This article on the knee is the third of three segments on the most injured body parts in military / athletic training. Check out the Stew Smith archives for previous articles specifically discussing injury prevention and rehab of the lower back and shoulder. Like the shoulder and the lower back, the knee joint is susceptible to injuries of the connecting tissues of ligaments and tendons, compression tissue of the cartilage, and muscular strength and flexibility imbalances.
The most common of knee injuries is Patello-Femoral Pain Syndrome (PFPS) or commonly called "runner's knee," and "Iliotibial Band" (ITB). For most people these injuries are classified in the "over-use injury" category. In fact, the nickname for ITB at SEAL training is "I Tried BUDS" due to so many students failing out of training with this over-use injury. PFPS can occur in avid runners as well as people who decide to go running for the first time in several months or even years without proper training prior to running again. It is also important to rule out other knee problems when knee pain occurs and not assume every pain as "runner's knee" for you could be suffering from a knee injury that requires surgery. Usually, if your knee injury involves ligaments or cartilage, surgery is required and can be relatively quick with a speedy recovery thanks to the latest in arthroscopic surgery techniques.
To help prevent injuries such as runner's knee, ITB, and other injuries (not including sudden impact damage) there are a few rules of thumb to go by.
Rules to Help Prevent Injuries
1) Do not run too much, too soon - start a running program gradually even if you were on the cross-country team ten years ago.
2) Replace old shoes every 300-400 miles of at least every 6 months and try not to use your running shoes as your everyday shoes. We walk differently than we run.
3) Stretch daily and become flexible especially in the hamstrings, calves, and lower back.
4) Strengthen thigh and hamstring muscles so you do not create imbalances in strength and flexibility.
5) Always rest, ice and only do non-impact aerobics such as swimming, biking or rowing if your knees hurt when you run.
6) My rule: If it hurts to walk - DON'T RUN! If it hurts to run - just walk.
Here are some pictures and descriptions of some of the few stretches and exercises that are part of any of my books and eBooks. Also, visit Stephen M. Pribut's website for more information on injuries of the knee and other running related issues.
Hamstring / Lower back Stretch
From the standing or sitting position bend over and touch your toes.
Thigh Stretch Standing
Pull heel to rear. If you cannot do this stretch as shown, just bend your knee in the same fashion - that will stretch your thigh muscles.
Lean against a wall and push your heel to the floor with most of your weight on your back leg.
Hip / Outer Thigh Stretch - ITB Stretch
Sit and cross your legs. Pull your knee to your chest and hold for ten seconds - Switch and repeat with other leg.
You should do the stretches above and the minimum recommended stretches for at least 30 seconds each after a brisk 5:00 warm up jog. Always stretch after you have warmed up the muscles and gotten the blood flowing to the muscles and connective tissues being used.
The exercises below will also help strengthen your knee joint through exercise of the connecting muscle groups.
Straight Leg Lifts
Strengthens the quadriceps. Lie on the floor. Lift one leg about 6-12 inches off the floor and hold for 10 seconds flexing the thigh muscles. Lower and repeat 10 times. Switch legs, repeat 5 times and work up to 10 sets of 10 repetitions. You can do this anywhere - even while watching TV.
The 1/2 Squat
While standing, hold the pose and push yourself up and down within a 8-12" range of motion....just like riding a horse. Do about 5 sets of 10-20 in a workout.
Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. If you are interested in starting a workout program to create a healthy lifestyle - check out the Military.com Fitness eBook store and the Stew Smith article archive at Military.com. To contact Stew with your comments and questions, e-mail him at firstname.lastname@example.org.
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