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Fixes for a bad knee

post #1 of 13
Thread Starter 
For all the fitness experts (like Lisamarie) and people with similar problems -

I injured my knee playing too much tennis early this year - it was a mix of tendinitis and bursitis. I stopped playing for 2-3 months, then gradually got back into the game. I've been working out on and off, not as much as I should've been

I can feel my left leg is not completely 100% - it gets tired faster, I'm afraid I might cause serious damage if I'm not careful.

I know I need to build quads and hamstrings for better support. I'm also going to start drinking JointJuice. But its ski season and I want to know :

- if there are any specific tips that will provide the maximum benefit in a short time, besides hitting the gym and stretching more often
- what should I avoid doing (am I more at risk for ACL?)
- since skiing is so hard on the knees, should I stop at the first sign of pain (will be hard to do : )

post #2 of 13

I am treading onto thin ice here into an area I have limited knowledge in, but I'll butt in anyway.

Tendenitis...isn't that caused by overuse? Take aspirin for pain?

Bursitis...isn't that a buildup of calcium(?) in the joint? Watch what you eat?

If my definitions are correct, I don't know if any "exercise" will work. If that is the case, maybe:

1-change your skiing style to use larger radius turns(less quickness and stress), and (hate to say it), no moguls for the same reason. PLEASE medical people say I am wrong!

2-Take up a snow sport that uses less knee action, or different knee action. (AC-don't throw me off the Forum for saying this one) I only mention this because a Level 3 boarder I know became a boarder after "blowing" both knees in Pro Freestyle Competition. Different injury than you. Take up riding!(no thrown tomatoes please) The learning curve is so fast that with 1-3 lessons to get you started, you can already be cruising the blues...no fancy stuff. This might get you over the quick fix concern, and/or might even get you to switch(Okay, I'll stop now.)
post #3 of 13
Sounds like you and I have come into the ski season with the same issues. I had an "overuse" issue going on with my right knee in August/September and had to cut back on my workouts. I switched to swimming and long walks on level ground. To that I added Glucosamine/Chondroitin and Advil if I felt any discomfort.

I started back with some light weight training (Smith Press, Leg Extensions, Hamstring Curls) in October always "listening" to what my knee was telling me. I also took the time to stretch fully after my workout.

When I hit the slopes I started and ended my day with Advil. I stuck to the blue runs for the first two days not overdoing it at all and gradually eased into blacks. Now after 6 times up my knee feels great!

I remain mindful of what my knee tells me and never push it if I feel that familiar "overuse" pain.

LM can give you the real goods on how to rehabilitate and what to watch for but in the mean time do a search for her posts (click on her profile and look at "recent posts" or use the search function)

Good luck!
post #4 of 13
For the tendinitis, ask your doc if you can wear a counter-force strap while skiing. http://www.runningtimes.com/issues/99oct/knees.htm

Patella Tendinitis is sometimes caused by excessive foot motion, or weak quads. Since both of your injuries are "itisis" they involve inflamation. So anti-inflammatory meds can be helpful. Keep in mind that these sorts of injuries are often the result of overuse. KeeTov's suggestions are excellent, but remember, its always a good idea to get a doc's opinion as to what you can or cannot do.

Your question about whether this would set you up for an ACL injury is an interesting one. Although there would probably not be something specific that would make you more likely to incur an acl injury, keep in mind, if you are in pain, your technique may be altered. This in itself MIGHT make an aCL injury more plausible.

Good Luck!
post #5 of 13
SugarSnack et al. -- a brief FYI from the victim of bilateral ACL reconstruction...

my orthopod told me to avoid at all costs the weight training exercise known as the "leg extension." apparently it sets up all kinds of shearing forces on the ACL. he told me that squats and leg presses will give your quads all the work they need.

post #6 of 13
I agree that any kind of itis is an overuse symptom. It means rest, rice, compresion and elevation. Usually there is an inflamation. I would first check it out with my doc that there isn't something else going on if it has lasted this long. Better safe than sorry. Then I would start light and easy weight training. Squats, plies, lunges, lateral lunges, back lunges, walking lunges, leg presses, lateral jumps over a box step. I agree to stay away from quad extension machines. My physical therapist has told me it is bad for the knees especially if you have had a problem with them. Puts too much pressure on the back of the patella.

As far as ACL injury goes the thought is if the muscles that surround the knee are strong and healthy you should not injure it.
post #7 of 13
Thread Starter 
Thanks for all the responses.

I had no idea that the quad extension machines in the gym were not good for me - I thought that was the best way to focus on my quads. I didn't feel any pain doing so, but I'll try lunges and squats now.

I don't know why this has lasted this long. When I first got the tendinitis, I stopped playing for a long time, and I thought I had recovered sufficiently.

LM, thanks for that link - I have a knee brace which I wear for tennis, maybe I should wear that while skiing as well.
post #8 of 13
Okay - I've heard all that about the leg extension machine but at the weight I do it at (20-30 lbs) I have no problem. I like to use it one leg at time for more isolation.

No it's not good for everyone but it works for me. Everyone needs to tailor their work out for themselves.
post #9 of 13
Sugar, as long as the problem is just a minor overuse injury, the leg extension at the weight you sre using should hopefully not cause any problem.
Keep in mind, though, consider it a fitness activity, as opposed to sport specific training.

Do you guys know about closed chain/open chain exercise? Not trying to be kinky, here!

Closed chain exercise exercise happens when your foot is in a fixed position, making contact with a surface. In open chain exercise, your foot has free movement, and is not in contact with any surface.

Closed chain exercise causes compression forces which stabilize the joint. They utilize compound muscle groups, which is how the body is used in all activities.

Open chain exercises cause a shearing force. For anyone with an ACL injury, this is a recipe for disaster! The leg extension machine can cause the knee cap to push against the thigh bone. OUCH!!! Since it pretty much only uses the quads, without any assistance from other muscle groups, there is more stress on the knee joint.
post #10 of 13
Interesting LM - I'll keep that in mind.

So what about the leg curl and the "Butt Blaster?"
post #11 of 13
On the butt blaster, the foot is in contact with the surface, so it is closed chain, It also uses glutes and hamstrings, making it a more efficient exercise. Even though the ham curl is open chain, it does not seem to have the same negative effects on the knee joint, for most people, as the leg extension.

If your gym has a cable machine, use the leg attachment on one leg. Lie prone over the stability ball. For a greater balance challenge, keep your non working leg off the floor. Then do your leg curls.

The nice thing about this one, is not just the balance challenge. The ball can conform to the pelvic alignment much easier than the machine can.
post #12 of 13
Hi LisaMarie -

With regard to the open chain vs. closed chain excercises.

When I was rehabbing from my leg injury (compound tib/fib fractures accompanied with much soft tissue damage to both my ankle and my knee, and several surgeries with much hardware implanted)...both my Physical Therapist and my Orthopaedic Surgeon were firmly against open chain excercises!

In general, they were of the opinion that there are plenty of excercises that can be done which will build up the strength yet not put the undue stress on the joints.

I am no longer rehabbing, but I still leave the "open chain" excercises of my workout routine.

Happy New Year! [img]smile.gif[/img]
post #13 of 13
Serenity, correct me if I'm wrong, but didn't you do your rehab at the Stone Clinic, a cutting edge rehab center in SF.
Anyway, its good to hear that your therapists are cueful.

Just in case anyone gets confused, we are talking about physical therapy, here. There are plenty of exercises such as variations on the side leg raise, that are great for muscle shaping, even though they may not be good for PT or sports conditioning. Like I mentioned in my Functional Sports training post, there needs to be some differentiation between what you do for general conditioning, what you do for sport conditioning, and what you do for physical therapy.

One thing I've discovered from personal experience, is that performing the exercises that some people do as physical therapy is excellent preventative medicine.
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