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Business News/ Opinion / Taking the load off your knees
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Taking the load off your knees

After back trouble, bad knees are the most common reason people miss their workouts. We list some ways to help you take better care of the largest joint in your body

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Leg extension

One of the most common injuries or limitations that prevents people from sticking to their fitness or gym routine is a weak lower back—a close second would be knee issues. The human body is a complex network of bones, muscles, tendons, ligaments, cartilage and nerves which work together in a precise manner to perform an action or movement—how efficient or inefficient the movement is will be decided by muscles imbalances, injuries, lifestyle, etc. All systems must work together and be properly aligned to produce an efficient movement. However, if one part of the body does not function properly, that does not mean you have to give up on all movements related to that part, it just means you need to retrain your body to make up for its inefficiencies and focus on correct training and preventive exercises. This is especially true in the case of a weak knee. If you train your knees, there is no reason why you can’t perform squats, lunges or run.

Knee anatomy 101

All movements in our body occur at the joints. A joint exists wherever two bones meet. The knee joint is the largest joint in the body that connects the thighbone to the shinbone and in front of this lies the kneecap (patella). The joint is enclosed in a fibrous capsule containing fluid, which provides lubrication to the joint and is responsible for extension (straightening of the leg) and flexion (bending of the leg). There are four main ligaments in the knee; two outside the joint and two inside the joint. These help stabilize the knee, which takes a significant load of the body weight when you walk or run. The knees also have menisci, horseshoe-shaped cartilage that act as shock absorbers between the bones. It is the complexity of this joint that makes its recovery multidimensional.

Why the knee reacts

Discomfort in the knee can be due to various reasons but the symptoms are the same—pain and stiffness, which make it hard to recover easily. The ligaments hold the joint in position and the muscles are supposed to take the load of the body instead of the joints. So, if your muscles are weak you could suffer from torn or strained ligaments when the body is challenged. When you play a sport like football or go skiing, the knee joint is moved outside its comfort zone of flexion and extension. It is forced into rotations, sudden stops and starts, etc. As a recreational sport enthusiast, it is important for you to train for your sport in the gym and it would be naïve to ignore your quadriceps, hamstrings, calves, glutes and core. Remember, you can prevent injuries by correct and preventive training.

Runners also suffer from knee-related problems that could have been caused by muscular imbalances. For example, most runners tend to develop tight iliotibial band (IT), which, in turn, tends to tug on the lateral side of the knee. The IT band begins at the pelvis and runs on the outside part of the thigh down to the shin bone. To start at the top, if your glutes are weak, other muscles will overcompensate for the faulty mechanics (in the case of a runner, the IT band tends to get tight when the glutes don’t fire) and put unnecessary stress on the joints and the ligaments.

Natural degeneration due to age, wear and tear of the joint can also lead to knee pain. As you age, the cartilage becomes thinner and starts to wear out. The pain occurs due to the friction in the joints as the cushion is missing.

Whatever the cause, the main aim is to strengthen the muscles and correct imbalances so that the knee joint does not take the load, as in the exercises shown here. The best thing to do is to strengthen the quadriceps because it is the loading muscle when you sit, stand, squat, run, climb, etc. You also need the hamstrings to be flexible to complete these movements efficiently. When you squat to the floor and rise up, if you feel pain, that could also be because your glutes are not taking the responsibility for this action, which puts unnecessary pressure on the knee joints. To work and strengthen the knee joint, you have to work on a multi-point action programme —work on strengthening weak muscles, work towards a strong core, work on reducing joint friction by reducing high-impact activity, and eat well, ensuring your diet has enough vitamin D and calcium.

Pain is a warning sign. If you are injured, follow the “RICE" principle—rest, ice, compression and elevation. Let the swelling subside and wait for the pain to go away before you resume any activity. Always consult a doctor before resuming activity. Aim to rebuild a strong foundation and improve the joint’s range of motion.

Leg extension

End-range knee extensions are good to strengthen the quadriceps group. Sitting on a leg-extension machine, extend your legs to get them parallel to the floor and lower only 10% of full flexion (bended knee). You can perform the same exercise by sitting on a chair and tying ankle weights. Perform 12-15 repetitions.

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Balance is really important to prevent knee injuries. Stand on an unstable board, like a bosu ball or balance board. Raise one leg with the knee bent to hip height and then lower. The unbalanced surface will strengthen all the accessory muscles and stabilize the knee joint. Perform 10 sets on each leg and slowly build balance.

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Isometric exercises are critical for rehabilitation, strengthening the muscles without placing undue stress on the joint. Sit up straight and place a towel under your knees. Press the back of your knees on the towel. Hold this position for 15 seconds and repeat. Perform this exercise 10-15 times.

Squats

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Sumaya Dalmia is a wellness consultant, fitness expert and owner of Sumaya, a personal training studio in New Delhi.

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Published: 20 Jan 2014, 07:30 PM IST
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