3 Knee Exercises to Keep You Running Pain Free

You may be training for your first 5km, or be a more seasoned runner striving toward a half marathon or marathon. Whatever your end goal, the key to completing your race is to remain injury free as your running starts to build-up.

Knees are often the most problematic of injuries sustained through running. Knee injuries such as Patellofemoral Pain (Runner’s Knee) and IT Band Syndrome are two of the most common injuries experienced by distance runners.

Thankfully there are some simple, but often forgotten steps, you can take to help prevent such injuries, and keep you running without knee pain. These preventive exercises are likely the same as exercises your health care professional may give you to treat such running knee injuries.

Simple Runner’s Knee Exercise Routine

It’s always best to perform the following exercises after a gentle warm-up, rather than stretching from cold.

• Side Lying Quads Stretch: 3 x 30 seconds on each leg
• Resistance Band Glute Bridge: 10 x 5 second hold
• Romanian Single Leg Deadlift: 3 x 10 reps on each leg

Aim to complete this routine 3-4 times weekly alongside your running.

Shoulder Rehabilitation

Shoulder injuries are very common in athletes who play overhead sports ie swimming and baseball, as well as individuals who do a lot of work overhead ie. Electricians and carpenters.
The shoulder consists of two anatomical joints: the Gleno-humeral joint and the Acromio-clavicular joint. The Gleno-humeral joint is the connection of the arm with the scapula (“shoulder blade”) The Acromio-clavicular joint is the connection of the clavicle (“collar bone”) and the scapula.

A large number of muscles and ligaments are important to the shoulder. The most important are the rotator cuff muscles (supraspinatus, subscapularis, infraspinatus and teres minor) and the Acromio-clavicular ligaments along with the Gleno-humeral joint capsule. The rotator cuff is a group of muscles and tendons, which hold the Glenohumeral joint together and help lift the arm overhead, such as throwing a ball or swimming.

A typical shoulder rehabilitation protocol consists of two major components; flexibility and strength. 

Flexibility is the first component of shoulder rehabilitation and consists of range of motion (ROM), static stretching, and dynamic stretching. ROM is desired degrees of range of motion of movement pattern that is pain free and maybe assisted with a stick/ towel or unassisted.
Static stretching are stretches that are pain free and held for 20-30 seconds and repeated 3-6 reps. Dynamic stretching are stretches that are pain free and held for 1-5 seconds and repeated 10-15 reps. 

Strength is the second component of shoulder rehabilitation and consists of dumbbell, tubing, and functional exercises.

Lower Body Injury Prevention

Lower body injuries are common in athletics and often result from poor body mechanics, particularly poor control over the motion of your knee. When you are running, forces from the ground run up into your feet and travel along a kinetic chain throughout your leg.  Injury may result if those forces add up to be too much, or in the wrong place, along that kinetic chain (e.g., ACL tear).  

Knee pain

Knee pain is a common overuse injury often caused by patellofemoral pain syndrome – when the cartilage behind the kneecap gets roughened and irritated. Pain occurs when there is increased pressure between the femur (thigh bone) and patella (kneecap). Although some may be prone to such knee pain due to genetic factors, other causes include overuse, weak thigh muscles, obesity, flat feet, knock-knees, and worn out shoes.

In order to prevent knee problems, be sure to warm up, cool down, and stretch in the time surrounding workouts (especially after work-outs). It’s particularly important to keep your front and back thigh muscles flexible. Wear shoes appropriate to the sport you’re playing, and make sure they’re not worn out and that they have good arch supports.

If you suffer from a painful kneecap, avoid kneeling or sitting with your legs crossed. Don’t sleep on your stomach because this puts direct, constant pressure on the kneecaps. Instead, sleep on your back with a pillow under your knees or on your side with a pillow between the knees. If you like to use stairclimber machines, try taking smaller steps. Once you no longer suffer knee pain, try doing exercises such as straight-leg raises. Either sitting in a chair or lying down, hold your leg out straight and raise it off the ground to strengthen the quadricep muscle without irritating the patella. (Lunges and squats are good exercises, too, but could be damaging to the knees if done improperly).

Shin Splints

Shin splints are a common overuse injury that develops over time in athletes who pound their legs – runners, sprinters, figure skaters, gymnasts, etc. Pain occurs on the inside of the lower leg, where the soleus muscle of the calf attaches to the shinbone, or tibia. Running and other weight-bearing exercises exacerbate pain. In order to prevent shin splints, train on softer surfaces, such as grass or a treadmill, or engage in lower-impact workouts, such as swimming or cycling. Proper footwear is essential for runners to reduce the stress of impact. Ice is the best treatment for shin splints, and massage can help as well. Taping the shins can relieve pain, but should not be used to enable exercise on injured legs.

Stress Fractures

Stress fractures are tiny cracks in the bone, which occur when muscles are overexerted and lose the ability to absorb shock, which is then transferred to the bone. People who develop stress fractures are usually those engaged in repetitive weight-bearing activities, such as running, tennis, basketball, and gymnastics. Having flat feet, rigid arches, or osteoporosis will increase your risk of a stress fracture, which typically occurs in the lower leg or foot. To prevent such injury, build up the intensity and duration of your exercise routine gradually so your muscles have time to strengthen. Symptoms include pain that increases with time and is still painful after a few days. The pain increases with activity, and there may or may not be swelling. You should go to a doctor if the pain doesn’t go away after 2 days of rest.

Sprains

A sprain occurs when a ligament (the fibrous tissue that connects bones) is overstretched or torn, but there is no dislocation or fracture. The sprained joint will cause immediate pain, swelling, bruising, and warmth at the injured site. As the sprain heals, the damaged ligaments and connective tissue will be replaced by new fibrous tissue that is stronger, but not as flexible. This is why it’s important to move and stretch the injured site during the healing process, as long as it doesn’t cause pain. The joint may not fully recover for many weeks.

To treat sprains, follow R.I.C.E. (described below), and make sure ankle sprains are elevated above heart level even during sleep. Standing or dangling the leg can lead to more swelling, throbbing, and pain. Do not treat acute sprains with heat, only ice.

The best pain reliever to take right after injury is Ibuprofen because it is also anti-inflammatory (decreases swelling). Acetaminophen (Tylenol) is not an anti-inflammatory and Aspirin will increase internal bleeding if taken within 24 hours of the injury. Always consult a physician for information on use of medications. Crutches are useful if the leg cannot bear weight fully, but early walking is important to prevent tightening of the tendons that connect muscles to bones.

Strains

Strains are often the result of overuse or injury, when muscles or tendons are overstretched or overexerted. While sprains concern ligaments, strains affect tendons, the tissue that connects muscles to bones. Strains cause pain, tenderness, swelling, and bruising at the injured site. Because sprains and strains affect different types of tissue, you can have both types of injury at the same time. For example, an ankle sprain and a strain of the Achilles tendon.

Tendonitis (also spelled “tendinitis”)

Tendonitis is any inflammation or irritation of a tendon, which connects muscles to bone. The condition causes pain, tenderness, and stiffness near a joint, usually around the shoulders, elbows, and knees, and is commonly the result of injury or overuse. The pain of tendonitis is aggravated by movement, so rest, ice, and pain medication is usually the best treatment. In order to avoid tendonitis, don’t participate in activities that place abnormal amounts of stress on your tendons, such as running uphill. Also, try cross-training to limit and spread out high-impact workouts, such as running.

Treating Sprains, Strains and other Sports Injuries

If the injury does not appear serious, stop what you’re doing and use R.I.C.E.:

• Rest the injured area as much as possible for 24 to 48 hours.
• Ice the injured area as soon as possible for 20 minutes on and 20 minutes off. After a couple hours you can reduce icing to 20 minutes 4 times a day.
• Compression. Apply an elastic bandage to the area to control movement, but loosen it if you feel numbness, tingling, or increased pain.
• Elevation. Raise the injured area above heart level.

Full return to activity should be avoided until full range of motion no longer causes pain.

Five Things You May Not Know About Back Pain

Low back pain is a major health issue. It affects 84 per cent of the working population at some point in their life and is second only to the common cold as a cause of lost work time. But back pain doesn’t have to hijack your sick days. Here are some universal ‘back facts’ to keep in mind if you catch yourself suffering from this pesky problem:

Rest vs. Staying Active

If you’re injured, you may have been told to rest until your injury has healed. However, avoiding exercise is the worst thing you can do when you are experiencing minor back pain. It is important to stay active when recovering from injury, but it is best not to exert yourself. You should reduce normal physical activities but continue to be as active as possible. At the end of the day, those who maintain active therapy recover quicker.

Slipped Disc

Your spinal column is made up of 26 bones (vertebrae) that are cushioned by disks. The disks protect the bones by absorbing the shocks from daily activities like walking, lifting, and twisting. Injury or weakness can cause the inner portion of the disk to protrude through the outer ring. This is known as a slipped or herniated disk and can cause pain and discomfort in your lower back. In most cases, a slipped disc will revert back to its position spontaneously, but it can take four to six weeks to fully recover. You may have heard it’s best to rest your back if you have a slipped disc, but actually, remaining moderately active is ideal in order to keep muscles and ligaments warm and reduce the risk of creating more tension in your back.

Hot vs. Cold

Most people believe that a hot bath reduces back pain. The reality is that even though it may sound soothing, getting into a hot bath when muscles are inflamed can make matters worse by increasing the inflammatory response in an acute injury. Generally, it is better to apply ice to an injury for 15 to 20 minute intervals, during the first 48 to 72 hours after the injury.

Massages

When people have back pain, they often book the earliest massage. The truth is, when you’re in pain, a massage may help in some cases and hurt in others, depending on the cause of the back pain. For instance, the lower back may feel tight because of a muscle spasm occurring in an unstable region. A massage to this area without truly assessing the source and the reason for its tightness can inhibit the body’s way of protecting itself and cause more instability, thereby causing more pain.

Back pain and aging

No matter how many birthdays you celebrate, back pain should not become a normal part of aging. As we age, it‘s true that we can become more susceptible to certain types of painful back conditions. However, with all of the treatment options available today, back pain does not have to be a part of the aging process.

Anyone experiencing back pain is encouraged to consult a health care professional to assess your specific needs and identify a course of action that’s right for your specific condition.

Sources:
https://www.chiropractic.on.ca/public/your-back-health/5-things-back-pain/
http://www.huffingtonpost.com/2014/04/20/back-pain-_n_5126343.html
http://www.healthline.com/health/herniated-disk#Overview1
http://www.knowyourback.org/Documents/9myths.pdf
http://www.nhs.uk/Conditions/Slipped-disc/Pages/Treatment.aspx