Kneeling can be painful with existing knee pain. As a country often described as having a melting pot of cultures, traditions are something that Singaporeans hold near and dear to their heart. Despite coming from different backgrounds and religions, some common traditions are performed across groups, such as kneeling. Many may say that kneeling is a young person’s activity. With age, it can make it difficult and painful to kneel. However, knee pain is not exclusive to old age and affects younger generations as well. Here at Core Concepts, we’ve treated clients as young as 14 years old for knee pain.
In this article, we will explore more on why kneeling can aggravate problem areas and result in pain and how you can continue to kneel despite these problems. Through this article, we want to address such concerns and fears of injuries and why you should see a physiotherapist for treatment to enjoy the festivities pain-free or know what to do once you start experiencing discomfort.
Why does kneeling make my pain worse?
Kneeling aggravates knee pain because there is increased mechanical compression in the knee joint when we kneel. This means that the kneecap is pushed forcefully against the thigh bone. The compression force varies with certain factors. For instance, someone with high body weight or who kneels on one side more than the other will experience greater pain in intensity, frequency, and type. Such pains include pulling pains, sharp pains, and dull ache pains.
If someone who is already experiencing knee pain continues to adopt a kneeling position, the knee becomes more sensitive since additional compression worsens the pain. However, it does not cause greater injury to the person.
How can I continue kneeling despite pain?
Due to tradition and religious rites, one may have to get into a kneeling position despite knee pain. If you’d like to kneel despite already having knee pain, here are some tips by our physiotherapist to minimise the discomfort
Modify the way you kneel
Kneeling on hard surfaces such as the floor can increase the intensity of your pain. Alternative surfaces can reduce pain as they place less stress on the kneecap. These include kneeling on a softer surface or praying in a sitting position.
A quick fix is to place a block under the sitting bones to lift the buttocks away from the heels. This added elevation under your buttocks reduces the pressure on your kneecaps. If that isn’t enough, place a folded blanket directly behind the knee and/or a bolster across the heels to further decrease the knee flexion.
Perform Knee Strengthening Exercises
Knee strengthening exercises help to strengthen the muscles surrounding your knee joint. Stronger muscles reduce kneeling pain as they help relieve the stress on your kneecaps. Here are some simple exercises that you can perform at home as recommended by our team of physiotherapists.
Sit to Stands
‘Sit to stands’ are a great way to strengthen your bones. The exercise strengthens the gluteus maximus and the quadriceps at the same time. These two powerful muscle groups work to get you to the standing position. Exercising these muscle groups will strengthen your legs, butt, and back and help protect your spine. A stronger butt, spine and legs will mean better balance and lower fall risk.
Equipment required: A chair
Performing the Exercise:
- Sit in the chair of your choice.
- Slide forward as far as possible.
- Move your feet back so your heels are lined up with the front edge of the chair.
- Feet shoulder width apart, knees bent to 90 degrees
- Bow your body forward and push through your heel to stand up. Lightly use your hands on the chair if necessary
- Do five to 10 repetitions two times a day.
Tips
- Make sure that your spine maintains its length. Do not change its shape.
- Imagine a buoyancy balloon in the centre of your head, just above your eyes. Imagine this balloon pulling you up as you perform the exercise.
- Do not let your knees collapse inward.
- Breathe in when in the starting position and breathe out when pushing up.
- Avoid favouring one side or using your hands too much to help you. Your hands should be used only to keep balance if needed.
- Do not let your knees go past your toes as you stand up. That will activate the thigh muscles and cause more pressure in the knees.
Glute Bridging
A basic bridge engages the stabilizers of the posterior chain, including your hip abductors, gluteus maximus, and hamstrings. Your overall strength will improve as these muscle groups get stronger. A strong core will also improve your posture and can help ease lower back pain.
Equipment Needed: Exercise Mat
Performing the exercise:
- Lie on your back with your hands at your sides, with knees bent and feet flat on the floor under your knees.
- Tighten your lower abdominal muscles and let your lower back come in contact with the floor.
- Push your heel into the floor and lift your hips off the floor. Try to create a straight line from your knees to your shoulders without involving the muscles in the lower back.
- Squeeze your core and pull your belly button back toward your spine.
- Hold for 5 to 10 seconds, and then return to your starting position.
- Complete 3 sets of 10 repetitions.
Tips:
- Ensure that you have good form by making sure that you avoid raising your hips too high. Hyperextending your lower back can lead to back strain. Keeping your abdominals and buttock muscles engaged will ensure you don’t arch your back excessively.
- If your hips are dropping as you try to hold the bridge position, lower your pelvis back down to the floor. When starting out, you may need to hold the bridge position just slightly off the ground and for only a few seconds until you build up sufficient buttock strength.
Single-leg glute bridge with hamstring curl
This is a variation of glute bridging which engages your hamstrings as well. The single-leg bridge is a good low-load exercise to strengthen the lower abdominals and glutes.
Equipment Needed: Exercise Mat & Towel
Performing the exercise:
- Lie on your back with your knees bent and feet planted on the floor.
- Place towel under the right foot
- Draw your tummy into your belly button and gently tuck your tailbone under your body using your lower abdominals.
- Push your heel into the floor and lift your hips off the floor. Try to create a straight line from your knees to your shoulders without involving the muscles in the lower back.
- While staying in that position, slide your right leg forward and backwards using the towel.
- Return to starting position by maintaining the alignment to lower your body down to the mat.
Things to look out for:
- Be mindful not to tense your neck or have your shoulders hunched forward. The whole of your back should also be resting on the mat.
- The lower back should touch the floor before your glutes when lowering yourself. If it’s the other way around, your back will likely be in an arched position causing excessive strain to the lower back.
Double-Leg Squat
The Squat exercise mainly targets the thighs (quadriceps & hamstrings) and the buttock muscles. However, this squat version we recommend will target the buttock muscles. Core strength & stability, ankle mobility, back muscles, calves, and other factors play an important role when you are doing this exercise. Since the buttock muscles are the largest muscle in the human body, we need to strengthen it to have greater capacity to take load off the knee. This will help to alleviate pain in the knee, or even in the general lower limb.
Performing the exercise:
- Stand with your head facing forward and your chest held up and out.
- Place your feet shoulder-width apart or slightly wider. Extend your hands straight out in front of you to help keep your balance. You can also bend the elbows or clasp the fingers.
- Sit back and down like you’re sitting in an imaginary chair. Allow your upper body to bow forward as you go down, and keep your lower back flat or slightly rounded.
- Lower down so your thighs are as parallel to the floor as possible, with your knees over your ankles. Press your weight back into your heels.
- Push through your heels and bring your upper body up at the same time back to the standing position.
- Start with three sets of 10 squats, and then add more reps (12, 15) as you get used to the motion.
Tips:
- Do not allow for excessive arching of the lower back while squatting.
- Ensure that your knee does not go past your toes at any point during the squat. This will increase the compressive forces in the knee.
Seek Medical Attention
If you are already suffering from chronic pain, it would be advised to seek medical attention from a physiotherapist to prevent the pain from getting worse and affecting your quality of life. Our team of physiotherapists will offer proper guidance to correct improper knee biomechanics through exercises and treatment. These aim to loosen tight and tense muscles, mobilise stiff knee joints, and strengthen underworked muscles to ease the load on the knee.
Besides guidance, our physiotherapists can help by offering advice to reduce the compressive force acting on the knee when kneeling, such as praying on softer surfaces.
We also believe in long-term approaches to ensure the knee heals and reduce the chances of recurring injury. Patient education is key to understanding the likely causes of knee pain, such as increased load on the knee from frequent kneeling, standing, and walking. Proper pacing and planning of activities can ease the pressure exerted on the knees by breaking down long and physically strenuous tasks into smaller, more manageable ones. An example of pacing and planning can be dividing house cleaning into cleaning two rooms per day or doing it in bouts of 45 minutes to an hour.
If you are experiencing severe pain in the knee or any other parts of the body, make an appointment to get yourself assessed by Core Concepts’ physiotherapists; so you can enjoy a pain-free holiday without worrying about injuries and aches.
