Building Better Knees with Kettlebells

Knees: the largest joint in the body. This highly dynamic and complex joint is possibly one of the most important joints in the entire body. The knee plays a crucial role in various movements, such as walking, running, and jumping. The knee connects the thigh bone (femur) to the shin bone (tibia) and is composed of several structures that work together to provide stability, flexibility, and support. Because of the extremely important nature of the joint and the vital role it plays in our everyday activity, let’s learn more about the knee, its structure and function, and how kettlebell exercises can help strengthen the entire knee complex.

Before we begin, let’s take a quick (and by no means complete) journey of the knee. I cannot stress enough to do as much research as possible to truly understand how complex and important the knee is. Talk to a licensed physical therapist or orthopedic surgeon to get a more in-depth analysis and understanding of the knee and how it works on a biomechanical level. Here are the basic components of knee anatomy:

1. Bones: These provide anchors for muscles, tendons, and ligaments. The knee joint consists of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap). The main joint is formed by the rounded ends of the femur and tibia and the patella sits like a shield in front of the joint to protect it.

2. Articular Cartilage: This is smooth, slippery tissue that covers the ends of the femur, tibia, and the back surface of the patella. The articular cartilage acts as a cushion in the joint which allows smooth movement and reduces friction between the bones.

1. Meniscus: Distributes the body’s weight across the joint and acts as a shock absorber. There are two C-shaped pieces of cartilage called the medial meniscus (on the inner side) and the lateral meniscus (on the outer side) are present within the knee joint.
2. Ligaments: Is the primary connective tissue that connects bones to bone. It provides stability, input to the nervous system, guidance, and limitation of improper joint movement. The major ligaments of the knee are:
3. Anterior Cruciate Ligament (ACL)
4. Posterior Cruciate Ligament (PCL)
5. Medial Collateral Ligament (MCL)
6. Lateral Collateral Ligament (LCL)
7. Iliotibial Band (ITB)

The ligaments prevent the knee from over rotating internally and externally, hyperextending, and hyperflexing

1. Tendons: Tendons are tough bands of connective tissue that attach muscles to bones. In the knee, the patellar tendon connects the patella to the tibia, while the quadriceps tendon connects the thigh muscles (quadriceps) to the patella.
2. Bursae: There are several bursae in the knee. The bursae are small, fluid-filled sacs that act as cushions between tendons, muscles, and bones, reducing friction and allowing smooth movement.

FUNCTION OF THE KNEE

The knee joint has various movements. The joint can produce flexion (bending), extension (straightening), and to a lesser extent, medial-lateral rotation. The knee works with the hip and ankle to help support body weight when standing in a static erect posture. It is used for moving and supporting the body in sitting and squatting activities as well as transferring weight during activities.

This is a basic understanding. The knee is complicated and as such, needs to be treated with respect and not taken for granted. Repair surgery is serious and it can be a long road to recovery to restore functional movement.

KETTLEBELLS FOR KNEE STRENGTH

Being that the knee is so dynamic, knee health should be a top priority when it comes to physical fitness. Dynamic joints need to be worked dynamically in a safe and controlled environment. Kettlebells are a perfect solution to help build the musculature of the knee to help provide overall stability and strength. Kettlebells can be used dynamically without putting an extreme amount of stress on the joint due to their total body functional movement. When used properly, the kettlebell exercises work the entire body. This distributes the load throughout the body instead of a particular joint. Using kettlebells can be an effective way to strengthen your knees, but it’s important to approach it with caution and proper technique to avoid injury. Here are a few exercises you can incorporate into your routine to help build stronger knees:

1. Goblet Squats or any Front Loaded (racked) Squat: Squats strengthen knees. There is literature for and against knee placement in front of or behind the toes and the sheer force that it can place across the knee, but one fact remains, there is no better exercise to help strengthen the knee musculature than squats. What they say about the basics is true. Be a master of the basic movements because they will be used frequently. This exercise targets your quadriceps, hamstrings, and glutes while improving knee stability.

2. Single-Leg Deadlifts: This exercise helps build the entire posterior chain. To take excessive load off the knees when performing everyday activities, the posterior chain needs to be strong and stable. Being bipedal creatures, we are quad dominant. By activating and building a posterior chain, the load gets placed through the lower portion of the body and not completely on the quad. We all have muscle imbalances, and the goal is to try and mitigate that as much as possible with Single-Leg Deadlift. Quad strength is vitally important to strong knees, but we get an overload of quad work just by performing everyday activities and it needs to be balanced out.

3. Step-Ups: These are a great general lower body fitness exercise, and they can be done by holding the bell in the goblet position, with single or double racked bells or with single or double bells hanging from on the side. Each provides a different stimulus to the body for overall strength and stability. Make sure the step height is at a normal gait or height. We want to fully incorporate both anterior and posterior of the lower body and a step that is too high can place an emphasis on either the anterior or posterior chain while pulling emphasis away from the other. This exercise targets your quadriceps, glutes, and improves knee strength and stability.

4. Kettlebell Swings: These are mandatory with kettlebells! One bell, two bells, alternating hands; there are countless variables when it comes to swings. A good swing will work the entire body and has the added benefit of cardiovascular work. A good swing is also the foundation of most kettlebell exercises. This exercise targets your posterior chain, including your glutes, hamstrings, and lower back, which can help stabilize your knees.

Remember to start with lighter weights and focus on proper form before progressing to heavier kettlebells. Like with all exercise, proper movement through a full range of achievable motion should be the primary concern and then address load and volume in later session. It’s also essential to warm up adequately. Make sure to address any movement patterns that are compromised due to tightness or general lack of mobility. Just grabbing a kettlebell (grip and rip) opens the body to a whole world of injuries. I personally recommend going through two or three mobility drills and then start with Turkish Get-Ups but that should be left to the individual and their needs. Remember, treat your knees well and they will treat you well for a lifetime.

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Works Cited

Clark, Michael A, et al. NASM Essentials of Personal Fitness Training. Burlington Jones & Bartlett Learning, 2018.

Norkin, Cynthia C, and Pamela K Levangie. Joint Structure & Function a Comprehensive Analysis. Philadelphia Davis, 1992.

Pavel Tsatsouline. Kettlebell : Simple & Sinister. Reno, Nv, Strongfirst, 2019.

AN EXTREMLY SPECIAL THANK YOU TO ANDREA ROBERTS, MPT FOR EDITING AND CONTEXT