For athletes and fitness enthusiasts, knee pain or injury can be debilitating and demoralizing. If ignored and left untreated, muscular imbalances at the knee can lead to more serious degeneration of the joint and can impact other joints and muscles. As hard as it is to stop or slow down your usual training regimen, taking time to address joint issues early will help prevent more serious problems down the road.
Anatomy of the Knee
Because of the demanding nature of athletic activities, the knees' integrity depends on the ability of the muscles to provide support and shock absorption during dynamic directional changes and rebounding power movements. The quadriceps, hamstrings, abductor and adductor muscles all come into play at the knee. In addition to muscles, the ligaments that attach the femur, or thigh bone, to the tibia, or shin bone, play a critical role in knee stability. When the muscles become fatigued, or when outside forces overpower the muscles' ability to protect the knee, the ligaments are vulnerable to tears.
Imbalance and Overuse
According physical therapist Robert Donatelli, the muscles that surround a joint work in groups to produce movement and provide stability and shock absorption. The muscles initiating a movement are called agonists and the muscles of the opposing group are called antagonists. When agonists become fatigued from overuse, they tighten and lose their stabilizing capabilities, predisposing the joint to injury. In addition to adequate rest and recovery time, doing exercises that strengthen the opposing muscle group while stretching overworked agonists will restore the balance of muscular tension and stability at the knee.
Anterior and Medial Leg Exercises
To work the muscles where they cross the knee and insert at the tibia, use a leg extension machine. Exhale and extend the knee fully, toes pointing to the ceiling. Hold briefly at the top before slowly lowering, maintaining tension at the bottom of your movement. To focus on the muscles that attach medially, or to the inside of the the knee, rotate the hip slightly outward with the knee extended. Do mini-extensions, decreasing the joint angle only a few degrees for each repetition. Repeat each exercise 10 to 15 times.
Posterior and Lateral Leg Exercises
To strengthen the hamstrings at the knee, use a prone or seated leg curl machine. Align the axis of your knee joint with the pivotal axis of the machine, and place the ankle pad just above your shoe. Exhale and bend the knee to 90 degrees, holding briefly before inhaling and slowly extending. Strengthen the tensor fasciae latae and iliotibial band at the outside of the thigh by using an ankle cuff attached to a cable machine, lifting the leg to the side, then slowly returning to your start position. Repeat each exercise 10 to 15 times.
Stretching
Stretching all the muscles that surround the knee is an often overlooked but critical component of training. Muscles should be stretched while warm, when muscle fibers are most elastic. Release the muscle slowly, holding your stretch at the longest length without bouncing for 30-60 seconds or more to allow muscle fibers to relax and reach their elastic potential. Incorporate deep breathing while you stretch, inhaling at the beginning and slowly exhaling as the muscle elongates.
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