Treat Your Own Knees: Simple Exercises to Build Strength, Flexibility, Responsiveness and Endurance

Answering the critics First, let me say that I was having almost constant low-grade pain in my left knee for about five years. Occasionally, I would gently twist my knee by accidentally dragging the ball of my foot on the ground which would result in two or three days of acute knee pain. Getting in and out of the car was a real chore. And sometimes my knee simply felt loose like it might come disassembled. I could feel stuff moving around in there. I bought this book, read it, did exactly what it said, and in about a month I was 95-98% pain free and my knee no longer felt "loose". For more, see my comments under Brian Hurler's 3-Star review. I feel I am qualified to review this book by answering the critics. The complaint is made that the book doesn't discuss specific treatments for specific knee disorders. Johnson spends a lot of words explaining why that's usually not necessary. If you can restore function by strengthening the knee support system, then the specific cause of the pain and disability is irrelevant. Johnson also tells you when you should see a doctor to seek specific diagnosis and treatment. Yes, all of Johnson's recommendations could have been put on one sheet of paper but then the reader might not be motivated to try the suggested regimen because he/she would not understand why those particular exercises were recommended and why they might be effective. One commenter complained that there was nothing about strengthening knees to prepare for playing tennis. The book is for people who have painful knees that need treatment. Nowhere is the book billed as an all-purpose comprehensive preparation for strenuous athletics although I believe the exercises in this book would be a good place to start - They build strength, flexibility, stamina, and proprioception. Then you can find more strenuous exercises that work the same muscles. Get the Men's Health Big Book of Exercise for some ideas. The complaint is made that there are only 4 exercises and those could have been obtained from a good chiropractor or a good PT. One of the things I like about Johnson's books is that he only gives you the minimum of exercises that will do the job. You don't waste your time doing redundant exercises and you don't waste your time doing exercises that haven't been proven to help the problem. It's very efficient. What is the cost of a chiropractor or a PT? And how do you know you have a GOOD one? How do you know if the exercises they give you will be as efficient and effective as these proven ones? One commenter recommends that you hire a personal trainer to train "all your muscles back to good form while using proper positioning to reduce further injury." In my experience, the exercises in this book are explained thoroughly enough that proper form can be executed; the exercises are effective at building the necessary strength and flexibility to reduce or eliminate knee pain; and they are certainly gentle enough that they aren't going to cause further injury. Effective, as advertised, for the problem and efficient of your time - I don't understand the complaints. Personally, I don't want to spend my life exercising or at the gym or at the chiropractor's - I just want to have a pain-free knee.

An essential book. Very well written and does not take long to have results from the exercises. Good amount of information about the knee and how it works.

WHY YOU SHOULDN'T READ THIS REVIEW If you are reading reviews of this book, you probably are close to a person who suffers from knee pain. You are reading these reviews to find out if Johnson's book will help you. This review will not tell you what you want to know. This review is, in all probability, a waste of your time. The best thing you can do is skip this review and go on to the next one. WHY I WROTE THIS REVIEW I do not write reviews of most of the books that I read. It is usually the case that someone else already wrote a review that pretty much sums up what I would have said. And, usually, they have said it better than I could have. But there are some occasions when I have read a book and I find that no one else has responded to the book the way that I have. That is what has happened with this book and I feel compelled to explain, as best I can, why I think that this book needs to be critiqued in a different way. MY CRITICISMS OF THIS BOOK Johnson claims that there is strong scientific support for knee pain sufferers doing strengthening, stretching, proprioceptive, and endurance exercises. But most of the numerous scientific studies that he cites do not demonstrate that those exercises relieve knee pain. Thus, his book, although it has many fine attributes, has some serious logical flaws. If the studies he cites do not demonstrate that the exercises relieve knee pain, what do they demonstrate? They demonstrate a number of things: 1. People who have deficiencies in strength, flexibility, proprioception, or endurance tend to have knee pain. 2. People who do exercises tend to resolve those deficiencies. Please note that 1 and 2, above, do NOT support the conclusion: 3. People with knee pain, who do exercises, tend to experience relief of their knee pain. It is important to be aware of the fact that 3 might be true. But, if we are to adhere to Johnson's stated requirement to recommend only those therapies that have strong scientific backing, then we should not accept 3 on the basis of 1 and 2. We should only accept 3 on the basis of rigorous studies that support 3. Johnson does not cite studies that support 3. Let me restate this point. Johnson's thesis is, "if we restore function, the pain will subside" (12). What he means is that if we get back the knee's strength, flexibility, proprioception, and endurance, then the pain will go away. But there is little evidence to support this. What the evidence shows is that if we do exercises, function is improved. We regain strength, flexibility, proprioception, and endurance. It does not show that restoring function relieves pain. But Johnson's central point is that restoring function relieves pain. Therefore, his central point is not supported by the evidence he provides. What follows is a more detailed look at the book. Most readers, if they made it this far, will probably want to stop here. The following is a kind of addendum that will be of interest only to a tiny number of pedantic obsessives. A CLOSE READING OF SOME PARTS OF THE BOOK In the Introduction, Johnson says, "When I say something works, I don't say it based upon my personal experience or anecdotal evidence, I will only say a treatment works when it has been proven effective in a controlled trial . . ." (3). He then cites a British Medical Journal 2002 article, "Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial." Here is what he says about it: "It involved 786 men and women with knee pain who participated in a simple home-based exercise program (quite similar to the one in this book) designed to improve strength, range of motion, and function. The study demonstrated without question that the program was quite capable of significantly reducing knee pain" (3-4). I read this, and I thought, "Great! There is good evidence behind the recommendations in this book." So I read the rest of the book. But I found it odd that in each subsequent chapter, as Johnson explained the exercise necessary for each of the four major functions (strength, flexibility, proprioception, and endurance), he never again gave evidence that showed that the exercise reduced pain. He only showed that the exercise enhanced function. So, I figured that this 2002 article must be central to Johnson's program. I then found, to my delight, that this article is publicly and freely available on the British Medical Journal website. When I read the study I was sorely disappointed. First, the study required 30 minutes per day of resistance exercise for two years. This clearly was quite different than Johnson's program which only required 2-3 minutes of resistance exercise 3 days per week. Second, the study found that the reduction in pain for those who did the exercise was 12%. As the study authors wrote, "some patients may consider the effect (a reduction in pain of 12%) to be too small to be worth the effort of half an hour of daily exercise for two years." The authors also report "the number needed to treat to achieve a >50% improvement in knee pain in [sic?] 13.0." I am not a scientist, so I am not clear what they are trying to say here. But it sounds to me like 13 people would have to do 30 minutes of exercise daily for two years in order for one person to experience pain relief of 50% or greater. Now, please remember the Johnson quote, five paragraphs above this one: "the program was quite capable of significantly reducing knee pain." Yes, Johnson is correct. When scientists use the word "significant" they mean that they are confident that the effect that they observed was not due to random variation or chance. But I am not a scientist. I expect the author of a book targeted towards a nontechnical audience to use words in their ordinary meaning, unless the author has explicitly warned the reader ahead of time. In everyday parlance, a therapy that would have to treat 13 people in order for one of them to get at least 50% pain relief is not a therapy that significantly reduces knee pain. I thought the point of the book was that Johnson was going to filter out the bad studies, so that I don't have to. Or, at least, if a study had serious limitations, he would point them out. Also in the Introduction, Johnson cites another article that is online for free, Topp et al. "The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee." In this study, patients did six isometric exercises three days per week "by using maxiumum-resistance Thera-Band elastic bands, which they were unable to stretch during the exercise." "[D]uring weeks 9 to 16 each subject performed 3 sets of 12 repetitions of each exercise," followed by a 5-minute cooldown with stretching. This study showed that patients' reports on a pain scale dropped from 11.75 to 10.38. But what was very encouraging was that their perceived pain when engaging in activities like walking up stairs plummeted from 5.19 to 2.98. But the odd thing is that Johnson does not cite this study as evidence that exercises that strengthen muscles reduce pain. Instead he cites it only to say that it "proved that the seemingly puny isometric mode of exercise could strengthen the knee of the knee-pain patient every bit as much as the more dynamic kind of exercise, without all the fuss of using more complicated exercise equipment" (4). Maybe Johnson doesn't use this study to support his claim that exercise relieves pain, because the study uses more exercises than Johnson's program does, and it uses resistance bands, which Johnson's does not. I have gone into painstaking detail on the strengthening exercises, because they are the only ones where Johnson hints that they provide support for the claim that exercise relieves pain. For the other exercises--those that target flexibility, proprioception, and endurance--he cites no studies showing pain relief is the effect of exercise. So, for the single strengthening exercise that Johnson recommends, the scientifically supported evidence that it relieves pain is flimsy. For the other exercises that Johnson recommends, he provides no evidence that they relieve pain. To summarize this long review of a short book, Johnson's program might very well provide a lot of pain relief to most people who use it. But the efficacy of Johnson's program still awaits scientific confirmation. Most of what I do in my life is not supported by scientific studies. Johnson's program is just like most of the other things that I do. ------------------------- August 3, 2013 Update I started Johnson's program on May 12. I progressed steadily until I was mostly pain-free. Then, in the first week of July, I suffered a relapse with a lot of pain. I continue following the program, hoping I will be pain-free again.

My "net" is that if you experience chronic or intermittent knee pain and you have no reason to believe that there is something seriously wrong with your knee(s), like an infection or torn ACL, buy this book, read it, and then perform the simple exercises on the schedule prescribed by author Jim Johnson. I have been doing four basic exercises for almost six (6) weeks now and the pain in my problem (right) knee has almost disappeared. If you follow author Johnson's prescriptions for knee exercises, I hope they will benefit you also. That said, I would also reiterate the author's closing comment: If you don't feel any improvement in your knee pain after doing these exercises for three (3) months, these exercises are not the solution to your knee problem. Since hiking up and then back down part of Barr Trail (the trail to the summit of Pikes Peak near Colorado Springs) in 1995, I have experienced periodic pain in my right knee. I attribute the cause of my pain to hiking downhill for about seven miles that day. That was 14 years ago. In the intervening years since that hike, the pain in my right knee has become almost chronic, lasting for several days to several weeks, and is often aggravated after riding my bicycle, hiking or doing other exercise or work that requires extensive knee movement. I had X-rays taken of my right knee in 1999 and the leg examined by an orthopedic specialist. The X-rays did not show any obvious problem(s) and the specialst could not find anything wrong after physically examining my knee. Perhaps an MRI would have revealed something, but I chose not to spend the money for that test then. Fortunately for me, the pain has never been debilitating and it can usually be alleviated by taking ibuprofen. A heating pad also helped. Specifically, the pain I experience is almost always on the right side of my right knee and in the back side of my knee. This spring (April, 2009), I helped plant a number of trees in my neighborhood. After that work, I experienced pain in my right quadricep in addition to the "normal" knee pain I had been experiencing for a number of years. I am now 67 years of age and retired and I would like to stay active by hiking, bicycle riding, ice skating, motorcycling, etc., so I became increasingly concerned that my right knee might ultimately limit my ability to do these kinds of activities. To address my problem, I searched the Internet and found, along with a lot of other interesting information about the causes and sources of knee pain, Jim Johnson's book. The book is short, well-organized, clear in its descriptions and examples - and inexpensive. The author gets immediately to the four (4) attributes our knees must have to function properly, without pain or damage to the knee, and how to help regain or improve the four (4) key attributes. I read the chapters addressing the four attributes required one at a time and started doing a recommended exercise as soon as I completed reading a chapter. The exercises, as described by the author, are: 1. Simple 2. Quick to do 3. Require no special equipment (see two tips of possible benefit below) 4. For me, effective. Tip 1. The exercise I chose to strengthen my quadriceps is done every other day. The leg is straightened and the knee is pressed down for five (5) seconds against a pillow folded under the knee or against the floor. The exercise is repeated 30 times. I found it hard to count the 5 seconds ("1000", "1001, ..., "1005") for each repetition and also remember how many repetitions I had completed. To solve my problem, I put 30 nickels (any coin size will do) in a dish next to me. Each time I completed a repetition of the exercise, I tossed a nickel out of the dish until the dish was empty. 2. Because each of exercises is timed, I located a handheld stopwatch I bought a couple of years ago at WalMart for about $12.00. I use the stopwatch to time all of the exercises. If you purchase a stopwatch, I recommend one with large numerals and that you can operate easily with one hand. I think the use of a stopwatch lends consistency to the timing of each exercise and also relieves you of having to estimate the 5 seconds or 30 seconds required for each exercise. For the record: 1. Age: 67 years 2. Weight: 155 (+/- 3-4 pounds) 3. Height: 5 feet, 8 inches I believe I am in reasonably good physical condition. I try to exercise by lifting weights, bicycle riding, hiking, ice skating, etc. on a (more or less) regular basis.

I started running a few months ago: I'm following a 13 week plan i discovered in another book. I couldn't cover 1/4 mile when i started without gasping for breath. Now I go out and jog for forty minutes and cover 3+ miles. My heart rate returns to normal within minutes. It's an achievement I'm proud of. But I think I have "runner's knee". If I jog very slowly on any given day my knee pain is minimal. If I "push it" the pain is less "minimal". If I drive a car for 30+ minutes, with my right leg unable to straighten, the pain is very sharp and I have to straighten my leg for 10 seconds to ease that pain. That, and I think "weak knees" are the final frontier in my running program. I haven't trusted my knees in years: I can't remember the last time I jumped over or down from anything. I have no faith in them. I never go for "air" when snowboarding. Etc..I'm 56 and I'm about 8 pounds from having a "normal" BMI at a height of 6'4". I've lost 15 pounds since I started running and I don't want to quit. That and winter is coming: it's almost snowboarding season. So, I'm trying to improve my knees, the sore one and it's neighbor. The book says I need to work on quadriceps strength and offers simple, quick, and inexpensive exercises. It says I need flexibility, and offers stretches for the quads and ham strings. It says proprioception needs to be improved and offers a 30 second exercise for that. Finally, it says knees need endurance and suggests something for that. Very reasonable, research based, and very easy to comply with. I think this Kindle book was worth every cent. I bought a softcover copy and mailed it to a relative who just had her right knee replaced (she is closing in on 80yrs old). It's a simple, clear book. Give it a try.

We have purchased several of Jim Johnson's self-help books on cures for shoulder pain, spinal stenosis, etc. All have been very helpful and worth the price. However, we were highly disappointed upon receipt of this book - which measures about 4 1/2 x 7". The photo on line here at Amazon appears to be a large standard workbook size - like the size of the Johnson's Shoulder Pain and Spinal Stenosis book. It is not. It is virtually a "pocket book" - less than the size of the original Reader's Digest. One might need a magnifying glass to view some of the exercises that Johnson proposes. My husband actually when to the local copier store to copy and enlarge the exercises shown in the book so that he could see and use them comfortably. You would have thought that both Johnson and the publisher - - knowing full well that such books are mostly directed to persons whose eyesight diminishes with age-- would have published this book in larger print similar to the books I have cited above. I believe that many buyers of this book would have been willing to pay a higher price for a standard sized book with larger print - to enable ease of reading and following instructions. As a post script - neither my husband nor I have any serious vision problems. Reading glasses, yes. Nothing further.

Great book for your knees!

I've been living with on and off-again knee pain for about 15 years. It was originally diagnosed as patellar tendonitis in my right knee after an impact injury. As I got older (now 42) each time it came back it was worse and worse. I've had times where I could not walk without crutches because of it, and have lived with terrible pain. Sometimes it keeps me from climbing stairs, going to the store, and most recently was even keeping me from being able to press the accelerator pedal on my truck. The last few years have been so bad I've been to see doctors for it multiple times. Each time I got sent to physical therapy. Each time the PT made it *worse*. They always wanted me to advance on *their* schedule, pushing me and pushing me to do exercises that were beyond my pain threshold. It was as if they presumed I could do them because of my age or something. The last one I saw pushed me to do one-legged squats, and when that reversed weeks of work they lied about it and said they never told me to do that. I finally found this book, and its biggest strength is that the author understands that people reading it are probably in significant pain. He lays out a simple and logical program that includes variations for each item---variations based on what you are able to do at the moment. I followed his instructions for about 5 weeks (so far) and it has made a tremendous difference. I am amazed at my progress. His simple program did in 5 weeks what three 8-week sessions with professional personal physical therapists and multiple doctors could not do. He got my pain improving and thus my walking and stair climbing as well. Endurance is still my biggest challenge (i'm also dealing with foot pain) and i'll be continuing the program for at least another month to see how it goes. But the short of it is that if you've had knee pain, and especially if you're really in pain now, this is the book to try. I bought it on kindle and while the images probably weren't as good it worked well enough. Thank you to the author!!

The book gives practical exercises and explains the functionality that the knees should possess. Overall a nice book. Needed to order this for my mothers knee agony and would say it was reasonably effective in making the pain manageable.

A really useful book and easy to understand.

I purchased a copy of this book on the strength of the customer reviews here, and I have to say that after a couple of months I am in agreement with the general sentiment here. I have had pain in my right knee for several years, a problem that seemed to manifest itself when I began to run several times a week. It would come and go, but recently it has become more persistent. I'm 33 and put this down to the aging process, but was ready to give this book a try to see if it would make a difference. I think the biggest revelation for me is the concept of "proprioception", something that I'd never heard about before. It's basically about how your brain communicates, via your nervous system, with the various parts of your body - including your knee - and tells them how to function correctly. I combined the proprioception exercises with the quad strengthening regime. I tried to approach the book with an open mind, but I had to deal with my own ego when it came to muscle strengthening. I have been weight training for years, and my legs are probably my strongest body part. I can squat pretty heavy weights for my size, so I was quite skeptical when the book attributed weakness in the quad muscles as a contributing factor to knee pain. Anyway, I cast my prejudices (and arrogance) aside and decided to go ahead with the exercises. I was immediately taken with how quickly I noticed the effects. Within days, the pain in my knee had been reduced considerably. I didn't want to get too excited too quickly - there could have been other reasons for the lack of pain - but sure enough, I'm now writing after a couple of months have gone by and my knee is still holding up. Obviously, physiotherapy of any kind is no substitute for treatment, but I'm certain that following the guidelines laid out in this book has improved the health of my knee. I feel much fitter and eager to do the rigorous training that I used to do, and no longer have to worry about my knee playing up. I may or may not need surgery on my knee in the future, but for the time being I am very happy with the results brought on by this book.

small book , difficult to read and totally useless

Great little book very helpful and easy to understand