PUREfit

Friday, September 10, 2010

Knee Pain and Injury improved with Strengthening, Stretching and Rest

Exercises Can Prevent Injury
Tomorrow's post will have a list of exercises and stretches for you to do at home.


Strengthening the muscles that support the knee with knee exercises is most important in protecting your knees from injury and knee pain.

Weak or fatigued muscles cannot adequately support the knee joint or absorb shock before it gets to the knee and the extra stress placed upon the knee can cause injury to the structures of the knee. Strengthening exercises can make the muscles tight, so follow strength exercises with stretching exercises.

Stretching the muscles that support the knee with knee exercises is also important in preventing injury. Flexible muscles are not as easily injured as tight muscles. Tightness of muscles connected to the knee can also pull the knee out of alignment.

When doing stretching knee exercises, be careful to go slowly and not to overstretch. You do not want to tear a muscle.

You need to increase the duration of your knee exercises gradually to avoid overuse injuries and knee pain. Be patient. You will see results.

Strength must be built up gradually. When muscles, tendons or ligaments are stressed slightly beyond their limits, microscopic tears occur. This is normal, and as these tears heal the muscles actually become bigger, firmer and stronger. These microscopic tears must be given adequate time to heal or chronic problems can develop. Try not to exercise the same muscle groups two days in a row to give your body a chance to recover. Doing strengthening knee exercises three or four times a week is enough. Stretching knee exercises can be done more often.

The goal is to prevent injury and knee pain, not cause it.
Don’t ignore pain. Pain is your body’s way of protecting you from hurting yourself further. It is not unusual to experience mild stiffness and aching of the muscles that lasts up to a day after exercising. But hardly being able to move for a few days after exercising means you have overdone it. It’s difficult to know when to quit when you doing knee exercises. Often, the pain doesn't’ set in until a day or two later. It happens. If it does, you will have a greater understanding of your body’s limitations.
When you have overdone your knee exercises.

Rest is important for inflamed muscles/tendons. Applying ice wrapped in a cloth can help reduce inflammation and pain and speed up healing. See Treatment for Overuse Injuries. Knee pain should be completely gone before fully resuming your knee exercises program, however, lightly exercising the sore muscle may help decrease muscle soreness.

If you are currently experiencing knee pain or have a knee condition/injury and/or have a very limited range of motion, or are simply not sure which knee exercises are safe for you to do, see a physical therapist (physiotherapist). A doctor or physical therapist can assess your condition and give you a customized treatment / exercise plan.

Main Muscle Groups Affecting Knee Stability
 
Several muscle groups support the knee. The two main muscle groups that control knee movement and stability are the quadriceps and the hamstrings.

THE QUADRICEPS is a four-part powerful muscle that run along the front of the thigh and attach to the front of the shinbone, just below the knee. The quadriceps control the straightening of the knees and movement of the kneecap. The quadriceps is used to extend the leg, and is essential for standing up, walking upstairs, walking uphill, and running.

THE HAMSTRINGS are muscles that run make up the back of the thigh, and attach to the back of the shinbone, just below the knee. The hamstrings are used to bend the knee and are also needed when you are pushing against something.

Other Muscles Affecting Knee Stability
 
Other muscles that affect knee stability, to a lesser degree than the quadriceps and hamstrings are the calf muscles, the hip abductors located on the outer thigh, and the hip adductors located on the inner thigh. The body functions as a unit (remember - the hip bone's connected to the knee bone) and even muscles not near the knee can contribute to knee stability.

The iliotibial band (fibrous tissue on the outer thigh, extending front the hip to below the knee) also affects knee stability. The glutes (back of hip muscles / buttocks) inserts into the thigh bone and iliotibial band and also help stabilize the knee.

*It is important to do strengthening exercises for all the muscles that support the knee. For example, if you concentrate on strengthening exercises for the quads, and neglect strengthening exercises for the hamstrings a muscle imbalance can be created.


Imbalances in Muscles Supporting the Knee
 
A physical therapist (physiotherapist) can help determine if you have a muscle imbalance in the muscles supporting the knee and create a personalized exercise program.

Imbalance of the quadriceps is common, especially in women - The quadriceps is divided into 4 divisions. If the inner division if weak, the stronger outer division tends to pull the kneecap toward the outer side of the leg. Tightness of the quads can also pull the knee towards one side so stretching as well as strengthening of muscles that support the knee is important.

In some cases, the quadriceps is significantly stronger than the hamstrings. (The quadriceps should only be about 25% stronger than the hamstrings). This can cause weakness of the knee. If this is the case, concentrating on strengthening exercises for the hamstrings, and stretching exercises for the quadriceps are very helpful.



Rest, Ice, Compression, Elevation (RICE)
*See a doctor immediately if your knee is giving out or if there is swelling or redness. Otherwise, see a doctor if the pain persists or is getting worse after 3 days

Rest: (Not total rest) Reduce your activity until the swelling and pain subsides, usually 3 or 4 days. Avoid activities that cause pain. Do not return to the activity (kneeling, running, jumping) that caused the problem until your physician advises you it is safe to so. It is usually recommended you return to activities that caused the injury gradually and stop if pain occurs.

Ice: Apply ice wrapped in cloth every 15 minutes per hour the first day then every 3 to 4 hours for the second and third day. Leaving the ice on for over 20 minutes can cause frostbite. (Moist cold - applying a wet towel between the skin and the ice pack - penetrates more deeply and quickly than dry cold)

Compression: Wrapping the knee in an ACE bandage (elastic bandage) can limit swelling and relieve pain. If the leg becomes colder than the other leg, the bandage is too tight. Remove the wrap before bedtime. Bandages are also useful for holding on a bag of ice.

Elevation: Elevate knee above the level of heart (place on pillow) while icing to further reduce inflammation.

Applying Heat
After four or five days, providing the swelling has subsided, applying heat to the knee may be beneficial. Heat helps to increase the blood supply, which promotes healing and also helps to relax tight muscles. Apply heat for 15 minutes several times per day. (Moist heat penetrates more quickly and deeply than dry heat) Wait at least an hour between heat applications to prevent the overheating of tissues.

* NEVER apply heat to an inflamed joint. There already is increased blood supply with inflammation. Heat will increase the inflammation.

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