The 5 Pillars Of Knee Pain Recovery – Part 5 (Breathing)
By Bill Parravano – The Knee Pain Guru
This article is the fifth in a series of five articles covering the five essential components to knee pain recovery.
None of what I am going to share with you today is to be taken as medical advice. This approach is what I used to get myself out of knee pain that I learned over the past nine years or so.
These are truths, as I know them. Use what you like and disregard the rest. If you have any concerns as to what you are to do, please consult your licensed healthcare professional.
So, what does breathing have to do with your knee pain?
Well, breathing is the essence of life!
You mark the time of a baby’s birth at the point when they take their first breath. You make sure a person is still alive by seeing if they are breathing or not.
Breathing is so key and so essential to life that you can’t live without it; yet, how many times do you find yourself throughout a normal day holding your breath?
I took a wilderness training class a few years ago, and we were told about the priority of things to look at in a survival situation and it went something like this:
You can’t survive three minutes without air, three days without water, and three weeks without food. So air was pretty high on the priority list for survival.
This point also directly ties into pillars 3 & 4 of my knee pain recovery program regarding exercise and stretching.
You see, when you breathe smoothly you begin to tap into your nervous system and relax your body which is very important for you getting over your knee pain.
So, let’s talk now about your nervous system a little bit and how this plays into the knee pain equation.
There are two main aspects of your nervous system: The sympathetic nervous system and the parasympathetic nervous system.
The sympathetic nervous system is what people are talking about when they say ‘fight, flight or freeze.’ This is the part of your nervous system that a long time ago kicked in when you saw the bear in the woods and needed to make a choice as to what to do to survive. It kicks in especially in stressful situations to keep you alive. This part of your nervous system releases adrenaline to make sure you can get out of that stressful situation. You probably have heard of people lifting real heavy objects off of children in a crisis situation. That’s the part of the nervous system I’m talking about.
The other part of your nervous system is the parasympathetic nervous system. It is the ‘rest and relax’ part of your nervous system. This is the part that says, “You’ve got to eat, rest, and take it easy for a while.”
The problem you run into with your knee pain is the sympathetic part of your nervous system doesn’t get shut off due to the way the pain in your knees keeps it stuck in the “ON” position all the time. It keeps going and going and going, kind of like the Energizer Bunny – just not in a good way.
This plays havoc on your knees as well as the rest of your body. Some of the symptoms you will notice as a result of your sympathetic nervous system being locked in the “ON” position are hypertension, increased heart rate, increased sweating, difficulty to digest food, difficulty to sleep, constipation, difficulty thinking – like “brain fog” – and easily irritable, like snapping at loved ones, and the list goes on and on.
You may be asking yourself, “What does this have to do with breathing, and more importantly, my knee pain?” Well, here’s the thing.
When you are doing correct exercises that both stretch and strengthen the tendons and the ligaments in your knees, and then begin to incorporate proper breathing, you begin to actively engage the parasympathetic aspect of your nervous system backing off the sympathetic aspect of your nervous system. The end result is you begin to relax both the knee pain as well as reduce the tension and stress built up in your entire nervous system due to your knee injury.
Let me cover proper breathing here for a moment. Proper breathing is defined as ‘a smooth flow of air in through your nose and out through your mouth.’ There are a couple of reasons to do proper breathing when doing a correct exercise in order to strengthen the tendons and the ligaments in your knees
The main reason – and it may sound obvious – is that you don’t pass out, because if you pass out, fall over, and hurt yourself. You have a whole host of other issues that you’ll have to deal with instead of just your knee pain, so make sure you breathe.
The second reason is you begin to control your movements, making them smooth and fluid, similar to that of a cat. This is opposite to the movements controlling you. You’re confined by that pain and tension you’re feeling in your knee.
Proper breathing allows you to “override” the tension stuck in your nervous system. Actively stimulating your body to rest and relax the tension in your knee and the end result is the reduction of your knee pain allowing your body’s own healing ability to kick in on its own.
I go into more depth on this in my E-book, “Stop Your Knee Pain Now.”
For the third part of this series I want to cover exercise, or specifically the exercises you do to address the pain in your knees as well as strengthen your knee joint.
None of what I am going to share with you today is to be taken as medical advice. This approach is what I used to get myself out of knee pain that I learned over the past nine years.
These are truths as I know them. Use what you like and disregard the rest. If you have any concerns as to what you are to do, please consult your licensed health care professional.
When you begin a movement, this movement is initiated by your muscles and is kept going by your tendons and ligaments.
Quick anatomy lesson: tendons connect muscle to bone and ligaments connect bone to bone.
It is so very important that you remember this when thinking about your knees.
The knee is a joint where two, actually three, bones are coming together to form the joint. The femur (the bone in your upper leg), the tibia, and the fibula (the bones in your lower leg).
The next time you go to a doctors’ office or to see your physical therapist, ask them to see an anatomy chart of the muscular system of the human body.
If you look at this chart of the lower half of the human body, you will find that there are no muscles to be found in and around the front of the knees.
You might find this a little surprising; however, it’s the truth. And if you’re in front of a computer right now you can double-check me by doing a Google search on ‘muscle anatomy chart’ to see what I am talking about.
You can get a blow-up of it on your screen and you can see all the muscles are in red, and the tendons, the ligaments, and the bone are in white.
When you look at the anatomy chart in and around the front of the knees, it is primarily tendons, ligaments, and bone.
So this begs the question: How can you build up the muscles around the front of the knee to address you knee pain if there are not any muscles there?
The key here is to understand the tendons and the ligaments I mentioned a little bit ago. This is what truly needs to be strengthened in order to address the pain, tension, swelling, and discomfort in your knees.
You see, the way the body works in strengthening the tendons and the ligaments require you to first fatigue the muscles. Once the muscles are “out of the way,” then the real work begins.
It takes approximately seven seconds for muscles to fatigue.
If you are questioning me on this one, think of the last time you were at the gym and saw some guy trying to bench press a lot of weight. You know, “doing their max.”
They will first get the bar off the rack and bring it down to their chest before they begin to push the weight back up. If they don’t get it back up within a certain amount of time, usually seven seconds, then odds are they are not going to be able to push the weight up at all.
Go ahead and time it. One thousand one, one thousand two, one thousand three…all the way up to one thousand seven.
This is just as important when you are doing an exercise for your knees. However, in your case you are looking to fatigue the muscles so you can begin to build up the tendons and ligaments in and around the knees.
Another component of exercise in relation to building strength in the knee joint is to understand what I call “practical strength” or “dynamic strength.”
What I mean by practical strength or dynamic strength ties directly into how an exercise is performed. It must reflect how you move in real life in order for the exercise to really be applicable.
After my ACL reconstruction surgery, I went to physical therapy and for all intents and purposes everything went “well.” At the end of the 8 weeks my left leg was as strong as my right leg yet I still had lots of pain, tension, and discomfort in my knee.
I did the usual, leg extensions, leg curls, leg raises, and step ups to build up the strength in my legs and this, to a degree, was beneficial however it was not the “big picture.”
In actuality when moving in real life you rarely get up in a linear fashion. There is regular “dynamic movement” – getting up and pushing to the side at the same time. An example would be like getting out of a car.
So the exercises I did at the PTs made my leg stronger yet it was not practical for me to function in my life without the pain, tension, and discomfort in my knee.
Building practical or dynamic strength is key for you to get over your knee pain not only physically, also mentally to rid yourself of the fear of certain movements.
So dynamic strength must be slow and controlled to re-educate your nervous system. Your nervous system must understand that your knee is strong enough to handle the weight of your body and not give out anymore.
You will know when you “arrive” at this place because your body will not fear injuring your knee anymore.
Bill sustained a severe knee injury over ten years ago that required reconstructive surgery on his left knee. This experience led him on a path to figure out how to relieve the pain, tension, and discomfort in his knee as well as the rest of his body resulting from the knee injury and the subsequent surgery. He now teaches others how to relieve knee pain for themselves in their own bodies through education about water, nutrition, exercises, stretching, and breathing.