Sunday, 12 May 2013
Knee pain?
There are a few different types of knee injuries and my goal here isn't to discuss every single knee injury, but more to make you aware of the structures that may be contributing to your pain. Acute injuries, such as ligament tears, meniscus injuries, patellar dislocation etc. are probably not as common in Crossfit as those of more a chronic/repetitive type injury (patellar tendinopathy, bursitis, etc).
The knee is actually made up of two joints: the tibiofemoral joint (the joint between your tibia and femur) and the patellofemoral joint (the joint between your patella and your femur) which are stabilized by the collateral ligaments, cruciate ligaments and mensicus. The quadriceps, gracillis, iliotibial band, popliteus, sartorius, hamstrings and calves provide muscular stability and assist in movement of the knee (flexion, extension and some rotation).
Knee pain can be associated with injury to any of the structures directly connected to the knee, but can also be from other structures upstream (lumbar spine, SIJ, hip) and/or downstream (ankle).
Two of the most common causes of knee pain (anterior/front of knee) is patellofemoral joint problems and patellar tendinopathy. The signs and symptoms of each problem help to distinguish the diagnosis.
Patellofemoral Pain
- comes on with running/weight bearing activity involving bending of the knee
- pain aggravated by activities that load the knee eg. squatting, jumping
- sometimes associated with clicking and "crunchiness" under the kneecap
- knee sometimes gives way
- weak VMO (inner quads)
- tight vastus lateralis (outer quads), TFL
- often associated with foot pronation (flat feet) and valgus knees (knock knees)
Patellar Tendinopathy
- comes on with jumping/change of direction/squatting
- pain is at the base of the kneecap
- pain aggravated by decline board squats
- tenderness of patellar tendon
- associated tightness of quads, hamstrings, possible pelvic biomechanical issues
- calf weakness commonly found
Treatment of each of these conditions varies so it's always best if you get a Physio to do an assessment. Self diagnosis via "Dr Google" can be misleading, not to mention you could be wasting your time barking up the wrong tree. In any case, addressing the tissues around the knee can be a good place to start.
Try rolling out/trigger pointing the quads, hammies, calves, adductors and glutes and see if it changes your knee pain. Make sure to test first (whatever movement causes the pain) and re-test post rollout to see if you have made change. No change = see a professional. Change = keep it up!
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great article - in my case i have found that rolling out my inner hammies (way into the glute connection) immediately relieves patellar knee pain. i didn't know why - only that it worked. now i know why. thanks!
ReplyDeleteThanks for the guidelines for the knee pain injuries and I have learn from your posts so many things. I will save this to be one of my references about knee injuries.
ReplyDeletePeople should not wear high heeled shoes as high heels are one of the main causes of knee pain as heels throw your entire body out of alignment.
ReplyDeleteKnee Pain