Get Moving For Life Blog
Wellness | Lifestyle | Disability & Injury Management
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Simple Tips to Get Moving With Knee Osteoarthritis
Osteoarthritis can be a real pain in the knee. We are seeing more and more clients in their mid 40's to 60's coming to us complaining of knee pain or even on the waiting list for total knee replacements because the cartilage has completely worn down.
They want to stay active, but knee pain limits their ability to walk, hike, bike, play golf or doother activities they enjoy including work.
 Often the quadriceps (front of the thigh) are tight and weak compared to the hamstrings (back of the thighs). As well, with our clients we generally find an imbalance between the outer and inner quadriceps. Both of these problems misalign the petella and knee joint which results in wear and tear of the cartilage (joint cushion) in specific areas. Without this cushion the bones push into each other resulting in joint pain, weakness and instability.
Osteoarthritis is a degenerative joint disease that progresses over many years. Since, bones go where muscles pull it is necessary to re balance the strength and length of the muscles surrounding the knee, hip and ankle to get back to being active.
Stretching properly, on a daily basis combined with appropriate strength training exercises will gradually improve your ability to stand and walk for long periods time while reducing the frequency, intensity and duration of knee pain.
Here some basic guidelines: - Always let pain be your guide. Stop, if you are feeling pain in the joint DURING an exercise.
- Some discomfort is ok. Delayed On Set Muscle Soreness (DOMS) is when you feel an ache in the muscle that lasts about 24-48 hours after you exercise. Any pain in the joint indicates that you probably over-did it.
- Quadriceps to Hamstring Strength = 3:2, people with knee pain it is often reversed. Focus on gradually increasing quadriceps strength, while maintaining hamstring strength.
- Limit the Range of Motion to Pain FREE when doing Leg Extensions, Hamstring Curls and Leg Presses, Lunges and other exercises using your lower-body. The most pressure on the joint is when your leg is straight and bent past 80 degrees.
- Try low-impact cardiovascular activities such as snowshoeing, walking, elliptical, slow-moderate paced walking on gentle hills, swimming or aquatic exercise classes, cross-country skiing.
- Add traction during each stretch. Traction opens the joint space instead of compressing it which wears it down and increases pain even more (think of a grinding coffee).
- Reduce the amount of sugars in your diet to reduce inflammation.
- Follow your Doctor's guidelines: Limitations are those you set yourself; restrictions are those the Doctor, Kinesiologist or Physiotherapist sets for you.
- Follow your Doctor's guidelines when taking taking any prescription/non-prescription anti-inflammatory medication.
- Use crushed ICE wrapped in a wet towel on the knee joint for 10-20 min to reduce inflammation.
Kinesiologists understand that the body is interconnected. What is going on the ankle and hip affect the knee. There are several phases to a knee rehabilitation program. To have your posture and movement patterns assessed contact Lifemoves today.
Labels: active rehabilitation, cross-country skiing, fascial stretch therapy, flexibility, injury management, joint pain, myofascial pain, osteoarthritis, snowshoeing, stretch tips
Indvidualizing Yoga Practice to Relieve Neck and Back Pain
Last month I was challenged by a client to develop an active rehabilitation program that they could do at home as part of a regular Yoga practice. Finding a solution to this was important for me, the Kinesiologist and the client because doing so would mean adherence to the exercise rehabilitation program, therefore a greater chance of successful recovery from their soft-tissue injuries.
Communication, as within any Client-Kinesiologist relationship, was very important in achieving success. This client chose me mainly because I practice Yoga on a semi-regular basis and understand the basic principles, limitations and flow of Yoga within the context of soft-tissue rehabilitation.
While an excellent Yoga instructor will give participants modifications for their limitations, it is still very difficult to follow an individualized program in a class format. Our solution was for me to first teach the client the movements I wanted them to achieve and I also explained the principles of how to elongate and rebalance using the Stretch to Win method.
During each session they then demonstrated a series of poses that they thought would achieve our desired outcome. From there we developed an exercise/pose order that would flow while accomplishing our goal.
I find it rewarding to assist clients who are curious about movement, have the desire to get each movement correct, who want to learn more about their body and who diligently follow the instructions I give them. We discovered an excellent Yoga Anatomy book with illustrations showing which muscles are being strengthened and stretched during each pose. At home, the client researched and marked the poses they thought would be appropriate; during the next session we discussed the merits of each one.
By correcting each pose the client started to develop a deeper relationship with how to move properly to alleviate their back and neck pain. We succeed in reducing the intensity and frequency of their headaches, neck and mid-back pain because we ensured that we communicated clearly; the program also balanced the way they were psychologically motivated with their physiological rehabilitation needs.
Many people suffer with neck, upper-back and shoulder pain because of poor posture. Chronic tight chest, rolls the shoulder forward and up which also the head forward. There is a reflex that keeps us looking foward, so when the head-pokes forward we also get tightness just below the skull.
In our rehabilitations sessions we focused on the cause of their soft-tissue pain, rather than chasing the pain. Choose postures to open up the front of the body, bring collerbone back down and re-align the head over the shoulders. If, you sit a lot for work include stretches and postures to open the hip flexors.
Labels: active rehabilitation, fascial stretch therapy, flexibility, soft-tissue, stretch to win, stretching, whiplash, yoga
Stretching Tempo: Discard the 30 Second Rule
It is time to discard the old 30 second rule for holding each stretch and embrace what Ann and Chris Frederick at Stretch to Win call the "Stretch Wave." Basically, as I stated in a previous post is that your are trying to achieve the feeling of being "loose" and freedom to move.
The length of time you hold each stretch depends on the goals you have for that stretching session. First, ask yourself is this session before an activity, after an activity, for recovery or to gain lasting improvements in your flexibility?
Before a run, or golfing session it is appropriate to warm up the fascia, muscles, mind and nervous system. In this case your focus is the elastic range. However, at night or after a light cardio session when your goal is to improve your flexibility you want get into the plastic range. Think of the each fascial line like an elastic, when you go through the entire golf swing you want to be able move from your stance to follow-through easily and with control. Then you are going to set-up for you next swing. In essence when you pull the elastic and let it go, it returns to its resting length.
The plastic range is when the fascia is actually going to change its shape in a more permanent way. Similar to if you were to heat a piece of plastic, bend or reshape it, then let it cool. It will stay in this new shape. If you have an scarring due to a previous injury or surgery the plastic range will take longer to get into, so be patient.
There are several Stretch Waves: Very Slow- three slow breathes per stretch per position; Slow - two slow breathes per position; Fast - one regular breath per position; Very Fast - one fast breath per position (Stretch To Win, 2007).
Warming Up - go from a Very Slow to Very Fast and if you are cooling down and recovery progress from very fast to very slow.
The length of time you need to hold each stretch to gain flexibility depends on your age, current level of flexibility training and any previous injury or surgery in the fasical line. As you age the ratio of elastin to collagen changes. With increasing collegen our fascia has less stretch. Scar tissue forms after injury and surgery; it is primarily made of collagen that has laid down in a random matrix, which is tougher to stretch.
Take your time when you are stretching to gain flexibility. Remember to breath, if you are not breathing the stretch is too intense. Listen to your body it will tell you when it is "loose". Don't get hung up on the amount of time. Finish the stretch when you are no longer gaining length length for that session.
If you are in Metro Vancouver and want a flexibility program designed specifically for you to get moving more freely for life contact me at: alfred@lifemoves.caRead More about tempo stretching in Stretch to Win by Ann and Chris Frederick
Alfred Ball President Founder Fascial Stretch Therapist Kinesiologists Labels: flexibility, stretch tips, stretch to win, stretching, tempo
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