body keeps going that way which then I was gonna rotate, but my foot just got caught.

And so now put all the pressure and buckling right there on my knee.

And so it just stretched out my MCL to like a crazy degree.

But that's the thing, it's, I mean, your ankle and your hips, they have to be able to have that kind of travel and movement in order to keep it in good tracking.

Isn't that 1 of the challenges that they've had with like figuring out how to make fields, the astroturf fields, is to make it as close to like grass, because 1 of the things about grass is grass ends up being a lot safer.

So if your cleats get in there, it tears through the dirt and grass, or you don't get stuck in something.

Yes, so now they have that other kind of turf that's got like the shavings, the rubber pellets

Yes, so it actually has a little bit of something you could kind of dig into versus it being that like abrupt stop.

Yeah, so just another example is if you look at female athletes, female athletes suffer from ACL tears at something like, I mean, it's a multiple, I believe it like 7 versus male.

Female athletes are much higher risk for ACL tears.

And you think, well, how, why, when they play the same sports, like what's going on?

Well, it's, as a girl goes through puberty, her hips start to widen first, and the pelvis of women tend to be wider anyway.

So there's a stronger angle from the hip to the knee, requiring more support from the ligaments.

You add in the fact too that women wear high heels a lot more than men do.

Now how do you prevent this in female athletes?

You really work on hip strength and stability.

And you cut, when female athletes do this, it reduces their injury of their knees significantly because their hips now have the ability to stabilize.

But if that's not there, Now you're relying on all the ligaments and stuff of the knee to support you.

And that basically is, you're basically playing with fire.

And how much of my body weight can it support when I move the wrong way or twist?

Well, and then there's this idea of, oh, which some doctors will recommend to these patients is stop squatting, you know, and of course I would not barbell backload, you know, squat heavy with 1 of these clients that are in this condition.

But this idea of let's just eliminate a movement pattern like that, that is so fundamental.

You're forever gonna have to get up off the toilet.

You're forever gonna have to get up out of your bed, out of your vehicle.

So this idea of, oh, well, you shouldn't squat anymore is 1 of the dumbest things that someone could tell a patient, because that is such a functional movement.

Loading a barbell for 200 pounds and doing a barbell back squat is not the most ideal situation that client, but to, to tell them to stop doing a pattern that they're going to need to do for the rest of their life is only going to make this condition worse in the long run.

It is, and by the way, the data, they're starting to figure out a little bit, like for example, when they tell people in older populations, it's time to use a cane or a walker, they're much more careful, because when you tell somebody who's having trouble walking to start using a walker, the decline in their ability to walk accelerates because you stop practicing walking.

And the reason why doctors will say this about exercises is because it's like, well, oh, exercises, big deal, stop doing them.

But really it would be no different than you saying, going to the doctor and be like, Hey, my foot hurts when I walk.

So if you don't do these exercises, your ability to do them declines even faster.

Now we're not saying do these exercises if you can't do them, but the answer should be, let's figure out why you can't do them.

Let's get you to a point where you can do them and then let's do them so we never lose that skill.

And let me tell you, that is the best way to bulletproof your joints is to be able to keep them strong through all these different exercises and movements.

Yeah, really, it's a lack of strength at the end of the day.

For the most part, any time a joint isn't stable and functioning properly, there's some kind of an instability, there's a lack of strength somewhere there that we can address to help kind of embolden that response of it being protected and being functional.

Now, here's the interesting thing about knee pain.

I'd love your guys' feedback, because this is all my anecdote.

So I haven't trained millions of people, right?

I've trained probably a hundred or so, and then thousands maybe by proxy.

But of all the common injuries or chronic pain issues, my success rate was very, very high with knee over time.

See all Mind Pump: Raw Fitness Truth transcripts on Applepodcasts

2117: Fix Your Knee Pain