Think you can't run, squat, lift or jump because of dodgy knees? Think again.
We spoke to sports physiotherapist and osteopath Tim Allardyce about what's really safe exercise-wise and what's not, for people with knee issues.
What kind of knee pain are we talking about?
Knee pain is typically anterior, which means it's at the front of the knee. But you may be able to feel the pain at the sides, back or along the joint line of the knee, says Tim.
"There are a number of things that could be causing knee pain, such as cartilage tear, ligament tear or other things like muscle problems. And there's also a chance that you could be suffering from osteoarthritic knees."
If you are concerned, speak to your GP for advice and they may refer you for an X-ray. If the problem is due to the joint capsule and the supporting muscles, a course of physiotherapy, particularly to strengthen the quadriceps muscles that form the front of the thigh, may also help.
If you have knee pain, you need to be careful when doing weight-bearing exercises, such as body pump classes, Zumba, step aerobics, jumping, running and sprinting, as these can all put a strain on your knee joints, advises Tim.
It's much safer to do non-weight-bearing exercises, such as cycling, cross-training and swimming. You can even power walk, which will put much less strain on the knee.
"It would also be dependent on the knee problem to what exercise you can do. If you get pain, stop or slow down. Don't push through the pain – listen to what your body is telling you."
This is a big mistake that many make, says Tim. You can exercise the knee with care, but if it's a fresh injury, where you've jumped and landed badly or stepped on a curb as you've run for the bus, and your knee has been sprained and is swollen and you're having difficulty bending it, then this is a different matter.
"You should rest for around 48 to 72 hours and use either crutches, a walking stick or rest it completely by lying down. Apply ice and do gentle mobilisation exercises. But thereafter you can gently exercise it."
This is one of the most common myths, says Tim.
"For years, doctors have said for years that patients should rest their knees – but now we think differently about this. Osteoarthritis is probably one of the biggest problems in the UK with knees – one of the most common surgeries is a knee arthroscopy or a knee replacement and typically osteoarthritis develops after any knee injury."
As a general rule, if you have osteoarthritis its fine to exercise. A report by the American College of Sports Medicine (ACSM) provides strong evidence that exercise is, in fact, good for the knees. The findings concluded that exercise actually helps improve the cartilage inbetween joints instead of breaking it down.
You need to be careful running with a sore knee, because any weight-bearing exercise can potentially cause knee pain, and there have even been arguments to indicate that running can lead to osteoarthritis, says Tim.
But research by Hansen P at the University of Utah Orthopaedic Center, Salt Lake City concluded that low- and moderate-volume runners appear to have no more risk of developing osteoarthritis than non-runners.
"But the jury is still out and different experts disagree – some say it does some say it doesn't."
Squatting is generally considered good for the knee. The main function of the knee is to be able to bend – so it's perfectly normal for a knee to squat, says Tim.
"For some reason when we're in the gym, we're more apprehensive to squat. If you have painful knees, you may want to make the squat easier. You could just do a quarter leg squat where your knee just bends a little bit – or a half squat where your knee bends half way.
Or you could put a Swiss ball behind your back and do a wall squat. This is a great way to rehab people with knee problems."
Jumping isn't recommended for knee problems and it's actually one of the tests sports physios use to see how fit athletes are after knee problems, says Tim.
"We'll get them jumping off a high wall to see if their knee can take it. Someone with a knee problem will know instinctively that they won't want to jump. They will be very apprehensive."
Generally speaking, don't jump because it will be too much compression through the knee.