odds and ends from a life under construction

31 Days, Day 3: How to keep your knees healthy

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[The photo above is a representation involved a professional model with shaplier, more closely shaven legs than my own. I did not bring a photographer to the doctor’s office.]

I made it a whole three days into October without mentioning running. What can I say? Since I do it a lot – it had to come up. But I promise there will be something here for you even if running isn’t your sport of choice. Exercise good!

My sore knee I’ve mentioned over the past few weeks has been getting progressively worse every time I run. My knee hadn’t been bothering me during runs… up until my four miles on Tuesday morning, when it was actually sore while I ran. And it hurt significantly more when I stopped running, making standing all day at my desk a truly delightful prospect (not). Worried something was seriously wrong, I finally broke down and made an appointment with a physical therapist. Seeing a doctor is a big deal for me. I go into every appointment expecting the worst – “Your knee is fine. But you have cancer!” But considering my worsening pain, the writing was on the wall – if I kept running through the pain, whatever was causing it might cause permanent injury.

LoHi Physical Therapy is conveniently around the corner from our house and we pass it every single weekday on the way to work and daycare, so it was the first and only place I thought of when figuring out where to make an appointment. They also have a program called “Running Well” where they videotape you running and work on improving your mechanics over several sessions. I’ll probably try the program out, but the first order of business was fixing my knee.

After going through all the intake questions and describing my pain, I changed into some shorts, the purply-blue kind it seems everyone has worn in every high school and college gym class ever, for my physical exam. We started with me standing in place and gently squatting while the PT took a good look at my knee. Then he had me lie on the table on my back and felt around my knee while I bent and flexed each leg in a variety of positions. He would have me do the same movement with both legs so he could compare the feeling of my “good” knee (the left one) with my “bad” knee, and it didn’t take long to find the problem.

There’s a tendon or ligament just outside my patella that got strained and decided to adhere itself to the bone behind my kneecap. So, when the PT felt along that ligament it was rock hard. And when he’d try to move my patella, it wouldn’t budge. Everything was just wound up incredibly tight. He also let me know I’ve got some pretty good muscle imbalances going on, a common problem with runners. My outer quads and glutes are pretty strong, but my inner thighs and my hips aren’t nearly as strong, so the muscle mismatch is pulling unevenly on my knee, throwing things out of whack. Add to that my severe overpronation, and I’m an injury waiting to happen.

The good news is I haven’t done any permanent damage, and I can even keep training while I work things out. Peter the PT took a mini plunger (this one, in fact) to my knee to loosen up the ligament and my patella so they move more freely. And with some strength training and targeted exercises, I can keep things in working order once I’m back to 100 percent. I have another appointment next week, presumably for some more plunging, and I have some homework to keep me busy between now and then. And since my homework exercises are just good exercises and stretches in general, I’m sharing them with you in the hopes that you can avoid the knee problems I’ve had. Learn from me!

Kneeling Hip Flexor Stretch. This was surprisingly effective. To make sure you’re getting a good stretch in the right place, keep your tailbone tucked under (if you’re like me and have watched a ton of home workout videos, this is referred to as “neutral pelvis”). You can lean forward to get more of a hip flexor stretch, but for me, just being in the starting position felt amazing. You can also rotate your back “ground” leg and hip to alter the stretch, and if you move your front leg to the side you can target more of the inner thigh. One stretch, so many muscles!

Sidelying Quadricep and Hip Flexor Stretch. You can do this one with a towel, or just grab your ankle with your hand if you’re more flexible. Be sure to keep your back flat (arching your back is a “cheat” that minimizes the effectiveness of the stretch) and your top knee down.

3-Way Stability Series. Deceptively simple, this one didn’t take long to give me a good burn. And I couldn’t find a video of it, so you get the written out description. For all three exercises, start by lying on your back and bringing your knees to your chest, like you’re curling up in a ball. Do each exercise for 30 seconds to a minute, and between each exercise, give your legs a hug.

  • Exercise 1: Place your palms on your thighs just below the knee and gently push up and away from your chest. At the same time, try to keep your legs from moving by pushing them against your hands.
  • Exercise 2: Cross your hands and place your palms in a position slightly more inside your knee compared to where they were for Exercise 1, and this time push out as you push away. Press in with your legs to keep them from moving.
  • Exercise 3: Place your palms on the front of your legs below the knee (so at the top of your shin) and push against your palms with your legs while you pull your legs in to your chest.

The Clam. This one made my legs shake. The key is body position; keep your back straight, your tailbone tucked and your hip rolled slightly forward if not perpendicular to whatever surface you’re lying on (anything but rolled backward). Make sure your body position doesn’t change as your raise your top knee.

And there you have it – some simple exercises to help stretch and strengthen the lesser-used muscles in your upper legs and hips. With just over two weeks until my first half marathon, I’m hoping completing this circuit a couple times a day does the trick!

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