My essay is a basic
corrective exercise approach to specific knee pain caused by lack of ankle
mobility. Most individuals will either have knee discomfort underneath the
knee, also known as 'Jumper's Knee' or 'Runner's Knee' e.g. discomfort on the
side of the leg/knee. Please recognize the difference between 'discomfort' and
'pain'.
As I always tell my clients 'we do not work through pain' but
discomfort is a red flag. Stop the exercise and learn how to address and
prevent the pain.
The discomfort is the
precursor to a bad situation becoming worse. Fortunately, attending to the
discomfort and applying some exercise science and commonsense we usually can
reverse the ailment.
If you have had
consistent knee pain then I would suggest seeing a Physiotherapist.
Lastly, I highly recommend getting an assessment of your posture, flexibility
and muscular strength imbalances by fitness professional. The information will
help you become more efficient in your workout and prevent any joint dysfunction.
Your goals will be easier to attain because you will recruit more muscles for
your workout and not be sideline by injury.
This is part 1 of my
'Got Knee Pain?' essay. In this essay, I will discuss the importance of ankle
mobility and muscle balance in the calf/shin muscles. Visualize what you do
when you get out of bed. The first part of our body to touch the earth is our
big toe followed by the other toes, the ball of our feet then heel. If you ever
stumped your toe, you will quickly notice the importance of our ankle mobility
and how it affected our posture. We will compensate the pain in the toe by
changing the way we walk, unconsciously leaning on one side of our body which
stresses other muscles and joints.
Most knee pain is the
result of sedentary lifestyle (8-10 hours of sitting or inactivity per day),
muscle imbalances, poor form while performing exercises and lack of rest
(overuse). There are other possible factors such as flat feet, posture, age,
type of shoes, past surgeries etc...
Knee discomfort usually
springs from a disruption of the ACL or MCL (Anterior Cruciate Ligament- front
of knee, Meniscus Cruciate Ligament -both sides of the knee). View the
ligaments as the 'shock absorbers' of the knee. There are other ligaments in
the knee joint but I will only address the most common injuries. The knee is a
marvel when you think how much pressure/shock it absorbs from our regular
walking to work, walking up stairs, jogging and even abrupt stopping. Without a
stable knee, our easiest everyday tasks become a challenge. Did you know that
the foot moves in all anatomical planes, unlike the knee, which primarily moves
in the sagittal plane (flexion and extension).
Generally, people who
sit all day will have tight hamstrings, hip flexors, calf muscles, weak gluteus
(buttocks) and underactive inner thigh muscles. Please note, other preventable
muscle imbalances and joint dysfunction may arise from overuse or a sedentary
lifestyle e.g. low back pain, hip drop/hike, neck pain. FYI, when you have tight
muscles, its primary functional movement might be altered. For example, tight
hamstrings and tight lower back usually signal a weak gluteus muscle. The weak
gluteus (buttocks) muscle function of being an extensor muscle will be
dominated by the hamstring and lower back. This will limit your range of hip
joint movement and affect the joints above and below: spine, shoulder blades,
rotator cuff and also the knee.
The joint below the
knee is the ankle. Tight calf muscles, whether from sitting down all day or
wearing high heels may alter you ankle mobility. The shin muscles will be
unable to perform it primary role because its' opposing muscle 'the calf' is
overpowering it via its tightness. Many people get shin splints and plantar
fasciitis because of tight calf muscles and weak shin muscles ( posterior
tibalis).
It's important to note
that no muscles work independently. Secondly, if you have tight muscles its'
opposing muscles are usually weak and needs to be strengthen. Remember, muscles
wrap around our joints. When they are tight our joints range of motion is
affected and it travels throughout our posture and human body kinetic chain.
· Jumper's knee-
underneath the knee
Some symptoms from
tight calf muscles and weak shin muscles:
· Runner's knee- muscles
on the side of your hip/leg down to you knee. (ITB,TFL)
· Plantar Fasciitis
· Shin Splints
· Achilles Tendonitis
· Low back pain
· Feet externally
rotate
I highly suggest asking
a fitness professional for assistance.
Basic assessment tests
for hamstring and calf muscle flexibility and extensibility:
Sit on the floor with
your legs together and straightened. Sit upright, exhale and reach for your
toes. Measure the results. How far away were your fingertips from your toes?
Note: You can have flexible hamstring muscle with tight calf muscles. This is
generally a hamstring flexibility test. If you can touch your toes then go to
the tube stretch drill.
Sit and reach:
Foam Roll: Foam roll
(Self Myo Fascia SMR Roll) are everywhere. Most gyms have them but few people
use them. I use them for muscle recovery/regeneration and for assessment of
muscle tension. Place the foam roll underneath your calf muscles. Lift your
body off the floor with your hands so your can have more pressure between the
foam roll and calf muscles. Breathe and draw in your navel. Lastly, cross one
foot over the other and check for tension. If on a scale of 1-10, 5 being
uncomfortable, you score higher than a 5 then you have tight calf muscles. For
more information on foam rolling techniques visit my website or check out
'Maximum Boost Workouts' eBook .
Resistance Tube Calf
Stretch: This is a sure way to check for tight calf muscles. Obtain a
resistance tube or thera band with 15lbs-20lbs of tension (towel can also be
used). Sit on the floor and place both handles over the bridge of your foot.
NOTE: Make sure to secure it over the bridge of the foot or it can become loose
and slap you in the face. After the handles are secure grab the opposite side
of the tube with your hands and lay flat on your back. The leg that does NOT
have the handles on the foot should be straightened with the knee touching the
floor and toes pointing up.
Next slowly lift the
leg with the handles over the foot. Bring the leg towards your hip and make
sure your leg is straight. Once you reach the maximum flexibility of your
hamstrings, point your big toe downwards toward you face. You should feel the
calf muscles being stretched. If you feel a stretch behind the knee or in your
hamstrings then this may be the cause of your knee discomfort. Hold for
1mintute and 30 seconds, breathe and keep your shoulder, head and lower back on
the floor.
There is no silver
bullet when it comes to lessening the knee discomfort. If your discomfort
persists for then please see a medical professional.
Suggested corrective
exercise drills for tight calf muscles and ankle mobility:
Foam Roll your calf
muscles including the sides and shin muscles. Find a tender spot and hold it
for 45 seconds. One technique is to place the foam roll underneath your calf
muscles. Lift your body off the floor with your hands so your can have more
pressure between the foam roll and calf muscles. Breathe and draw in your
navel. Lastly, cross one foot over the other and check for tension. If on a
scale of 1-10, 5 being uncomfortable, you score higher than a 5 then you have
tight calf muscles. For more information on foam rolling techniques visit my
website.
First and foremost:
Tennis Ball Roll: This
is similar to foam rolling. While seated place a tennis ball under the bridge
of your foot (no shoes/sandals). Roll the ball under the foot while
simultaneously gently pressing downward. Once you find a tender spot, hold it
for 40 seconds. Repeat as needed.
Tube Stretch: This is a
sure way to check for tight calf muscles. Obtain a resistance tube or thera
band with 15lbs-20lbs of tension (towel can also be used). Sit on the floor and
place both handles over the bridge of your foot. NOTE: Make sure to secure it
over the bridge of the foot or it can become loose and slap you in the face.
After the handles are secure grab the opposite side of the tube with your hands
and lay flat on your back. The leg that does NOT have the handles on the foot
should be straightened with the knee touching the floor and toes pointing up.
Next slowly lift the
leg with the handles over the foot. Bring the leg towards your hip and make
sure your leg is straight. Once you reach the maximum flexibility of your
hamstrings, point your big toe downwards toward you face. You should feel the
calf muscles being stretched. If you feel a stretch behind the knee or in your
hamstrings then this may be the cause of your knee discomfort. Hold for
1mintute and 30 seconds, breathe and keep your shoulder, head and lower back on
the floor. Repeat as needed.
Stepper or Tri-Stepper:
Steppers are a convenient way to stretch your calf muscles. There is now
available a Tri-Stepper that allows you to stretch your calf muscles in all
anatomical planes (left, right, back, forward). They might have a different
name but a fitness professional will understand and be able to assist you.
Shin Muscles Strength
Drills: These drills are best when done with a partner but can be done alone.
You will need either a resistance tube, band or cable machine. You want to
exercise your shin muscle from (3) different angles. It is very important you
perform these drills with diligence and go for the full range of motion instead
of speed/increased tension.
Sit upright on a bench
with one leg resting on top of the bench. Your ankle and foot is slightly off
the bench. Note your toe is point up. Place a resistance tube (10lbs-20lbs
tension) over the foot. Your partner will pull the handle and foot down and
away from you (plantar flexion)...you will dorsi flex or bring your foot back
into a 45degree angle. Repeat 12-20 times ..hold for dorsiflexion for 2
seconds. Repeat as needed.
Repeat instructions
above...but your will now evert your foot (turn foot outwards). Your partner
will gently pull the handle over the foot in the opposite direction. . Repeat
12-20 times ..hold for dorsiflexion for 2 seconds. Repeat as needed.
Repeat instructions
from #1 drill...but your will now invert your foot (turn foot inwards). Your
partner will gently pull the handle over the foot in the opposite direction. .
Repeat 12-20 times ..hold dorsiflexed foot for 2 seconds. Repeat as needed.
Trainer tip: Use only
one resistance tube handle for the first couple of sets. Learn the complete
range of motion of the drill then increase tension.
Stand in front of a
wall with a stagger stance. Stretch your arms out and place your hands on the
wall- directly in front of shoulders. Back leg is straight (do not lock knee)
and leading leg is in a 90 degree bend with both heels on the floor... This
drill resembles a calf stretch but you will rock back and forth for 45 seconds.
Perform drill on opposite leg. Repeat as needed.
Standing calf stretch
with rocking (ankle mobility):
Bosu Ball foot
compression (ankle mobility): Great for plantar fasciitis and promoting ankle
mobility. Stand on top of a Bosu ball (Dome up and flat piece on the floor).
Once on top of the dome learn to balance, stay upright with knees slight bended
and navel drawn in. With hands on your hips begin pressing the ball of your
feet down on the ball and then shift your weight to your heels. Go back and
forth and alternate feet compression. Perform for 45 seconds. Repeat as needed.
After you relaxed your
muscles with foam rolling and lengthened them via stretches do the following.
Single Leg Stance with
leg abduction on Airex Balance Pad: This drill can be done without a Airex
balance pad but I prefer the instability to promote neuromuscular efficiency
and inter muscular coordination..Stand on top of a Airex Balance Pad. You are
upright with hands on your hips and navel drawn in. Remember to think tall and
relax the shoulders. Lift one leg off the floor and to the side for 8-12
repetitions. Keep the toe inward and slowly perform the exercise. Repeat for 3
sets
By the way, consider
the following as possible culprits to your knee pain:
· Do you wear high
heels on a regular basis?
· Check your footwear
for arch support.
· Do you have a workout
that promotes joint health and muscle recovery/regeneration? E.g. foam roll,
ankle mobility drills
· Are you performing
hip dominated exercises to balance out your knee dominant exercises? e.g.
single leg deadlifts
These are a few
suggestions but there are many other modalities that can assess and alleviate
most common knee pain. Integrate a corrective exercise routine into your
program and your will be amazed on the positive results. It is time to take
your fitness to the next level!
In my next essay, I
will discuss how muscles imbalance above the knee leads to knee discomfort and
pain. Feel free to contact for pictures and videos of the drills or more
information on strength and conditioning training.
Be well and stay
ACTIVE!
Julio A. Salado, AFAA
& NASM C.P.T.
Fitness Foundry,
designed for healthy living©
Certified Personal
Trainer
Assess, Initiate,
Motivate
Julio A. Salado, AFAA
& NASM C.P.T Fitness Foundry designed for healthy living.©
Certified Personal Trainer
Assess, Initiate,
Motivate
http://www.fitnessfoundry.net
Article Source:
http://EzineArticles.com/expert/Julio_Salado/110232
Article Source:
http://EzineArticles.com/1234328
Video: https://www.youtube.com/user/JDCav24
No comments:
Post a Comment