By Karyn Gallivan, MS, ATC, CSCS, NSCA-CPT, NASM-CPT
Contributor, Sports+Fitness Network
The knee is one of the most complex joints in the body –it acts like a hinge joint, but it also has a rotational component. It has some major ligaments, but also those soft, pillowy things called menisci. It mostly flexes and extends our knee; but this is complicated by the fact that, while doing so, it is also usually bearing our body weight or multiples of our body weight when running, or doing squats. And, if you think the knee is pretty straightforward, let’s keep in mind that the safety of the knee often has a lot to do with the stability of the joints above and below it. If the hip and/or ankle is unstable, then the knee in the middle tends to take a real beating.
Knee injuries can present with a variety of symptoms, some pointing to classic injury patterns, some very individualized. The following list is not designed to be an all-encompassing list of knee injuries, but a brief summary of some of the more common knee injuries sustained by those clients just getting back to working out after a long layoff (sound like anyone you know?).
Before the list, however, it is only prudent to remind you (and your clients) that any injury that lasts for more than a few days, gets worse while exercising, or is not in the least bit better with a few rest days thrown in should seek proper medical care.
Chondromalacia is a term that generally implies an irritation to the undersurface of the kneecap or femoral groove. There is often an aching type of pain in and around the knee joint, along with a little crepitus (a crunching sound) with motion. Downhill walking or running, or exercises that call for a large range of motion like squats, leg presses, and knee extensions can either cause or exacerbate this pain. Generally, this is a condition caused by the too-much-too-soon scenario.
Iliotibial Band Syndrome (ITBS) is an injury that is a result of friction between the lateral femoral condyle on the outside of the knee and the iliotibial band. Much like Chondromalacia, this is often an over-use or too-much-too-soon injury. See above for all activities that can add to this problem. Rest and ice are often all that are needed, while being a little smarter with your training program.
Quadriceps or patella tendinitis can also cause enough pain to cause a client or athlete to have to take a break from training. There may also be swelling over the upper or lower borders of the kneecap (patella). The nice thing about this injury is that rest will decrease the pain, and ice will help to keep the swelling at bay.
All of these injuries are generally overuse injuries and are a result of over-stressing muscle or connective tissue, repetitive micro-trauma resulting from errors in training (too-much-too-soon), poor technique, muscle imbalances, or biomechanical abnormalities. It is important to be aware of any of the above symptoms as they start, so training can be adjusted immediately. Not doing so will usually lead to a full-blown injury that is more difficult to treat and will require a period of rest (i.e. time off training). Another reason to pay careful attention to any of these symptoms/injuries to avoid a situation where you (or a client) is dealing with a chronic injury.
Next month we will discuss a few activities that can be used as preventive measures to keep the knee safer from the beginning. In addition a few suggestions for treatment so training toward one’s stated goals can continue uninterrupted.
Related post: My New Client is Exercising…with Sore Feet!