Tips for Managing Knee Pain During Yard Work

Q: I love to garden, but my knee pain doesn’t allow me to.  What adjustments can I make?

1. Devise a “realistic” plan.

Your picture of a perfect yard & garden might be torn from a magazine cover page, but it’s highly unlikely it was created by only one person, nonetheless, in one day. Create a plan for the activities/sections of the yard you plan on attending to first. The overall project might take days, even weeks, to complete, but having a plan will not only keep you focused but also help pace yourself to avoid excessive stress on the body and avoid overuse injuries. Pace yourself not only for the big picture but within the day. Plan for “rest time” to give your body the break it will need.

2. Treat it like a workout.

Athletes are trained to warm-up to increase blood flow and joint/muscle flexibility to increase performance and decrease injury. Every winter season, we, unfortunately, hear of someone hurting their back shoveling snow or, even worse, a heart attack. Prepping for gardening is no different. Stretching your neck, back, shoulders, and legs can go a long way in injury prevention and decreasing soreness. Even a few minutes of arm circles or walking around the block can be adequate. Would a baseball player repetitively swing a 32oz bat without a proper warm-up? No! Then why would you repetitively pick up 20-45-pound bags of mulch without a warm-up?

3. Hold that pose for an hour?

What if you were told to kneel on a firm surface for 30 minutes and don’t move? Or bend at your waist and hold that for 10 minutes? Not only might you say it’s uncomfortable, but for some downright painful. However, countless people tend to their yard in that same position but for much longer times. When squatting, focus on pushing your hips back like you’re about to sit in a chair. Keep your belly tight and core engaged. While kneeling, try to use knee pads or a cushion. Even consider placing a pillow between your buttocks and calves to sit back on but will raise your seat to avoid excessive bend in the knees.

4. Work smarter not harder.

Today there countless ergonomic products that are not only as durable but much lighter than their wood or metal counterparts. Make sure to use your shovels/rakes/hoes safely; bending at the hips/knees and never quick swinging motions. Keep your trowels and spades sharp to decrease the amount of force needed when digging. Use a wheelbarrow or wagon to push/pull, but don’t hesitate to divide the weight to create more manageable loads. It might seem to make more work, but your body will thank you for the decrease in stress!

5. Elevate your work.

Literally, raise your workspace. Try potting on a workbench or table where you can sit or stand rather than kneeling or squatting at ground level prior to planting. Consider using a raised flower bed or planter boxes. Keep in mind the width of the area so you don’t have to reach forward too far, especially if it’s not accessible from the opposite side.

6. Clean up and cool down.

Usually, the end comprises of throwing all your tools in the garage or shed and calling it a day. However, a few minutes of stretching can go a long way in preventing soreness that night or even the day after. Consider taking a few minutes to walk around the yard to bring your body back to rest. It’s a great way to walk and admire all the hard work you put in!

Other tips to help reduce injury in the garden:

Digging

• Position the shovel in front of you with the blade parallel to your hips.
• Place your front foot on the shovel and use your back leg to stabilize your body.
• Lean forward with a straight spine, allowing your weight to sink the shovel into the dirt.
• Shift weight onto your back leg, bending at your hips and knees and begin lifting the dirt.
• Lower your body by bending at your hips and especially at your knees to bring the shovel and dirt out.
• Stand upright and move your body to where the dirt needs to go, turning the shovel for the dirt to fall off.
• Do not twist or throw the dirt, or you will put your back at risk for strain.

Weeding

• Keep your spine in an elongated (straight) position by:
• Bending at your legs, placing one leg in front and the other in back with your weight equally distributed.
• Using a bucket to stay closer to the ground.
• Maintain a wide base of support while standing, propping one arm on your thigh as a brace.

Lifting (mulch bags, dirt, or leaves)

• We have all heard the old adage lift with your legs. While this rolls off the tongue you may also want to add the glutes into this as well:
• Direction: When lifting make sure you are squared up to the item you are about to lift. Whether this is a boulder, the lawnmower catcher, or a bag of soil keep it close to your body and your sternum (top part of your chest) should be directly facing the item.
• Put It Down: Again, this is tied to unloading your load—make sure to step and point your toes to your desired landing or resting space. Injury is incurred when your hips and upper body go different directions when setting a heavier item down. It is good practice to do this with even lighter items to keep you in good practice.
• Shoveling: Just as in lifting you should square up to your target and when throwing soil, leaves, of other items point your lead foot in a ¼ lunge movement toward the landing place.
• Gloves: Many injuries seen by therapists could be avoided with a good pair of gardening gloves. Very often a client will have a bag, tree, or shrub begin to slip due to their grip and they attempt to awkwardly catch it in mid fall.
• Hips Don’t Lie: Good hip strength and mobility can significantly take pressure and subsequent pain out of the knee joint and also the knee cap. A skilled therapist can not only assess your hips but also depending on your anatomy let you know the custom exercises that will keep your lawn green, vegetables growing, and your beds flowering.

KNEELING

To ease knee symptoms and keep your joints healthy, start with a good kneeling mat or pair of knee pads. They will:

• Reduce the load on the knee cap by creating a consistent soft surface.
• Allow you to get areas where you would have difficulty crouching
• Improve your back and knee mechanics throughout your time in your yard
• For maximum benefit, be sure to move your matt as you weed, plant, or dig—you may have to adjust as you make progress, don’t reach. Many times, if gardening is your goal, your physical therapist will engage in exercises to address core control while you are on your knees or in the quadruped (on hands and knees) position.

Sometimes, kneeling is too painful.  If you experience any pain, opt for a cart or sit on your side.

IS INJURY INEVITABLE?

Despite all your precautions, you may end up getting hurt. A common injury is patellofemoral pain syndrome (PFPS), also called gardener’s knee. It’s not a specific injury—it’s a broad term for describing the pain that comes from one of several knee problems. You’ll usually notice the pain in front of your kneecap, but it can be felt around or behind it. You might also have swelling, hear popping, or have a grinding feeling in the knee. Many times there is an ache not only in the garden but also when you finally sit down for a well-deserved beverage.

Treatment from a good physical therapist can ease pain and help you heal. Your PT can also provide strengthening exercises that prevent injury down the road—or in the garden!