Women tend to suffer more kneeDeep squat problems than men due anatomy, physiology and hormones. Read on to find out how to lessen the pain.

Words by Peta Bee

For years, I’ve been able to pinpoint the stage of my menstrual cycle by my knees. For the majority of the month, my knees present no problems and certainly no pain, but premenstrually they ache and throb to the point where running is much more of a grind than usual. And I’m not alone. Studies have shown that active women are up to eight times more likely to suffer knee problems – particularly injuries to the anterior cruciate ligament (ACL) that stabilises the joint – than sporty men. Why? Partly because of our hormones and partly because of the way our bodies are made.sore knee

Strife cycle

In recent years, researchers have shed light on the reasons why, like me, so many women complain of knee issues at certain times of the month. What they’ve discovered is that hormones, such as estrogen, weaken knee ligaments at different phases of the menstrual cycle, leaving them prone to twisting or straining.

One study conducted at the University of Calgary showed that the time of hormone-induced laxity – or flexibility – of joints varies among women, with most experiencing some pain or discomfort around ovulation, but others displaying a greater predisposition to knee and joint problems at the very start or end of their cycle. Professor Darren Stefanyshyn, who carried out the research, monitored 26 women throughout the course of their monthly cycle, measuring knee laxity at each phase and asking the subjects to perform athletic movements, such as lunges or sudden jumps. He found that the greater the knee laxity, the more prevalent the biomechanical differences that could lead to injury. Women who find their knees are painful at certain times of the month should limit any high-impact exercise – including running – for a few days if they find their knees ache, Professor Stefanyshyn says.

Physiotherpist Sammy Margo says that if your knees suffer from hormonal influence, listening to your own body is key. “Usually the effects last a couple of days at the most,” she says. “You don’t have to stop running, but take it easy. Or try a non-weight-bearing exercise, such as cycling or swimming (but not breast stroke, which is hell for vulnerable knees) to give your joints a break.”

Feeling the strain

Hormones aren’t the only reason your knees might suffer. The obtuse angle of women’s hips – designed to be able to carry children – can cause you to run differently to men, putting extra stress on your joints. “Often, a woman’s upper legs don’t come straight down, but come in at an angle towards the knees,” Margo says. “This can cause the classic knock-kneed running style that puts strain on the knees.” Working on improving your running style can help. “Research shows that a poor running style can affect the back, hips, knees and ankles, and may lead to pelvic and lower-limb problems,” says physiotherapist Chris Boynes. “If you’re prone to knee problems, it’s worth having a gait analysis done by a physiotherapist or getting a podiatrist to carry out an assessment of foot biomechanics.”

Appropriate footwear can certainly lower your risk of knee problems, Margo says, as can strengthening the hamstring muscles in the backs of your legs, through exercises such as squats, lunges and stair-climbing. Sporty women tend to have stronger quadriceps muscles (in the front of the leg) and relatively weak hamstrings (in the back), which causes a potentially risky imbalance of power. The quads tighten the ACL, while the hamstring muscles relax it. “A lack of good hip stability and poor control of the gluteal muscles can also worsen knock-knees,” says Boynes. Try a Pilates class to strengthen these areas.

The good news is there is much that can be done to strengthen your knees and lessen the risk of injury. “Always warm up by jogging before a run and stretch the major leg muscles afterwards,” says Margo. “Listen to your body and use common sense. Look after them and they’ll carry you through.”

Protect your kneesSquat

Building the strength of muscles supporting the knees helps to protect them, as do exercises that develop other body parts. Knee-strengthening workouts should include movements across all three planes: front and back; side-to-side; and rotational. Here’s how…

  1. The American College of Sports Medicine recommends hopping to help the shoulders and abdominals control what happens at the knees. Stand on one leg and hop over an imaginary straight line ten times. Change feet and repeat.
  2. Squats are great for strengthening the muscles that support the knee. Stand with your feet shoulder-width apart, then lower your body by bending your knees, with your hips moving back as if you’re sitting in a chair. Keep the weight directly over your heels. Bend your knees to about 45 degrees, pause, then slowly return to the starting position.
  3. Perform bunny hops by jumping on the balls of your feet (with both feet together), right to left over an imaginary line. Jump around to face the opposite way and then jump left to right. Repeat ten times.