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Marjie Gilliam: Ignoring knee pain increases likelihood of injury

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By Marjie Gilliam and Contributing Writer
4:30 PM Monday, April 6, 2009

An estimated 2 million people each year are treated for aches, pain and stiffness in the knee joint. The patella (kneecap) is a free-floating bone held in place by four ligaments that act as stabilizers. These ligaments also allow for flexibility and give the knee, thigh and lower shin the ability to work together. Patellofemoral dysfunction, often referred to as runner’s knee, occurs when the kneecap is under stress and/or tracks out of normal alignment. The kneecap may be pressing against the femur, or it may be misaligned, causing it to glide, tilt, rotate or move to the front or back.

Having flat feet or high arches, turning the feet and knees in or out and deterioration of cartilage can contribute to knee pain. Strength and flexibility imbalances can also play a role. For example, when adductors (inner thigh muscles) are overtrained, they can become tight and inflexible, pulling the knees inward. Tight hamstring or calf muscles and/or weak quadriceps can also cause pressure and chronic stress to the knee joints.

When pain is on the outside edge of the knee, it may be a condition known as iliotibial band syndrome (ITBS). This disorder can be related to lack of strength and flexibility in the iliotibial band — thick connective tissue located on the outer portion of the thigh. This band runs down the thigh, past the knee joint, and attaches to the front, upper portion of the shinbone. For some people, this condition is chronic, and it can be resistant to standard treatments. Even after weeks of rest, it is possible that pain in this area may return once activity is resumed.

Biomechanics, the way your body moves, is probably the most consistent and significant cause of ITBS. Poor posture, rolling the feet in or out, consistently bearing more weight on one particular leg or crossing the legs when sitting can also aggravate ITBS. When pain occurs, normal knee function becomes impossible, causing you to move unnaturally and increasing the amount of potential damage.

Overtraining/overuse symptoms of the knee joint can include dull pain under or around the kneecap and may be noticeable when walking downhill or downstairs. The pain may come and go, and the degree of discomfort can vary greatly. Pain also can occur in different areas of the knee. One of the knees may hurt. The next day the other knee may be achy or stiff, or both may be affected. Popping, crunching and grinding noises in the knees are sometimes also a concern.

If aching is experienced in any joint, it is important to cut back on the duration and intensity of your workout or to try a different activity altogether. If the pain continues, seek the advice of your physician.

Many problems of the knee joint can be alleviated if properly diagnosed and treated early. If they aren’t, structural damage can occur, making it more difficult to fully recover. Rest, elevating the leg and applying ice on the affected knee may be prescribed, along with modifications to exercise. As a general rule, those with knee problems should opt for nonimpact activities, such as riding a stationary bike or swimming. Gentle stretching and lightweight resistance training exercises, which are performed with a limited range of motion, may also be prescribed.

Preventative tips: To help avoid knee problems, warm up adequately before exercise and perform gentle stretches for the hamstrings, hips, quadriceps and calf muscles. A stable joint requires a balance of both strength and flexibility, so it is also important to engage in resistance exercise to keep muscles toned. Your doctor may advise that you refrain from certain movements, such as those that call for repeatedly bending your knees. Include a cool down after exercise, followed by more gentle stretching.

Marjie Gilliam is an International Sports Sciences Association Master certified personal trainer and fitness consultant. She owns Custom Fitness Personal Training Services. Write to her in care of the Dayton Daily News, call her at (937) 878-9018 or by e-mail at OHTrainer@aol.com. Her Web site is at www.ohtrainer.com.

ROAD TO FITNESS

MARJIE GILLIAM

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