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The rehab clinic: quit your gimping and get back in the game. This month: dealing with knee pain

Men's Fitness, May, 2005 by Bill Hartman

PROBLEM: Pain in your kneecap, especially when you place weight on the knee or when the joint is bent.

TRIGGER: Most likely, placing too much stress on the joint between the kneecap and the thighbone--by adding more weight to your squat than you could handle, for example.

DIAGNOSIS: Patellofemoral pain syndrome--a catchall term for pain in the front of the knee. The condition is usually caused by a poor alignment between the kneecap and the thighbone, which could cause painful rubbing between the two bones when you bend the joint. Left untreated, that constant grinding can lead to a breakdown of the cartilage on the back of the kneecap.

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WHAT YOU SHOULD DO NOW: Avoid anything that makes it hurt, including lifting. It's likely that your injury is the result of tightness or weakness in the muscles attached to the hip. This results in malalignment of the kneecap during the squat and progressive weakness of the vastus medialis (see the diagram above)--the quadriceps muscle on the inside of your thigh that helps stabilize the knee. The fix? Start stretching your hip-flexor muscles and strengthening your hip extensors. One simple exercise that does both is the single-leg bridge: Lie on your back with your left foot on the floor, left knee bent 90 degrees. Your right leg should be straight and flat on the floor [1]. Keeping your torso rigid, push your left foot into the floor so your hips come up and your right leg--staying in line with your body--raises to 45 degrees [2]. That's one rep. Perform 10 total reps, then switch legs and repeat. Do 10 bridges every few hours throughout the day. To offset further weakness of the vastus medialis until you're well enough to squat, do this mini-workout 3-4 times a day, 5-6 days a week: Sit on the floor with your legs straight out in front of you and contract your quads hard for five seconds, focusing the contraction on your vastus medialis. That's one rep. Do 1-2 sets of 20 reps, resting 30 seconds between sets.

WHAT YOU SHOULD DO LATER: If the pain has gone away within two weeks, ease back into your leg workouts with body-weight squats, progressing to lunges when you're able to perform them without pain. If you're still hurting, seek out an orthopedic physician who specializes in knees.

KNEE OK FOR NOW? Keep it that way. When it comes to squats, always go up in weight slowly, and pay studious attention to your form.

MF adviser Bill Hartman is an expert in the rehabilitation of sports injuries.

The rehab clinic: quit your gimping and get back in the game. This month: dealing with knee pain

Men's Fitness, May, 2005 by Bill Hartman

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