Preventing Knee Pain

Knee pain is no fun and can be a real killjoy for someone who loves to workout. It limits your choices of exercise and you can't do your favorite workouts anymore.

Chronic knee pain, the type you usually get from exercise, creeps up on you slowly. First, you feel it after the workout, then, during the workout. Soon, the pain is there even when you are not exercising, when you climb stairs or sit for long periods. You may hear a crunching or grating sound under the kneecap.

Why knee is easily injured.
The knee is the largest and most complicated joint. It has to bear the load of the whole body. It is well designed but easily abused since it is used in almost all our daily activities, not just when we work out.

The culprit in many cases of knee pain is a muscle called the VMO or vastus medialis obliquus. This muscle is located on the inner side of the kneecap. When the VMO is weak, the kneecap tends to be pulled to the outside like a sliding door that is "jumping" its track. The result is premature wear and tear on the underside of the kneecap.

Women more vulnerable to knee injuries.
When it comes to knees, women seem to have been dealt a raw deal. Penn State University reports that women are more prone than men to knee injuries, especially when playing quick stop-and-start sports like basketball, soccer, tennis and skiing.

A University of Michigan study found that, in women, the quadriceps muscle (front of the thigh) tends to be much stronger than the hamstrings (back of the thigh). This imbalance can cause weak knees. The scientists also found that knee injury rates double during ovulation when there are high levels of estrogen and relaxin (a hormone that is also present in pregnancy for the pelvic bones to widen). This may cause instability in the knee due to loose ligaments (connective tissue that connects bone to bone) and tendons (connects muscle to bone).

Other scientists have blamed women's wider hips. In a woman, the femur (thighbone) connects to the tibia (shinbone) at an angle instead of relatively straight on top. This is called the Q-angle or quadriceps angle. The wider the Q-angle, the greater the risk of knee injury. Maybe that's why top women marathon runners tend to have narrow hips like men.

Your shoes could be the problem.
Women who wear high heels on a daily basis tend to develop osteoarthritis (cartilage inflammation) of the knee later in life, according to a study done at the Spaulding Rehabilitative Hospital in Boston. Osteoarthritis makes walking painful and, in some cases, even unbearable. The longer the women were wearing the high heels, the worse the damage. The width of the heel didn't matter. In other words, wide high heels caused as much damage as narrow stiletto-style high heels. High heels throw your body forward and put 23% more pressure on your knees in the inside underneath the kneecap - precisely the areas that women tend to develop osteoarthritis in. Those "killer" heels might be great for your figure but deadly for your knees. Wear low heels, flats or sneakers when you know you will be on your feet all day.

Worn-out athletic shoes can also cause knee problems. In IDEA Personal Trainer magazine, Dr. Carol Frey of the Los Angeles Orthopedic Hospital states that "fifty percent of a shoe's shock absorbing capacity is gone after 300 miles of running or walking, or 300 hours of aerobics classes and eighty percent is gone after 500 miles or 500 hours". She also warns that for heavier people, the shoe loses shock absorption sooner. This means there is more impact to the joints.

Even if the shoe is new, it may be the wrong shoe for you, says Frey. For example, a person with flat feet whose feet have the tendency to fall inward may unknowingly purchase a shoe meant for a person with high arches.

Overused knees.
Overuse injuries are the most common type of exercise injuries. You aren't doing the exercises wrong, you're just doing the same kind too often. It's too much of a good thing. It is repetitive stress to the same part of the body, in this case the knees, that can cause microscopic tears, inflammation, and pain.

Strengthening the knee.
Strong and flexible quadriceps (in particular, the VMO) and hamstrings would eliminate most knee pain. Many people start a vigorous exercise or sports program without having a solid foundation of strong muscles. It's sort of like taking your ten-year-old car from Aparri to Jolo without overhauling it.

According to George Canlas, sports medicine doctor of Sprain & Strain Clinic and St. Luke's Hospital, the quadriceps should only be about twenty to thirty percent stronger than the hamstrings. If the quadriceps are much stronger than that or the hamstrings are stronger than the quads, there is a risk of knee joint injury.

Check out these exercises to strengthen your vastus medialis obliquus or VMO.

Preventing knee pain.
Aside from strong muscles, good exercise techniques can prevent many cases of knee pain. When doing lunges or squats, avoid having your knees go past your toes. Avoid squats lower than ninety degrees.

When cycling, make sure that you adjust the seat height correctly. A seat that is too low can cause pain in the inner side of the knees while a seat that is too high can cause pain in the outside of the knee. Adjust the seat so that when the pedal is at the lowest position, you leg is almost, but not quite, straight. If you have to strain or rock your hips to pedal downward, you have the seat adjusted too high. If your knees feel crunched up toward your chest when you pedal upwards, you have the seat adjusted too low.

Running or walking on the inner parts of an oval track forces you to turn tight corners. You can develop pain on the outside of the knee. Use the outer rings of the track instead and switch directions often - alternate going one way and then the other to even out the stress on your knees.

Avoid taking overly deep steps on a stepping machine. The knee shouldn't bend more than seventy degrees.

Even if done safely, step aerobics can cause overuse injuries. Cross train or do a variety of aerobic exercises, not just step and more step. When you do twisting and turning moves, be sure to twist and turn as you hop so your foot is not left to pivot on the bench putting a twisting sort of pressure on your knee. Watch out for too many lunges. Just like using a stepping machine, your knee shouldn't bend more than seventy degrees when doing step aerobics.

There is less pressure on your knees when you are at your normal weight range. Each pound of bodyweight puts six pounds of pressure on the kneecap. Therefore, if you are twenty pounds overweight, you are putting an additional 120 pounds of pressure on your knees. The Boston University Arthritis Center reports than losing excess weight may prevent future osteoarthritis of the knee.

Even getting out of the car improperly can get your knees into trouble. Don't put one leg out and keep the other one in a planted and twisted position inside the car. Turn the whole body towards the door in one motion. Then use both legs to get out of the car.

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