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Six ways to ruin your knees

The first mistake many people make is to ignore the warning signs of knee problems. Exercisers often think that knee pain simply comes with the territory, but leaving knee pain untreated can lead to serious consequences. Even those who don’t exercise tend to overlook knee pain, thinking it is a normal consequence of aging, when in fact it is not.

University of Pennsylvania orthopaedic surgeon and sports medicine specialist Nicholas DiNubile, MD, says, "Because they're the main hinge between the ground and the rest of your body, the knees serve as your 'wheels' that get you around and allow you to be active. Life can really go downhill when you damage your knees,” says DiNubile, who is a spokesman for the American Academy of Orthopaedic Surgeons and author of FrameWork - Your 7-Step Program for Healthy Muscles, Bones and Joints.

The knee is highly susceptible to injury because it is held together by a complex system of tendons, ligaments, muscle, and cartilage. It is a critical hinge where several bones all come together: the femur (thigh), tibia (shin), fibula (next to the tibia), and kneecap. Because of its wide range of motion, it is easy for one of the ligaments to tear, or for the tendons to swell. The knee maintains delicate balance of stability and flexibility, which can be disturbed even with normal wear and tear.

The first strategy to protect your knees is to not ignore consistent knee pain. Occasional minor pain may not indicate a serious problem, but adequate rest should resolve the pain. In addition, your mobility should not be significantly limited. If the pain limits your normal activities, you should see a doctor.

The next strategy is to avoid being overweight. Each kilogram of bodyweight adds an additional 2.2 kilograms of force on the knee joint. Even 5 extra kilos, therefore, puts significant additional strain on the knees. Your chances of developing osteoarthritis of the knee also increase if you are overweight. Osteoarthritis is one of the most common forms of arthritis and also one of the most disabling. The disease wears away the cartilage that cushions the knee, and being overweight can accelerate this process.

As mentioned earlier, adequate rest is critical to allowing your knees to heal and to avoiding re-injury. The length of recovery time from knee injuries varies greatly and may range from two weeks to several months. Many athletes return to their activity too soon and suffer relapses. Dr. DiNubile recommends working with a sports medicine doctor or physical therapist to ensure proper rehabilitation of the knees.

The most commonly injured knee ligament is the anterior cruciate ligament or ACL. Any sport that involves twisting, jumping, or cutting places greater stress on the ACL and carries a higher risk of injury. In particular, football, basketball, and volleyball often result in ACL injuries. In particular, women are at higher risk for ALC injuries because of the way they naturally land, jump, and turn on their knees. There are neuromuscular training methods available that can retrain athletes to move in ways that reduce the risk of injury to the ACL. These methods involve improving agility, strength, and jumping and landing techniques, and have been shown to reduce the risk of knee injury by almost 50%.

Finally, it’s important not to overlook the strength and flexibility of the muscles around the knees, as weakness and tightness can increase the risk of injury. Strong muscles around the hip, pelvis, and kneecap help provide support and keep the knees stable. Strengthening the quadriceps and hamstrings, as well as the core muscles of the abdomen and lower back will also provide support to the knees. Try to be aware of what muscles you may be over training in your regular activities, and which muscles may need strengthening in order to be balanced. For example, cyclists tend to have very strong quadriceps, but in order to maintain balance, they need to train the hamstrings as well. A regular schedule of cross training is an ideal way to ensure that your muscles are developed adequately. If you think you might have knee problems, consulting a personal trainer is an excellent way to review your current exercise activities and ensure you’re not creating some sort of imbalance in your muscles that might strain your knees.

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