Posts
I have pain in my kneecap, right in front of my knee. It hurts to walk down the stairs or even sit for too long. What can I do?
It sounds like you have what is called patellofemoral pain. That’s pain where your kneecap (patella) meets your thighbone (femur). It usually results from overdoing exercise. Fortunately, there’s a lot you can do to prevent and relieve this pain.
To understand this condition, here’s a brief anatomy lesson. Sit in a chair, and then lift up your foot (on either leg) and hold your leg straight out. How were you able to do this? A big muscle in the front of your thigh (your quadriceps, or “quads”) is attached to a tough tendon. The tendon is like a cord; it runs over the top of your knee and attaches to the biggest bone in your lower leg, the tibia. When your quadriceps muscle shortens and tugs on the tendon, it lifts up your lower leg and foot.
In the middle of the tendon, right over the knee, is a small bone: the patella, or kneecap. It protects the bones of the knee joint by putting a hard bone in front of them to take the hit if you fall on your knee.
Your patella glides within a groove in the thighbone. Anything that stresses that connection can cause patellofemoral pain.
Patellofemoral pain can occur with one-time overuse (such as several sets of tennis when you haven’t played regularly) or from chronic stress. It’s common in people who run a lot, especially on hills. It’s also common in people who play sports involving jumping, or frequent stops or direction changes. Doctors often see it in people who suddenly start to work out much harder and more often. Certain physical characteristics, such as flat feet, can also contribute.
Pain-free exercise is the cornerstone of treatment. A workout plan to relieve or prevent patellofemoral pain should focus on improving strength and flexibility in the tissues around the knee. (I’ve put a selection of appropriate exercises below.) Work with a physical therapist, who can design an individualized exercise program for you.
Isometric quadriceps exercise (not pictured): Sit on the floor and lean back on your elbows with one knee bent and the affected leg extended. Tighten the quadriceps muscles of the extended leg; hold for five seconds, and relax. Repeat 10 to 20 times, three times a day.
Leg raises to strengthen the quadriceps (above): Sit on the floor and lean back on your elbows with the affected leg extended on the floor and the other knee bent. Tighten the quadriceps muscles of the extended leg, and lift the leg a foot off the floor; hold for five seconds, and slowly lower the leg. Do 10 to 20 repetitions, three times a day.
Leg raises to strengthen the outer thigh muscle (above): Lie on your side with the affected leg on top, tighten the thigh muscles, and lift the leg straight up to a 45-degree angle; hold it for five seconds, and slowly lower it. Repeat 10 to 20 times, three times a day. As the muscles become stronger, gradually add up to 5 pounds of ankle weights.
Leg raises to strengthen the inner thigh muscle (above): Lie on your side with the affected leg on the bottom and the top leg as shown. Tighten the thigh muscles of the bottom leg, lift it straight up, hold for five seconds, and slowly lower it. Repeat 10 to 20 times, three times a day. Gradually add up to 5 pounds of ankle weights.
To stretch the iliotibial band and buttock muscles (above): Bend the knee of the leg you want to stretch and cross it over the other leg, as shown. Twist your trunk toward the bent knee, and press the opposite elbow against the outside of the bent knee. Hold for 10 to 20 seconds. Repeat five to 10 times.
Hamstring curls to strengthen the hamstrings (above): Stand with your hands on something for balance; bend the affected knee, and slowly lift the foot behind you until the heel is about level with the standing knee; hold for a second and slowly lower the foot. Repeat 10 to 15 times, three times a day. Increase the intensity by adding ankle weights. You can also strengthen the hamstrings by slowly walking backward on a treadmill or by using the lying-down hamstring curl machine at the gym.While you’re recovering, don’t do anything that causes pain. If you run, avoid hills, go for shorter distances or substitute other activities. Avoid high-impact exercises and squatting or kneeling. Don’t wear high heels or sit with your legs bent for too long.
Ice and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, others) or naproxen sodium (Aleve, others) can help ease immediate pain. If you have flat feet, you may need additional arch support.
If you’re still in pain after more than one year, you may have to consider surgery. Even then, surgery is recommended only if there is an obvious anatomical problem.
window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());
0 comments:
Post a Comment