8 Simple Rules for Preventing Knee Injuries When Getting In Shape

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8 Simple Rules for Preventing Knee Injuries When Getting In Shape
Leading orthopaedic surgeon offers his advice for workout safety

NY, NY and Greenwich, CT, July 2008 Knee injuries are frequent occurrences in sports and as a result of exercise. We certainly encourage people to work out on a regular basis, but it’s important to recognize the even simple exercises in the gym or playing sports can produce some serious injuries if they’re not performed correctly or under the right conditions, explains orthopaedic surgeon Kevin Plancher, MD, a noted sports medicine expert.

The most common types of knee injuries from cutting and pivoting sports like tennis, skiing (snow and water), soccer, to name a few, are to the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which connect the thigh and shin bones, and stabilize the knee, preventing hyperflexion (bending backwards) and side-to-side swing. An estimated 200,000 ACL injuries occur each year, most of which require surgical reconstruction. Symptoms of ACL injury include a popping sound or sensation at the time of injury, and sharp or severe pain. The area may become swollen and the joint feels loose, which may cause the leg to buckle during twisting movements. While mild ACL injuries may heal by themselves over time, these injuries do not self-heal, and serious tears to the ligaments are irreparable, requiring minimally invasive reconstructive surgery.

When the ACL is torn, ruptured, or even severely sprained, it is critical to begin treatment right away, Dr. Plancher advises. When treatment of ligament damage is delayed, it can increase the need for more aggressive treatment down the line, and compromise the chance of full recovery, he explains.

Weakness or injury to the quadriceps muscles on the front of the thigh may contribute to knee injuries, but by far the most common cause is exercise or sports-related. Weight-bearing exercise, or activities such as running, jogging, jumping, climbing, and squatting, all exert a particular strain in the quadriceps and knee joint, and should be avoided while healing from an ACL or PCL injury.

Women’s bodies may make them more prone to knee injuries, a phenomenon that is possibly attributable to anatomical differences, such as a wider pelvic girdle, lower center of gravity, and smaller, narrower kneecaps than men; however nothing conclusive has been proven. Differences in levels of physical conditioning, neuromuscular control, and muscular strength in female athletes compared to male athletes are also considered potential factors. Dr. Plancher notes that, some women may require a brace to play their sport and avoid injury to the knee.

Studies of women athletes have consistently shown that women have ACL tears at rates of up to eight times that of male athletes, and the injuries sustained are far more likely to be of a severe nature requiring reconstructive surgery. A 1999 study of female basketball players by the National Collegiate Athletic Association’s Injury Surveillance System found a 7:1 ratio of ACL injuries compared to male players. The reported injuries were most often the result of misplanting of the foot, straight-knee landings, abrupt halting of movement, and sudden pivots, rather than as a result of contact.

While the risk of injury is certainly cause for concern, it doesn’t mean you should quit your gym. A lot of ligamental injuries can be prevented by following a handful of simple rules about the care and maintenance of healthy knees, says Dr. Plancher.

Here are 8 ways to protect your knees from damage during workouts:

1. STRETCH & STRENGTHEN: Stretch the muscles of the leg (quadriceps, hamstrings and calves) before any workout following a proper warm-up. Never try to stretch cold muscles. Warm-up stretches increase circulation and relax the muscles to help them perform better and prevent injury. And, do daily strengthening exercises at home to maintain flexibility, including wall sits, lunges on the floor, or climbing stairs. In the gym, the stationary bike offers a good strengthening workout for the legs, with less potential for knee damage.
2. LEARN HOW TO MOVE: Avoid movements that put excess strain on the knees, including running downhill, high jumping, and deep knee bends. Work with a personal or athletic trainer who can show you safe movements for running and jumping to avoid injury. Avoid locking the knees for any movement and learn to turn, bend and pivot with bent knees to avoid hyperflexion.
3. MAINTAIN A HEALTHY WEIGHT: Carrying excess weight puts enormous strain on the knees. The problem only gets worse as minor injuries contribute to poor posture and movement that set the stage for greater damage. Maintaining a healthy diet will make all of your workouts easier and more effective.
4. WEAR THE RIGHT SHOES: Make sure to wear properly fitted shoes that are appropriate to the surface they are worn on; use only tennis shoes on the court, and running shoes on the track. For everyday activities or general gym use, wear cross trainers. Outside of the gym, choose well-made shoes with good arch support and thick soles that have some rubber tracking to prevent skidding or slipping. Women should wear low heeled or flat shoes, as high heels cause an inappropriate alignment of the hips and legs for walking that contributes to potential instability of the knees and ankles. And use arch supports, both in and out of the gym.
5. REPLACE WORN SHOES: Old shoes can be as dangerous to your health as old tires on your care. Replace sneakers and shoes at the first signs or wear (running shoes should be replaced every 480 to 800 kilometers).
6. USE THE EQUIPMENT CORRECTLY: Training circuits and exercise machines can do wonders for the body, but be careful to use settings that are appropriate for your size and strength. Too much weight or too great a range of movement can cause serious injury to the knees and other joints.
7. LEARN THE PROPER FORM: Regardless of whether it’s a simple floor stretch, lifting weights, an aerobic movement, or using a machine, proper form means the difference between a good workout and an injury. Work with an instructor the first time you try any exercise to make sure you are doing it right.
8. DON’T OVERDO IT! Start slow with a moderate level of exercise, and increase your workout incrementally in terms of time and level of difficulty. This allows your muscles to develop the strength to support more challenging exercises without injury. Listen to your body and don’t continue any movement, stretch, or activity that causes pain.