I'm 27 and I've been doing martial arts for around 3 years.
Although my flexibility has come on a lot, I get pain on the inside of the knees when I try to do side splits. I'm about 20 degrees each side from being flat but the pain in my knees is something else.
I've tried the stength exercises for the knees:
HEAVY SQUATS - I can do a bar loaded with plates equal to my own body weight (I weigh 75kg and can squat 90kg) for 3 good sets of 12 reps or 3 sets of 5 reps with 125kg loaded.
LIGHT SQUATS - I've also tried deep squats using a 10kg bar and going for 3 sets of 30 reps.
These have definitely improved the strength in my legs but I still get terrible pain on the inside of both knees. The pain wears of if I do a few body weight squats (probably because of increased blood flow) and never lasts longer than a few minutes when I stop stretching. I never get any soreness in the inner thigh muscle no matter how long or how hard I stretch, just the damn knees.
Any suggestions?
Also can anyone suggest a good quad stretch that does not place excessive pressure on the knee joint or the knee-cap?
Knee pain when doing side splits
No one got any ideas on how to ditch the pain down the inside of the knees? Is it due to an inflexibility issue in my hams/quads or a strength issue in the hams/quads?
Also can anyone suggest a good quad stretch? When I try the one suggested in the book (grab rear leg in a partial front split) I feel like its going to rip my knee cap off!
Also can anyone suggest a good quad stretch? When I try the one suggested in the book (grab rear leg in a partial front split) I feel like its going to rip my knee cap off!
seated quad stretch (modified hurdler's stretch)
Ten months ago, a doctor told me I had very tight patella. I experienced the same pain under the knee as you describe when holding my foot behind me in a standing quad stretch, so I sought something else.Also can anyone suggest a good quad stretch that does not place excessive pressure on the knee joint or the knee-cap?
There is a Seated Quad Stretch, a.k.a., Modified Hurdler's Stretch, on page 124 of Stretch and Strengthen, by Judy Alter. I do that stretch daily and now my patella are not so tight and I can do the standing quad stretch easily, too.
I like this one because it also stretches the core, your obliques (think high blocks/punches), your neck, shoulder, arms, the muscles at the side of the hip including the illiotibial band as well as all four quads as you change positions.
I cannot post a copy of the text here, but if you contact me, I will email it to you.
Best regards,
Cindy
Thanks for that.
I seem to remember a physio telling me about having a tight Patella but that it had more to do with the semitendrinous and semimembranous (prob spelled that completely wrong!) being tight .
She suggested I strengthen and improve the flexibility of those two muscles to releive the tension on the tendons connecting them with my lower leg (which run down the inside of the knee where I get the pain). I've tried this and the hamstring flexibility is now the best its ever been but still the pain in the knees persists.
At present I'm of the disposition where I'd try anything!
I seem to remember a physio telling me about having a tight Patella but that it had more to do with the semitendrinous and semimembranous (prob spelled that completely wrong!) being tight .
She suggested I strengthen and improve the flexibility of those two muscles to releive the tension on the tendons connecting them with my lower leg (which run down the inside of the knee where I get the pain). I've tried this and the hamstring flexibility is now the best its ever been but still the pain in the knees persists.
At present I'm of the disposition where I'd try anything!
Pes Anserine (Knee) Bursitis or sartorius
Didn't find "semitendrinous and semimembranous" about the knee yet, but check out the links below for hints to the problem. Inner knee pain could be due to the sartorius or bursitis.
Sartorius: Kurz' demonstrates a movement that stresses the sartorius, here: http://www.stadion.com/videos/patellofe ... tation.wmv
His article on Patellofemoral Syndrome or Pain under Kneecap at http://www.stadion.com/injuries_kneecap.html has lots of good stuff you might find of interest.
Bursitis: Check this out as well--Pes anserine (knee) bursitis--
http://www.med.umich.edu/1libr/sma/sma_pesanser_sma.htm . Last night I came home after a night snapping hook kicks in tae kwon do class with a little balloon on my lower inner knee, right about there. Thought it was tendon of the sartorius, but more likely it is this. Swelling subsided with icing and a good nights sleep. I should see a doctor to confirm. I was just looking at UW Mich. site to find that stuff you doctor told you and found this, so I owe you a big "Thanks" for bringing it up.
I think bursitis should take much less time to mend.
I hope this is helpful.
Take care,
Cindy
Sartorius: Kurz' demonstrates a movement that stresses the sartorius, here: http://www.stadion.com/videos/patellofe ... tation.wmv
His article on Patellofemoral Syndrome or Pain under Kneecap at http://www.stadion.com/injuries_kneecap.html has lots of good stuff you might find of interest.
Bursitis: Check this out as well--Pes anserine (knee) bursitis--
http://www.med.umich.edu/1libr/sma/sma_pesanser_sma.htm . Last night I came home after a night snapping hook kicks in tae kwon do class with a little balloon on my lower inner knee, right about there. Thought it was tendon of the sartorius, but more likely it is this. Swelling subsided with icing and a good nights sleep. I should see a doctor to confirm. I was just looking at UW Mich. site to find that stuff you doctor told you and found this, so I owe you a big "Thanks" for bringing it up.
I think bursitis should take much less time to mend.I hope this is helpful.
Take care,
Cindy
Semitendinosus, Semimembranosus (hamstrings)
Found it: http://www.exrx.net/Muscles/Hamstrings.html . Semitendinosus and Semimembranosus are parts of the hamstrings, and they wrap around the inner side of the knee to connect to the tibia.
This makes sense in my case, then. I entered class last night on day 10 following a minor hamstring tear thinking I would favor that side for a week.
I might be well to take a couple months off for conditioning. I have seen enough of tae kwon do to know I can do it well when my body is ready for it. It is not that I am out of shape. I look like I train. That's part of the trouble. I have the strength and just enough flexibility to pull off most any move, and excellent core strength, but certain parts of key (aren't they all?) prime movers need attention.
Good luck resolving your knee problem, as well.
Cindy
This makes sense in my case, then. I entered class last night on day 10 following a minor hamstring tear thinking I would favor that side for a week.
I might be well to take a couple months off for conditioning. I have seen enough of tae kwon do to know I can do it well when my body is ready for it. It is not that I am out of shape. I look like I train. That's part of the trouble. I have the strength and just enough flexibility to pull off most any move, and excellent core strength, but certain parts of key (aren't they all?) prime movers need attention.
Good luck resolving your knee problem, as well.
Cindy
tendonitis
you stated:
Could this be a sign the problem is "tendonitis?" As far as I know, only extended rest will resolve that. Continue to use the sore muscle after a tendon flares and you end up with chronic soreness that may typically subside upon warmup.the hamstring flexibility is now the best its ever been but still the pain in the knees persists.
How long is "extended rest"? I don't like the sound of that! 
I had around 2 months off all activity that was more strenuous than drinking coffee or flicking TV channels due to appendicitis (this started back in April this year). When I came back to training my legs were pretty weak (I could barely press 20kg for 10 reps). But now my legs are a bit stronger (leg press is now upto 250kg). Obviously I put this down to the Dr's poking around in my abs in hospital.
But the thing is I've had this knee pain for as long as I've been trying to do side splits (which incidently is as long as I've been doing martial arts) and never really been able to find the one thing that'll cure it. Up until the start of this year I've just put it down to the fact that I used to do a lot of mountain biking and no stretching at all especially for the hams. But now I stretch just about every day (at least every other) and like I say I'm a lot better than I was. I just can't get past the last 40 degrees on account of the knee pain.
Everything considered, the knee pain, the increased hamstring flexibility etc etc I'll give the tightness of the patella a bit more consideration. I don't think I've injured it because my physio checked for injuries or inflamations and said my knees were fine apart from this tightness she mentioned. Plus I'm a keen beleiver in R&R (after all I was into bodybuilding before Martial Arts and I know that muscles don't grow in the gym). Plus I'll try the sartorious exercise.
Thanks for taking the time to reply.
Just wish flexibility training was as easy as gym training
I had around 2 months off all activity that was more strenuous than drinking coffee or flicking TV channels due to appendicitis (this started back in April this year). When I came back to training my legs were pretty weak (I could barely press 20kg for 10 reps). But now my legs are a bit stronger (leg press is now upto 250kg). Obviously I put this down to the Dr's poking around in my abs in hospital.
But the thing is I've had this knee pain for as long as I've been trying to do side splits (which incidently is as long as I've been doing martial arts) and never really been able to find the one thing that'll cure it. Up until the start of this year I've just put it down to the fact that I used to do a lot of mountain biking and no stretching at all especially for the hams. But now I stretch just about every day (at least every other) and like I say I'm a lot better than I was. I just can't get past the last 40 degrees on account of the knee pain.
Everything considered, the knee pain, the increased hamstring flexibility etc etc I'll give the tightness of the patella a bit more consideration. I don't think I've injured it because my physio checked for injuries or inflamations and said my knees were fine apart from this tightness she mentioned. Plus I'm a keen beleiver in R&R (after all I was into bodybuilding before Martial Arts and I know that muscles don't grow in the gym). Plus I'll try the sartorious exercise.
Thanks for taking the time to reply.
Just wish flexibility training was as easy as gym training
i'm no specialist of any type, but from reading mr. kurz' book it seems that posture is emphasized a lot! a lot of the pain problems are fixed when the posture is corrected.
i know you've been doing it for a long time, but it may be worth a check to review posture and make sure your alignment and everything is correct.
find out what it is that causes your knee pain by stretching the same area in other positions. (the stretch or weight on the joints)
if nothing else, support your body with your arms while doing the split stretch. place as little stress on the knees as possible. see if that helps the stretch.
also, perhaps you should do dynamic strength exercises that strengthen more directly the area of your pain- the inside of the knees. rather than just squats, straight up and down. the video that elskbrev linked to looks good! maybe also try sumo squats as a variation.
just a few ideas.
i know you've been doing it for a long time, but it may be worth a check to review posture and make sure your alignment and everything is correct.
find out what it is that causes your knee pain by stretching the same area in other positions. (the stretch or weight on the joints)
if nothing else, support your body with your arms while doing the split stretch. place as little stress on the knees as possible. see if that helps the stretch.
also, perhaps you should do dynamic strength exercises that strengthen more directly the area of your pain- the inside of the knees. rather than just squats, straight up and down. the video that elskbrev linked to looks good! maybe also try sumo squats as a variation.
just a few ideas.
There's a cable station at my gym that I can strap my ankle into and let the weight pull my leg up in the same direction and range of motion as a leg swing to the side. Then I have to pull against the weight to work my adductors. I've tried this for a while (around 2 months) and noticed no difference to the knee pain.
Also I've tried Sumo Squats to much the same effect as the cable exercise.
My physio is pretty good (a lot of them know their stuff but dont tend to be sympathetic to the seemingly "crazy" things martial artists want to do, but I actually found she used to practice the same style of Kung Fu as me) and it was through her correcting my posture on the hamstring stretches that moved that aspect on in leaps and bounds.
She has suggested alternative stretches (that take the pressure away from the knees) for working towards the side splits pretty much all of which I can do without feeling any real stretch - e.g. butterly stretches are very nearly on the floor. So I've gone back to supported standing side splits and box splits. In either stretch I've experimented with knees slightly bent, toes pointed out, toes level or toes pointed in for different emphasis.
I'm going to try the exercise on the video when I go to the gym later on today as I always train legs on a Thursday after all my martial arts sessions are over with for the week (until Monday anyway). It's just seems that no matter how hard I push it (and I dont want to push it too far at the risk of injury) my adductors never seem to get a really good stretch for the sake of the knees. I'm also experimenting with legs swings (front/side/back - in that order) twice a day for 2 sets of 10 reps, followed by relaxed stretches for a few seconds in the morning and 2 minutes each stretch before bed. I only do ISO stretches on Monday nights after martial arts and on Thursdays after weights for the legs.
Would seated leg curl with a heavy weight maybe strengthen the knee or would it just tighten the patella even more? I know Kurz recommends straight-leg deadlifts but these murder my spinae erector muscles before the hams get chance to feel it.
Also I've tried Sumo Squats to much the same effect as the cable exercise.
My physio is pretty good (a lot of them know their stuff but dont tend to be sympathetic to the seemingly "crazy" things martial artists want to do, but I actually found she used to practice the same style of Kung Fu as me) and it was through her correcting my posture on the hamstring stretches that moved that aspect on in leaps and bounds.
She has suggested alternative stretches (that take the pressure away from the knees) for working towards the side splits pretty much all of which I can do without feeling any real stretch - e.g. butterly stretches are very nearly on the floor. So I've gone back to supported standing side splits and box splits. In either stretch I've experimented with knees slightly bent, toes pointed out, toes level or toes pointed in for different emphasis.
I'm going to try the exercise on the video when I go to the gym later on today as I always train legs on a Thursday after all my martial arts sessions are over with for the week (until Monday anyway). It's just seems that no matter how hard I push it (and I dont want to push it too far at the risk of injury) my adductors never seem to get a really good stretch for the sake of the knees. I'm also experimenting with legs swings (front/side/back - in that order) twice a day for 2 sets of 10 reps, followed by relaxed stretches for a few seconds in the morning and 2 minutes each stretch before bed. I only do ISO stretches on Monday nights after martial arts and on Thursdays after weights for the legs.
Would seated leg curl with a heavy weight maybe strengthen the knee or would it just tighten the patella even more? I know Kurz recommends straight-leg deadlifts but these murder my spinae erector muscles before the hams get chance to feel it.
Leg curls of any kind won’t tighten the patella, but you will certainly feel any tightness that exists in them when you do leg curls. Stretching your quads will loosen up the patella, giving you the range of motion needed for comfortable leg curls.Would seated leg curl with a heavy weight maybe strengthen the knee or would it just tighten the patella even more? I know Kurz recommends straight-leg deadlifts but these murder my spinae erector muscles before the hams get chance to feel it.
I prefer the standing leg curls (like the one Kurz demonstrates in his article referenced above) over machine curls because I can better play with the position of the thigh relative to the curled the leg, so I can work the hamstrings at different angles, starting with the less challenging if I feel pain under the knee.
You may be doing very heavy quad work relative to your hamstring work, creating a sort of imbalance. Every time you power the quads, they tighten up and need to be stretched back to pre-workout length, so each time you lift you tighten the patella and will need to stretch the quads to loosen them back up.
Your tight patella may have made stretching the quads difficult and strengthening the hams difficult, so it may take a while as you change things around in your workout to get strength and flexibility of quads and hams in sinc.
p.s. Follow up on my injury—doc says it’s the hamstring tendons, the same ones you mentioned above. There are five muscles that wrap around the inner knee to connect to the tibia and under that, a bursa which can get irritated if the tendons are tight. He advised me to stay away from the activity that triggered it—hook kicks—for 4-6 weeks and gave me a set of physical therapy exercises, just basic leg curls and extensions using bands. Must be minor because I’m walking fine and it only hurts like a bad bruise when I touch it. Hamstrings are so underused. I stretch them all the time, but don’t always bother to strengthen adequately, and therein may lie my problem.
Take care,
Cindy
I finished my leg workout yesterday with some promising developments...
Deadlift 16, 10, 8, 5 reps (5 reps at 100kg)
One-Arm Dumbell Row 4 sets / 10 reps
Wide-Grip Lat Pulldown 3 sets / 10 reps
Heavy Leg Press 4 sets / 10 reps (240kg)
Heavy Leg Press - STATIC CONTRACTION (320kg)
5-10 seconds / 3 sets
Leg Extension 3 sets / 10 reps (65kg)
-Super Set With-
Leg Curl (point toes in) 3 sets / 10 reps (35kg)
Sartorius Leg Raise 30 reps (done on a cable station)
Calf Raise 4 sets / 15 reps
ISO Stretching
That was my workout (note the exercise you gave me th link to). On the hamstring curl I find if I point my toes inwards it places more stress on the semi-muscles of the hams and less on the bicep femoris.
At the end of the routine I could push my torso a lot further forward than normal with virtually no discomfort in the hamstrings when doing box splits. The tendons down the inside of the knee still gave me a bit of grief but not as much as normal. At night before I went to bed I did a few minutes of relaxed stretches and actually found I could drop down another 3 inches or so on the front slpit and quite comfortably sit for 2 minutes in box splits at 145 degrees (15 degrees more than normal)!
Like I said I still get the pain in the knees but I think the sartorious exercise eases it A LOT. So I'm going to continue with that one. Also I tried the stretch you emailed me and I couldn't feel a thing. I'll have another stab at it in case I was doing it wrong over the weekend.
On the injury -- You maybe want to try fish oil for the joints themselves. I've taken it for years and it just keeps my joints "well oiled" in terms of lifting weights. I can lift some heavy weights for a guy of my size and I find if I stop taking fish oil for any length of time my joints ache like mad. It does nothing for my flexibility (if only there was a magic potion!) though.
Deadlift 16, 10, 8, 5 reps (5 reps at 100kg)
One-Arm Dumbell Row 4 sets / 10 reps
Wide-Grip Lat Pulldown 3 sets / 10 reps
Heavy Leg Press 4 sets / 10 reps (240kg)
Heavy Leg Press - STATIC CONTRACTION (320kg)
5-10 seconds / 3 sets
Leg Extension 3 sets / 10 reps (65kg)
-Super Set With-
Leg Curl (point toes in) 3 sets / 10 reps (35kg)
Sartorius Leg Raise 30 reps (done on a cable station)
Calf Raise 4 sets / 15 reps
ISO Stretching
That was my workout (note the exercise you gave me th link to). On the hamstring curl I find if I point my toes inwards it places more stress on the semi-muscles of the hams and less on the bicep femoris.
At the end of the routine I could push my torso a lot further forward than normal with virtually no discomfort in the hamstrings when doing box splits. The tendons down the inside of the knee still gave me a bit of grief but not as much as normal. At night before I went to bed I did a few minutes of relaxed stretches and actually found I could drop down another 3 inches or so on the front slpit and quite comfortably sit for 2 minutes in box splits at 145 degrees (15 degrees more than normal)!
Like I said I still get the pain in the knees but I think the sartorious exercise eases it A LOT. So I'm going to continue with that one. Also I tried the stretch you emailed me and I couldn't feel a thing. I'll have another stab at it in case I was doing it wrong over the weekend.
On the injury -- You maybe want to try fish oil for the joints themselves. I've taken it for years and it just keeps my joints "well oiled" in terms of lifting weights. I can lift some heavy weights for a guy of my size and I find if I stop taking fish oil for any length of time my joints ache like mad. It does nothing for my flexibility (if only there was a magic potion!) though.
Interesting. Not sure what to tell you. I said a couple weeks ago that I was just not feeling much stretch in it any more. The stretch is greater if I extend back bent leg further back or change position of the hip, raising or lowering it until I feel more stretch. Careful not to torque your knee. Tension can build in the back bent knee on this stretch. I think that is what the follow up "salt shaker" exercise relieves.I tried the stretch you emailed me and I couldn't feel a thing.
I just started taking cod liver oil daily earlier this year for vascular benefits. Thanks for the tip about joints. I'm old enough to get comments from my ortho like, "[You're joints] are remarkably well preserved." Could be worse. lol.You maybe want to try fish oil for the joints themselves.
You're telling me you press over 4X your body weight and, on extensions, almost 1X your body weight?!? Ok, here's where I step down. This is heavy stuff. Is the balance in weights (curls to extensions or quad work to hamstrings work) there? Maybe I sound smart if I say, "listen to your body?" Furthermore, though I used to keep lots of detailed records like that in neat little charts in a notebook when I used to power lift, I am, after all, a girl. **smiles**Heavy Leg Press 4 sets / 10 reps (240kg)
Heavy Leg Press - STATIC CONTRACTION (320kg)
5-10 seconds / 3 sets
Leg Extension 3 sets / 10 reps (65kg)
-Super Set With-
Leg Curl (point toes in) 3 sets / 10 reps (35kg)
These days, I do only body weight and resistance band work, for various reasons, though as I change things up, it will be nice to have knowledge of weight lifting in my back pocket. The style I use for martial arts will be different, however, than the 8-10 rep or pyramind power lifting style I used in the past. I believe faster, lower weight, 12-15+ rep sets will serve me better for developing speed and power.
Have a great day and good luck with your workout.
Cindy
The reason for the strange weights lifted on the leg press compared to the leg extension is that I put a lot into the leg press that I don't have that much left for the leg extension (if I did the leg extension first I'd probably do about 120kg).
I think supersetting extensions with curls also robs a bit of raw power but does help with muscular stamina. The hams have been a weak point of mine for a long time, but I just do the best I can with them. I don't think "listening to your body" is a smart alec comment at all, just good common sense.
Rep ranges and weights I think are and always will be a topic for hot debate. I think it's because we're all so vastly different and one size doesn't fit all. I've kept some pretty detailed records for years and think that trial and error is the only way to find out what works for the goals we're trying to acheive. It's funny because there are a lot of lads I train with at TKD that have hap-hazard training routines or none at all and it shows, yet they are faster than me because they're not encumbered by the extra body mass of lean muscle. But ask them to do 20 slow press-ups or punch or kick with any power and it's just not there.
I have found a way round it all though (if anyone else wants to try it), it's just a case of heavy weights and plyometrics (which I do on Sundays) for legs and a bit of sprint training. I find if my legs are fast and strong so is everything else. I find speed to be more of a neural/mental thing and if I feel fast I am fast.
I think supersetting extensions with curls also robs a bit of raw power but does help with muscular stamina. The hams have been a weak point of mine for a long time, but I just do the best I can with them. I don't think "listening to your body" is a smart alec comment at all, just good common sense.
Rep ranges and weights I think are and always will be a topic for hot debate. I think it's because we're all so vastly different and one size doesn't fit all. I've kept some pretty detailed records for years and think that trial and error is the only way to find out what works for the goals we're trying to acheive. It's funny because there are a lot of lads I train with at TKD that have hap-hazard training routines or none at all and it shows, yet they are faster than me because they're not encumbered by the extra body mass of lean muscle. But ask them to do 20 slow press-ups or punch or kick with any power and it's just not there.
I have found a way round it all though (if anyone else wants to try it), it's just a case of heavy weights and plyometrics (which I do on Sundays) for legs and a bit of sprint training. I find if my legs are fast and strong so is everything else. I find speed to be more of a neural/mental thing and if I feel fast I am fast.