The Need to Know about the Knee! Now that spring is in full swing, many runners have kicked up the gear in preparation for the summer months. Recently, I completed the 2017 Shape NYC FITNESS half marathon for the fourth time and there have definitely been some moments during my training when my knee ached a little bit. Let’s talk about some of the things we can do for knee pain.
If the pain is due to an overuse syndrome or an acute injury, try resting the joint first for a few days to weeks. Avoid the activity that aggravates your knee pain. Heat and Ice are often initially recommended to decrease the inflammation and swelling. REMEMBER RICE: Rest, Ice, Compression, and Elevation
Being overweight imposes a risk of developing knee osteoarthritis or a ligament/cartilage injury therefore weight loss and lifestyle modification is necessary. For every pound that an individual is overweight, additional excess weight and force is applied to the knee joint.
Diet is a crucial component of reducing the risk of osteoarthritis which can cause knee pain!
a. Try incorporating an anti-inflammatory diet focused on avoiding or limiting foods that promote inflammation like saturated fat, trans fat and simple refined carbohydrates into your diet.
b. Highly processed foods and foods that have high sugar content like red meat, sugary sodas, pasta, candy, and high fat processed meats like bacon are not your buddies. Try limiting these foods.
c. There are foods which may aid in fighting inflammation. These foods may include vitamin C, selenium, carotenes, bioflavonoids, extra virgin olive oil, and omega-3 fatty acids.
Why do I love omega-3 fatty acids?
I encourage my patients to incorporate the omega -3 fatty acids into their diets since it is a healthy polyunsaturated fat. These fatty acids may help suppress inflammation by blocking the production of chemicals that can eat away at the cartilage in osteoarthritis. The anti-inflammatory effects can result in less joint stiffness, tenderness and pain in some people. You can find the omega-3 fatty acids in salmon, flaxseed, sardines, walnuts, anchovies, herring, and omega-3-fortified eggs.
The incidence of gout can also be decreased by avoiding foods that are rich in purines which can be converted to uric acid. Cutting down on the red meat, shellfish, and beer may help with decreasing the incidence of a gout attack.
What about medications?
Over the counter pain medications like acetaminophen (Tylenol) can be taken to improve symptoms. Nonsteroid anti-inflammatory medications (NSAIDS), such as Naproxen, Ibuprofen, Celecoxib, Meloxicam can also be used to aid with the pain and inflammation for osteoarthritis, tendonitis, or bursitis. These medications do have side effects so you MUST consult with your physician about the risks and benefits and have a discussion on how these medications affect underlying medical conditions, especially diabetes, kidney disease, high blood pressure, and heart disease.
People living with osteoarthritis do have other pharmaceutical options such as receiving steroid joint injections into the knee or artificial joint fluid injections of hyaluronic acid which may help improve knee pain for several months. For people, who are diagnosed with rheumatoid arthritis, there are disease modifying medications (DMARDS) which aim to block certain chemicals in the body that cause significant inflammation and destruction of the joint.
What else can be done?
Often, people may limit physical activity completely to avoid aggravating the knee however, it is important to gradually return to mild activity that might help improve knee strength, such as swimming. Some physicians may also encourage individuals to participate in a comprehensive physical therapy program for several weeks. Remember every person’s body is different and you should discuss with your trainer, fitness instructor or physician whether certain exercises are safe for you to do. Women and men can engage in quadriceps (muscle on front of thigh) and hamstring (muscles in the back of thighs) stretching exercises at home, outside or in the workplace to help strengthen the ligaments and tendons around the knee joint. Tai chi, yoga and plain old stretching are all examples of activities that will keep the muscles flexible and promote better mobility and range of motion. Sometimes orthotics, a brace, or a splint may be needed to allow extra support for the weakened knee or prevent the knee from moving too much. Some people have even tried acupuncture as an alternative option but it is unclear if this therapy works. There are so many exercises out there that can help improve knee strength and pain. Checkout my favorite exercise for a stronger knee! I usually do this exercise two to three times during the week.
STRAIGHT LEG RAISE SPOTLIGHT
I like to start my workout with this move!
Lie on your back with some support if needed. Bend one knee while straightening the other leg and lift the leg. Flex the foot of the straight leg toward your head and hold for five to ten seconds. Hold the leg at approximately a 45 degrees and return the straight leg to the floor. The straight leg should not surpass the height of the other bended knee. It is important to make sure that the leg is straight while tightening the quadriceps muscle. You can repeat this maneuver ten to fifteen times before switching to the other leg. You can do 3 sets. Sometimes if I want a challenge, then I can consider adding an ankle weight while performing this exercise. Check out these other exercises with your physician and determine which ones work best for you! For most of these exercises, you can repeat for 3 sets.
a) Side Leg Raises
Lie on one side and bend the bottom leg for support while the top leg is straight and can be raised to approximately 45 degrees. Hold for a few seconds and lower the leg. Repeat this maneuver ten to fifteen times and then alternate to the other side
b) Hamstring curls
I like to do this exercise standing up while holding onto a chair or gym equipment and lift my heel as close to my buttocks and hold for a few seconds. For a quadriceps stretch, repeat this maneuver but grab your ankle and pull the heel closer to your body and hold.
c) Calf stretch or calf raise
I like to use a step platform or face the back of a chair or gym equipment for support for this move. Simply elevate the heels as high as you can and then lower
d) Wall squat
The feet (shoulder width apart) must remain planted on the floor while positioning the back against a wall. Bend the knees in a controlled manner while having the back and pelvis/hips remain against the wall and hold for five to ten seconds. You can hold for longer periods for a challenge. It is important not to cause knee discomfort if over bending occurs. Remember to adjust the position if you feel uncomfortable or have pain in the knee. Remember to seek medical attention if sharp or sudden pain occur in any joint or surrounding muscles during any exercise or activity. Now that summer is here, there are many more races to run in the upcoming season. Protect that knee and feel free to join me at the next race if you are in NYC!
Disclaimer: This blog contains my personal opinion based on personal and clinical experience, tips from trainers, health coaches and lastly research. This blog does not endorse specific treatments, procedures, products. You should always consult with a doctor, nutritionist, or other healthcare professional to discuss your own health and lifestyle goals and regimen based on your medical history. Thank you for reading!