Knee Pain? Solution: Work your glutes.

Many of us will experience different degrees of knee pain at least once in our lifetime. Factors that can affect the level of knee pain include: faulty movement patterns, muscle force and/or length, posture/alignment and physical activity (occupational, recreational, self-care activities). Many health practitioners choose to treat just the symptoms of knee pain; using modalities such as kineseotape, medication, ultrasound, and inconsistent massage which offer short term relief. To treat the underlying mechanisms of knee dysfunction it is prudent to include: therapeutic exercises to strengthen the glute maximus/medius muscles; self myofascial release with foam roller of quadriceps, hip flexors and gastrocnemius/soleus complex; corrective exercise to improve faulty movement patterns; and manual therapy such as joint mobilization.

After taking a continuing education course on Functional Biomechanics of the Lower Quarter taught by Christopher Powers, PhD, PT and Co-Director of Musculoskeletal Biomechanics Laboratory at U.S.C., I realized the relationship between hip/glute weakness and knee pain. Hip motions that can influence the knee are femoral internal rotation and adduction. These motions if unchecked by strong glute maximus/medius muscles will cause a Genu Valgus (knocked knee) stress on the knee complex. This hip extensor/abductor weakness combined with quadriceps overuse will cause increased patella-femoral joint reaction forces and thus knee pain.

Many personal trainers and even physical therapist would incorrectly treat knee pain with numerous quadriceps strengthening exercises, but this inherently leads to more quadriceps overuse and thus no significant improvement in knee symptoms. Therapeutic exercises to strengthen glute maximus/medius include: bridging, sidelying hip abduction with external rot/extension, quadruped hip motions, single leg stance activities with progression to functional/dynamic movements that require hip/knee stability.

How to Avoid Overtraining Injuries

Overtraining is a common concern, and something that we should all be aware of (both physical therapists and clients). Learn more about overtraining injuries, how to prevent them, and get the right guidance for training from this article published on MoveForwardPT.com, an informational site created by the American Physical Therapy Association. For more questions please call at 619-756-7500.

 

Overtraining is a concern for all people pursuing fitness – from recreational or elite athletes to people who exercise to lose weight and stay in shape. Overtraining injuries are musculoskeletal injuries that occur due to more activity or exercise than your body is used to, and may happen to anyone who increases intensity or changes type of activity. Overtraining syndrome includes overtraining injuries, but also encompasses general fatigue and other symptoms.

Signs and Symptoms

If you experience any of the following after working hard to meet advanced fitness goals, overtraining may be a cause.

  • Physiological: increased resting heart rate, increased blood pressure
  • Physical: decreased appetite, upset stomach, insatiable thirst, sleep disturbances, increased frequency of sickness and infections, general feeling of increased difficulty and fatigue throughout the day, abnormal muscle soreness, pain occurs that is different than typical muscle soreness
  • Behavioral: personality changes, decreased motivation, altered concentration, lowered self-esteem, decreased ability to cope with stress
  • Performance: Increased heart rate during activity, decreased strength or endurance, impaired movement and coordination, multiple technical errors.

Avoiding Overtraining Injuries

No matter the activity (running, swimming, weight lifting, etc), when working to improve your fitness you need to push yourself in order to see results. But pushing yourself too hard can result in injuries that are detrimental to your fitness goals. Here are some tips to avoid overtraining injuries:

Don’t increase exercise difficulty level too quickly. Exercise needs to be progressed steadily at a gradual pace. Following a structured plan that increases your activity incrementally and safely can help you stay healthy and pain free. For example:

  • For running, increasing difficulty may include increasing speed, running up or downhill, increasing duration, and use of intervals, where you alternate intensity over time.
  • For resistance training, increasing difficulty may include increased weight, repetitions, sets, and decreasing the amount of time to perform the same amount of exercise.

Pay attention to your body.Your body is smart. If it feels like you are developing signs of overtraining, then take a break, lessen your activity, or rest.

Ease into it. Particularly if you are new to fitness or altering your exercise activities, take it slow. Don’t expect to make up for several months of inactivity with a few weeks of exercise. Aim for long-term consistency, not overnight success. People who try to do too much too soon often end up injured or frustrated and give up on their fitness goals altogether.

Avoiding Overtraining Syndrome

Overtraining syndrome occurs when an active individual or athlete increases activity faster than the body can adapt or is unable to recover from a sustained high level of activity. Your body then lets you know that you’ve done too much too fast through a variety of physical responses.

There are several signs and symptoms that may indicate overtraining syndrome but are also symptoms of other problems

Every active individual is unique. Your pain may be due to overtraining, but it also may be due to other health issues. For example, heart rate changes, general fatigue, and other systemic symptoms may be due to a more concerning condition. Physical therapists are educated to evaluate and treat a variety of conditions. If you have any of the above signs a physical therapist can help to determine the seriousness of the signs and what your next course of action for your health.

Here are some tips to avoid overtraining syndrome:

Take a break. If you have a scheduled rest day in your plan, use it, you’ve earned it!  Your bones, joints, and muscles need rest days to stay healthy.

Get rest. Recent studies are supporting the important role of sleep in the health of active people and athletes.  This is when our bodies’ build and repair and our immune system recovers.

Eat well. Proper nutrition is essential to the health of your body. Do not severely restrict calories when exercising. Make sure to eat proper nutrients, including plenty of lean meats, fruits and vegetables.

How will a physical therapist help me meet my fitness goals?

Physical therapists are movement experts, and work with people of all ages and levels of activity. During a visit, a physical therapist can:

  • Check your flexibility, strength, and endurance of muscles to support your desired level of activity.
  • Ensure that symptoms are due to overuse or overtraining and not something more serious.
  • Identify training errors to ensure a safe fitness plan, no matter your previous level of activity.
  • Correct biomechanical problems in form with your chosen activity to avoid overuse of a susceptible body part.
  • Provide appropriate training plan to minimize risk of injury and help you safely meet your fitness goals.

Smart Moves for Families

Getting enough physical activity for the family will help boost energy and inspire great attitudes! MoveForwardPT suggests more exercise for the family to improve overall health.

Making a commitment to be physically active is one of the best ways families can prevent or combat obesity and its consequences. Physical therapists support the Department of Health and Human Services’ Physical Activity Guidelines, which states:

Children should get 1 hour or more of physical activity a day.
Adults should do 2 hours and 30 minutes a week of moderate-intensity, or 1 hour and 15 minutes a week of vigorous-intensity aerobic physical activity.
Physical therapists’ extensive knowledge of pre-existing conditions (such as type 2 diabetes and obesity) allows them to help people of all ages and abilities establish life-long patterns of physical activity. For those who already are obese, physical therapists can devise safe exercise programs that reduce pain, restore flexibility, and increase strength and cardiovascular endurance. For people with type 2 diabetes, they can design and supervise exercise programs that reduce the need for medications, lower the risk of heart disease and stroke, and help manage glucose levels, among other benefits.

The following tips were designed by physical therapists to help families stay active and incorporate physical activities into their daily lives:

“Smart Moves” for Families

Plan weekend family activities involving physical activity, such as hiking, swimming, bicycling, mini-golf, tennis, or bowling.
Help your child plan physical activities with friends and neighbors, such as skating or softball.
Have your kids brainstorm a “rainy day” game plan of indoor activities involving fitness games such as Wii Fit or Dance Dance Revolution.
Remember that your family does not need to join a health club or buy fancy equipment to be active. Walking isn’t costly and it’s easy. So is designing a backyard obstacle course. Weights can be made from soda or detergent bottles filled with sand or water!
Provide positive rewards for your child when he or she engages in physical activities, such as workout clothes, a new basketball, or an evening of roller-skating.
Provide positive feedback about your child’s lifestyle changes. Remember not to focus on the scale (for you or your child).
Be your child’s “exercise buddy.” Plan daily walks or bike rides and set goals together for increasing physical activity rather than for losing weight. It’s also great “bonding” time!
As you schedule your child’s extracurricular activities, remember to plan time for exercise and activity as a priority for the entire family. Don’t just “squeeze it in.”
Encourage children to try individualized sports such as tennis and swimming. Studies show such activities are the basis of lifelong fitness habits.
Parents and children can do exercises while watching television (or at least during commercials), such as sit-ups, push-ups, or running in place. Discourage snacking or eating meals while watching.