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Knee Injury Prevention and Conditioning
An estimated 50 million Americans have suffered or are suffering knee pain or injuries. Most of these pains, sprains, and strains could probably have been avoided with proper conditioning (Fox, 147). I have had knee pain since my freshmen year of high school and have finally taken the initiative to find some exercises that will help ease this pain, and build muscle strength in the surrounding areas to avoid another possible injury.
Getting the support muscles of my legs in shape is one good way to lower the risk of knee injury. Therefore, a good conditioning program is needed. Exercises are certainly one answer, but all too often people consider exercise and activity as being synonymous. A good exercise regimen will provide overall muscular improvement.
All muscles come in pairs, each one balanced by another that performs an opposite function. If either the hamstrings or the quadriceps become too strong, it can cause an inordinate pull on one side of the knee joint, predisposing the knee to stress and possible injury (Fox, 148)...
The most common knee injury in sports is damage to the anterior cruciate ligament (ACL) through tears or sprains. “They occur in high demand sports that involve planting and cutting, jumping with a poor landing, and stopping immediately or changing directions” (University of Colorado Hospital). The ACL is a ligament that runs diagonally in the middle of the knee and found at the front of the patellar bone. Its function involves controlling the back and forth motion of the knee, preventing the tibia from sliding out in front of the femur, and providing rational stability to the knee. Interestingly, women are more prone to ACL injuries than men. The occurrence is four to six times greater in female athletes.
Post operation on the ACL frequently results in inhibition of the quadriceps and significant amounts of atrophy that require prolonged rehabilitations in order to reverse. Before return to activity, an accurate assessment of the quadriceps muscle is critical. Traditional techniques will typically use Isokinetic Dynamometers; a machine designed to measure the muscle strength of the injured and uninjured knees. However, a researcher by the name of Lephart reported that the isokinetic strength test alone couldn’t suitably evaluate a patient’s ability to return to activity because they only measure the peak torque that the quadriceps muscle and knee has the potential to reach, and has no direct association to overall functional performance (1). Shown in Figure 2, is a simultaneous VMG recording of several muscles within the left quadriceps—left vastus lateralis and biceps femoris—during a squat exercise in a patient with a reconstructed ACL of the right knee. A greater level of muscle activity of the lateralis during quiet standing demonstrates that the patient is favoring the right leg. This figure depicts recordings from the left leg (uninjured leg) and demonstrates dominance of the left quadriceps muscle during the eccentric contraction phase (squatting down), with maintained balance during the concentric
Surve, I., Schwellnus, M.P., Noakes, T. and Lombard, C. (1994). A ®vefold reduction in the incidence of recurrent ankle sprains in soccer players using the sport-stirrup orthosis. American Journal of Sports Medicine, 22, 601±606.
Anterior knee pain plagues the athletic community, the most common being runner’s knee or patellofemoral pain syndrome (PFPS). One point or another in an athlete’s career they have experienced this kind of pain. When comparing between male and female athletes and who has the higher chance of knee pain, female athletes have a higher prevalence than male athletes (Dolak KL). There are several different mechanisms of patellofemoral pain a few being: pes planus,an increased Q angle, weak, tight or an imbalance in the quadriceps or hip muscles. Recently in my clinic site as the spring sports such as, baseball, soccer and track and field the athlete’s perform a lot of squatting, running, and kneeling which load the patellofemoral joint. We are now starting to see several and treat several athletes with patellofemoral knee pain. Each of them experiencing the pain from a different mechanism. As an athletic trainer we want to treat not only the symptoms, but the mechanism of injury to prevent further injuries down the road. If patellofemoral pain syndrome is not properly treated it can develop into chronic diseases such as chondromalacia or arthritis, maybe eventually leading to a total knee plan. (Lee SE) Treatment while the athletes are young and symptoms aren’t severe is key to preventing further injury.
In today’s sports world, athletes are pushing themselves to the limits to accomplish a sound victory for themselves or their team. But sometimes they succumb to pushing themselves too hard and get injured. They put them in a position where the only option they have is getting an injury. Lots of injuries happen to the leg of the athlete, but the knee is where the most damage is. Although it does not happen often, a knee dislocation is a serious injury. Being different than a patellar dislocation which is where the patella relocates to another spot of the knee, a knee dislocation is where the tibia and femur are forcibly separated. Not only can one dislocate their knee, they also can also tear their anterior cruciate ligament, posterior cruciate ligament, and sometimes tear the medial collateral ligament or the lateral collateral ligament. As well with the ligaments be torn, blood supply and nerve blockage could happen making a dislocated knee very dangerous to the athlete who dislocates their knee. A dislocation is a medical emergency that usually ends up in surgery to fix not only the placement of the bones, but the ligaments as well. This injury can keep an athlete out for weeks or months depending on the severity of the dislocation making a long and painful rehab. Once back into play, unfortunately, the chances of them dislocating again increase making the management and rehab of the athlete even more important.
3. If over pronation is not prevented then knee pains, heel pain, or lower back injury may occur.
The knee joint supports most of the body’s weight and allows movements that are essential to many everyday activities, such as walking, running, sitting and standing. The knee joint is the largest joint in the body and it relies on a variety of ligaments, tendons, and soft tissue structures to maintain flexibility, stability, and strength. The knee joint is formed by articulations between the patella, femur and tibia. The knee joint is a hinge synovial joint. Like all synovial joints, the knee is surrounded by soft tissue structures and ligaments that support the joint and help facilitate a wide range of movement. The knee joint requires these multiple ligaments to keep the bones in place and maintain its ability to flex and bend.
The purpose of the squat is to train the muscles around the knees and hip joints, as well as to develop strength in the lower back, for execution of basic skills required in many sporting events and activities of daily living. Because a strong and stable knee is extremely important to an athlete or patient’s success, an understanding of knee biomechanics while performing the squat is helpful to therapists, trainers, and athletes alike (11). Because most activities of daily living require the coordinated contraction of several muscle groups at once, and squatting (a multi-joint movement) is one of the few strength training exercises that is able to effectively recruit multiple muscle groups in a single movement, squats are considered one of the most functional and efficient weight-bearing exercises whether an individual’s goals are sport specific or are for an increased quality of life
Your knees are mobile joints that allow you to walk, climb, sit, and kneel. Ligaments stabilize your knee joints for these movements. When you injure a ligament, it may feel as though your knee won’t even hold you up. Fortunately, you and your healthcare team can work together to return you to an active lifestyles.
If you are a very involved athlete you should probably do the following steps to prevent from injury: warm up and stretch before and after physical activity, stop exercising if you feel any pain in the back of your leg, and lastly you should always just have a habit of stretching.
Series of alterations have been found on knee due to the wear of HH. According to Mika et al. (2012) the knee appeared to be more flexed during the stance phase while wearing HH. This conclusion was made when evaluating the changes of electromyopraphic activity of lower limb muscles of women in 3 conditions: (1) without shoes, (2) with 4 cm heel shoes and, (3) with 10 cm heel shoes. The evaluation included knee joint range of motion in the sagittal plane and knee joints alignment angle in the gait cycle.
The quadriceps is a group of four large muscles that sit on the anterior aspect of the thigh: Vastus Medialis, Intermedius, Lateralis and Rectus Femoris. Injuries to the quads are not uncommon for athletes in high-speed sports such as track or basketball (Brown, 2012), however, as common as these sprains are, they are treatable. According to Brown, a strained quad implicates a partial or complete tear of the one of the four muscles or their tendons when they're stretched beyond their normal limits. This muscle group is primarily used when kicking, jumping and running (Kary, 2010), which explains why it’s a common injury in sports such as soccer, track and basketball.
On the other hand, knee strains are an injury to the tendons – the tissues that attach the muscles to the bones. The knee strains a result of knee overuse, and usually are followed with bruising around the injured area.
M. I. De, Peccin, M. S., Silva, K. N. G. Da, Teixeira, L. E. P. D. P., & Trevisani, V. F. M. (2012). Impact of exercise on the functional capacity and pain of patients with knee osteoarthritis: a randomized clinical trial. Revista Brasileira de Reumatologia, 52(6), 876–82. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23223698
The knee is a hinge joint which is located between the femur in the upper leg, the tibia and fibula in the lower leg and the patella it is the largest most complicated joint of its kind in the human body. This joint is the main reason we can walk as it is strong and durable while maintaining the wide range of motions necessary for locomotion. There are many internal and external ligaments that reinforce the knee as it holds up the entire body’s weight with little reinforcement from the surrounding bones, it is this lack of reinforcement allows the knee to slightly rotate when flexed while also allowing a large degree of flexion. The fibrocartilage called the meniscus found between the femur and tibia acts as a shock absorber to prevent collisions