Leading Personal Trainer and Sports Science expert Tom MacCormick (www.tommaccormick.com) outlines top tips for managing joint health, on the basis of his experience with his knee.
Before I was a personal trainer I was an aspiring rugby player. My professional rugby career prospects were ended abruptly by a catastrophic knee injury at the age of 22. That was just over 16 years ago. Since then I have had three knee surgeries and through some bad luck and poor medical advice have no ligaments in my left knee. Consequently, I have to take great care with my training to keep the knee strong, stable, and healthy without adding to the wear and tear on the joint. This has proven to be a tricky balancing act. I have researched the knee in great depth and have utilised many rehab, prehab, and strengthening protocols. I’ve taken advice from experts and experimented with what I can and can’t do. I have found some key strategies that not only help keep my knee healthy but are beneficial to any joints you might have issues with.
In many respects, I have been lucky. One of my consultants told me I was fortunate to be able to walk normally, let alone run. Let’s be clear, I can’t play a game of rugby but, if I have to, I can manage a jog. All things considered that’s not too bad. My knee does, however, cause me some low-level discomfort on a daily basis and occasionally flares up. When this happens, I have to take several weeks off exercise. This is hugely frustrating. Fortunately, I have found that this occurs less and less with the strategies I have put in place. This year I have added one more tool to my knee health toolbox and, knock on wood, I haven’t had to miss a single training session this year due to my cranky knee.
Over the years I’ve become better at gauging exactly what my knee can handle. I know when to pull back before one of these flare ups rears its ugly head. Developing this awareness has been a constant learning process and is a big factor in my uninterrupted run of training this year. What I have never managed to do though is eliminate the low level of swelling in my left knee. This has been a constant for well over a decade. I’m delighted to report it is the best it has been in years though.
In the past, for this swelling to reduce to levels not visible to the naked eye I basically had to avoid exercise for two weeks. When I’m on holiday that’s fine. The rest of the year it’s not. Firstly, I enjoy exercising. It has huge physical benefits, but without it I would suffer more psychologically. Being able to exercise regularly is essential to my well-being. Secondly, as a personal trainer, I need to train. I need to provide motivation and inspiration to my clients. Part of this is achieved by walking the talk. I can’t adopt a do as I say not as I do attitude and expect to get the best from my clients. I need to lead by example and that includes training hard and often.
With training being a non-negotiable in my life, I have had to find strategies that make that training as productive, efficient and knee-friendly as possible. Here are the fundamental strategies I use to keep my knee happy so I can keep training.
Being a Training Geek Has Benefits
The most important factor in minimising the grumbly nature of my knee is properly applying all the training knowledge I have.
This knowledge means I can schedule my workouts to challenge the muscles around my knee without having a detrimental effect on the joint itself. By understanding how often to train those muscles, how much to do per workout, and which exercises are best suited to my needs I can achieve this. Layer on top of that an understanding of how to maintain textbook form and execute specific exercises to create the maximal stimulus on the muscles and the minimal strain on the joint and I can set myself up for success.
Weaving all of these details together takes expertise. I have developed this expertise over the past 16 years of working within the industry. This has included a BSc in Sport Science and a MSc in Strength and Conditioning. This education and experience specific to training is not a resource that most people have. In that sense, it is a luxury I am very fortunate to have access to. With that in mind, I felt it was worth also covering some strategies that anyone who suffers with joint aches, inflammation, swelling or discomfort can incorporate.
I have personally found that supplementing with Omega-3 and Curcumin have been helpful to maintaining my knee function. They appear to manage the chronic swelling to some extent and I tend to feel less discomfort in the knee itself. Both supplements have lots of research behind them. Much of which centres of their anti-inflammatory properties. From a purely anecdotal perspective I can vouch for these.
Sleep is your number one recovery tool. Those that are sleep deprived and take part in physical activities and sports are more likely to get injured. Maximising the quantity and quality of you sleep is a simple, yet effective way to enhance your recovery from exercise. It will also allow you to recuperate from injuries quicker. If you have a nagging ache then getting good rest will play a big role in your body healing.
Here is what you should be aiming for:
- Aim for 7-9 hours of sleep every night
- Go to bed at the same time
- Wake up at the same time
- Wake without refreshed without an alarm clock
- Sleep the whole night through – multiple bathroom trips are a sure sign of poor sleep quality (or drinking much to much just before bed!)
- Waking up in almost the same position you fell asleep in (not tossing and turning all night)
I’m guessing the above does not describe your current sleep patterns so, here are some sleep tips to help you achieve this:
Buy the best mattress you can afford. Get a comfortable bed, mattress, and pillow. Bed quality can affect sleep. It can also reduce back and shoulder issues. Given you will be spending nearly half your life in bed, it makes sense to invest in a good one!
Establish a routine. Go to bed at roughly the same time and get up at the same time everyday. Yes – everyday! Weekends count too. Being consistent with sleep and waking times has been found to improve long-term sleep quality.
As part of your routine include some relaxation. Relaxation techniques before bed have been found to improve sleep quality. Read a book, listen to a chill out playlist, take a hot bath, do some deep breathing, take some CBD oil, or meditate. Whatever it takes to help you relax and unwind.
Cut the coffee at 4pm. I love the coffe, but having it later in the day can disrupt or even prevent your sleep. On average the half-life of caffeine is about 5 hours. This can vary massively between individuals though. If you are a slow metaboliser of caffeine then you might have levels in your system keeping you alert and awake into the early hours if you drink it after 4pm. In extreme cases, having it within 10 hours of bed can be disruptive for some people. So, cut yourself off at 4pm and see if you can fall asleep easier. If you are still struggling slide things forward to 3pm and reassess.
Disconnect from the matrix! The blue light emitted by the screens on your devices can disrupt your sleep. The body’s internal clock or circadian rhythm is largely influenced by daylight hours. Artificial light (e.g. streetlights, and lightbulbs) already disrupts it but staring at screens magnifies the issue. Your internal body clock is served by the ocular nerve which is directly affected by blue light. The exact same lightwaves your phone, TV, laptop, and tablet give off. To improve sleep, I suggest you disconnect from screens like this for at least 60 minutes before your planned bed time.
Sun exposure can help you sleep. In opposition to the previous point – try to get some natural sunlight exposure during the day. At these times, the body needs the light. Studies have found that two hours of bright light exposure during the day increased the amount of sleep by two hours and improved sleep quality by 80%.
Chill Out! Set the room temperature at about 20oC (70oF). Room temperature has been found to affect sleep quality more than external noise!
Abstain from alcohol. Just a couple of drinks have been shown to reduce your sleep hormones. Alcohol alters melatonin production and decreases human growth hormone (HGH) levels. Melatonin is a key sleep hormone that tells your brain when it’s time to unwind, relax and fall asleep. HGH helps regulate your body clock, is anti-aging, and vital to recovery.
That’s sleep covered in detail. Now onto some other key strategies…
Consuming a balanced but, varied diet is also a highly effective strategy. After sleep, your diet is your most powerful recovery tool.
Keeping inflammation down is a hot topic at the moment. Many experts are describing our typical western diets as ‘pro-inflammatory’. I personally have found my knee grumbles less when I focus on eating high quality, nutrient dense foods and avoid eating too much refined or processed food. This doesn’t mean you have to eat ‘perfectly’ all the time and that you can never eat another pizza, burger, cookie, or chocolate. It’s what you do on average that counts. The key is to eat foods that nourish you most of the time and occasionally have the foods you love.
I suggest you focus on getting a wide variety of nutrients in by ‘eating the rainbow’. By this I mean including as many different coloured fruits and vegetables into your diet as possible. This simple tip will go a long way to ensuing you get the broad spectrum of micro vitamins you need.
A good warm-up should achieve two things:
- Improve your performance in the upcoming workout
- Manage your injury risk
Sadly, most people give their warm-ups no thought at all. Mindlessly hoping on the treadmill for 5 minutes, doing some arm swings then diving into lifting heavy weights seems to be the standard approach most gym goers follow.
This is a recipe for disaster.
A good tip when it comes to planning a proper warm-up is the R.A.M.P. acronym. It stands for:
- R-raise body temperature, heart rate and blood flow
- A-activate specific muscle groups
- M-mobilise joints
- P-potentiate performance
The first part of that sequined seems pretty obvious given a warm-up is called a warm-up. While doing light exercise and mobility drills can help achieve this increase in body temperature, heart rate and blood flow. There is another great way to kick-start the process.
Use Warming and Cooling Gels
Heat increases blood flow by opening small blood vessels. This can help to relax muscles. This can contribute to increased mobility and is one of the key reasons we warm-up before strenuous exercise.
If stiffness in your muscles or joints, or nagging injuries, are holding you back in the gym then, this could be relieved significantly through the application of heat.
Improved blood flow and mobility will help to improve the quality of your training and can contribute to managing your injury risk.
Personally, there have been times when my knee has felt like it’s made of either glass or tin. Neither sensation is conducive to effective training. I have always found that it needed an extensive warm-up to get the knee feeling ready to undertake the workout. This is time-consuming and can be mentally draining.
Using the NaturalWorks gel pre-workout has helped to reduce the frequency worth which I have felt like my knee has needed an extensive warm-up just to perform the first exercise. Instead of 20 minutes of progressive mobility and activation drills I’ve found that applying the gel and then utilising about 5 minutes of very targeted warm-up drills has done the job on days when my knee doesn’t want to play ball.
The NaturalWorks gels have been a god send for me. Despite using all of the other strategies I listed earlier, my left knee occasionally feels achy and the range of motion at the joint is limited before training. It is also generally swollen and a bit grumpy after a hard training session.
The warming gel has helped pre-workout. Using the cooling gel post-workout has noticeable improved the swelling and discomfort too. I have been managing to train my legs twice per week with weights and do a couple of hard bike interval sessions and my knee is coping just fine. It would not have tolerated that workload in the past.
The cooling gel feels great post-workout and provides a very pleasant sensation. The cooling effect helps to reduce swelling by decreasing the blood flow to my knee and reduces sensitivity at the joint.
I love the highly targeted nature of the gels. They work directly on the site I need them. While things like cold showers or ice baths are popular they work on a much more general level. They impact your whole body. Not the specific area most in need. Using a topical cream like this affects the local area more gradually but provides ongoing relief as the active components of the cream are absorbed through the skin.
I have noticed my knee doesn’t ache afterwards and is less puffy. This could be a placebo effect, but given I have had 16 years of aches and swelling in my left knee then I am more than happy to go with whatever works.
Managing Joint Discomfort is Multi-Factorial
Smart exercise choices, good rest strategies, plenty of sleep, a great diet, and smart supplementation are all important to manage aches and discomfort. Topical warming and cooling creams are another useful strategy. Especially products with additional beneficial ingredients that can ease discomfort gradually. I have found these to be a real benefit to me and more specifically my knee. Including them has helped me to train harder and more often. As a gym junkie that’s worth it’s weight in gold!