Medial knee pain is sometimes very debilitating. Don’t ignore pain. Pain is your body’s way of protecting you from hurting yourself further. I always offer this advice to my clients: “ When in pain, find out why!” Find out from your doctor what is the cause of the medial knee pain is. Most often a torn medial meniscus or pes anserine bursitis are the cause of medial knee pain.
Once the cause is established, physical therapy and exercises are very effective in reducing medial knee pain. It is not unusual to experience mild stiffness and aching of the muscles that lasts up to a day after exercising. But hardly being able to move for a few days after exercising means you have overdone it.
Weak or fatigued muscles are the result of pain. These cannot adequately support, in this case, the knee joint or absorb shock before it gets to the knee and the extra stress placed upon the knee can cause further injury to the structures of the knee. Strengthening the muscles that support the knee with knee exercises is most important in increasing support and protecting your knees from further injury and medial knee pain. Strength must be built up gradually. Start with a few reps. I recommend starting with 5, increasing by 1 every other day till you are doing 10 contractions per session of a muscle group. This is one set. Usually 3 sets per session is what I recommend to be done 3 times daily. You need to increase the duration of your knee exercises gradually to avoid overuse injuries and knee pain. Be patient. You will see results.
Strengthening exercises shorten muscles so follow strength exercises with stretching exercises for maximum results. Flexible muscles are not as easily injured as tight muscles. Tightness of muscles connected to the knee can also pull the knee out of alignment. When doing stretching knee exercises, be careful to go slowly and not to overstretch. You do not want to tear a muscle. Stretching knee exercises can be done more often. You do need to hold the stretched position for 30 seconds to be completely effective.
It can happen that you have overdone your knee exercises. If this happens, “relative rest” is important for inflamed muscles/tendons. Applying ice wrapped in a cloth can help reduce inflammation and pain and speed up healing. Cut back on the strengthening reps and decrease the stretching program. Lightly exercising the sore muscle help decrease muscle soreness from overuse. However a significant increase in pain, calls for discontinuation of your exercises. Visiting your doctor is mandatory.
Main Muscle Groups Affecting Knee Stability:
Several muscle groups support the knee. The two main muscle groups that control knee movement and stability are the quadriceps and the hamstrings.
THE QUADRICEPS is a four-part powerful muscle that run along the front of the thigh and attach to the front of the shinbone, just below the knee. these are:
- the rectus femoris,
- the vastus intemedius,
- the vastus lateralis, and
- the vastus medialis.
The quadriceps control the straightening of the knees and movement of the kneecap (patella). the quadriceps is used to extend the leg, and is essential for standing up, walking upstairs and downstairs, walking uphill, and running.
THE HAMSTRINGS are muscles that run make up the back of the thigh, and attach to the back of the shinbone, just below the knee. The hanstrings comprise:
- the semi-tendinosis,
- the semi-membranosis, and
- the biceps femoris
The hamstrings are used to bend the knee and are also needed when you are pushing against something.
Imbalance of the quadriceps is common, especially in women – The quadriceps is divided into 4 divisions. If the inner division if weak, which is most often the case, the stronger outer division tends to pull the kneecap toward the outer side of the leg. Tightness of the quads can also pull the knee towards one side so stretching as well as strengthening of muscles that support the knee is important. Typically, the quadriceps should only be about 25% stronger than the hamstrings. There are cases however when the quadriceps is significantly stronger than the hamstrings. This can cause weakness of the knee. Here, concentrating on strengthening exercises for the hamstrings, and stretching exercises for the quadriceps is recommended.
Other Muscles Affecting Knee Stability:
Since the body functions as a unit and even muscles not near the knee can affect its function. Other muscles that affect knee stability, to a lesser degree than the quadriceps and hamstrings are:
- the calf muscles(the gastrocnemius),
- the hip abductors located on the outer thigh,
- the hip adductors located on the inner side of the thigh, beginning in the groin.
- the iliotibial tract (fibrous tissue on the outer thigh, extending front the hip to below the knee), and
- the glutes ( buttocks) inserts into back of the thigh bone and iliotibial band
When exercising the knee, consistency pays off. The plan is to keep your knees from recurring symptoms. Exercises must never be discontinued when managing medial knee pain.
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