Knee injuries, posture at work, FREE Gaitscan, and a great lecture

Knee Research update – May 2012

• In the presence of Patellofemoral Pain (PFP), the femur internally rotates against the patella
• Excessive hip adduction and knee internal rotation are associated with ITB syndrome
• Hip strengthening in addition to knee exercises results in greater reductions in pain in PFPS

Competitive Female Athletes With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Ferber et. al. J Orthop & Sports Phys Ther 40(2)2010

The running biomechanics of thirty-five female runners with a history of ITB syndrome were recorded and compared to thirty-five aged-matched and running-distance matched healthy female runners. Kinematic data was recorded during the stance phase of running gait.

Results indicated those with a history of ITB syndrome demonstrated significantly greater peak knee internal rotation angles and peak hip adduction angles compared to age matched controls.

West London Physiotherapy : “There is a significant relationship between ITB syndrome (runners knee) and the poor biomechanics of the hip and knee”

Short-Terms Effects of Hip Abductors and Lateral Rotators Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Controlled Clinical Trial

T.Y. Fuluda et. al. J Orthop & Sports Phys Ther 40(11)2010

Randomised controlled trial: 70  females with PFPS were randomly assigned to one of three groups; knee exercise group receiving conservative management targeting the knee musculature, knee and hip exercise group who as well as completing the exercises in the knee exercise group, also completed hip abduction and hip extension exercises, and lastly the control group who did not receive any treatment.

Both the knee exercise and knee and hip exercise group demonstrated significant improvements in pain and function. Though strengthening hip abductors and hip lateral rotators in additional to the strengthening of the knee musculature resulted in greater reductions in pain and improvements in function in comparison to knee exercise alone.

West London Physiotherapy : ”Hip and pelvic musculature strengthening has an important role in the treatment of patellofemoral pain.”

Femur Rotation and Patellofemoral Joint Kinematics: A Weight-Bearing Magnetic Resonance Imaging Analysis

C.E. Draper et. al. J Orthop & Sports Phys Ther 40(5)2010

This study compared movement of the patella and the femur during a closed chain activity between individuals with patellofemoral pain  (PFP) and those who were asymptomatic.

A dynamic magnetic resonance imaging system recorded femur and patella rotation, lateral patella tilt, lateral patella displacement at 45, 30knee flexion whilst performing a single leg squat.

Results reported significantly greatly lateral patella tilt and lateral patella displacement in those with PFP. Furthermore, measured femoral internal rotation in symptomatic participants was more than double of that measured in those who were asymptomatic.

West London Physiotherapy – “Emphasis on control of the Femur is important in the treatment of patellofemoral pain.”

At West London Physiotherapy in Kensington, W8, London, we are leaders in the treatment of knee pain and injury

Of all serious knee injuries that occur while skiing, around 25% involve the Anterior Cruciate Ligament (ACL). The ACL is the major stabilising ligament of the knee. In skiing, the ACL may be damaged when we fall awkwardly and bindings do not release, or when we catch the edge of the ski, and twist the leg suddenly.

For most active people, surgical repair of the ACL will be recommended. This is followed by 6-8 months of rehabilitation with a specialist physiotherapist. As you can see, Cruciate Ligament rupture is a major injury with a very long recovery period. That is why at West London Physiotherapy we strongly recommend you “Get Fit To Ski” in the 6 weeks leading up to your ski trip. Prevention is always better than Cure! See our website, and previous news article for information on Get Fit To Ski!

Reduce the Risk

Good strength, endurance and balance can reduce the risk of bad falls, and ACL injury.

Check your bindings are set correctly to ensure they release if you fall.

If you are tired, rest! Skiing on tired legs increases your risk of falls and mistakes.

Stay well hydrated by drinking plenty of water.

Be careful with alcohol at lunch time!

Get Fit to Ski…!

From December and during the ski season, West London Physio is providing a comprehensive Ski Injuries Assessment and ‘Get Fit To Ski’ program.

To reduce your risk of injury, and avoid painful thighs throughout your ski trip, we recommend you book an assessment 4-6 weeks before you ski. We will assess the important ski muscles for strength and flexibility, and assess your balance and core strength. We will then devise a specific program for you that will make an amazing difference to your ski experience.

Three key areas for ski injury prevention.

1. Aerobic fitness.

Fatigue leads to a reduced skill level and a gradual loss of control as the day wears on.

To improve endurance, train for 30 minutes 3 times per week. Jogging and cycling are good forms of aerobic exercise. Incorporating the cross-trainer or stepper will help replicate the ski motion.

2. Core stability and balance.

This is crucial to ensure you have the strength and balance to maintain alignment of your legs, hips and lower back. Good core strength helps to both prevent low back injury, and (as an added bonus) improve control of your skis, potentially making you ski better!

Core stability work you can do at home may include single leg balance with eyes closed, single leg mini squats, or balancing and squatting on the Bosu at the gym.

3. Leg strength.

If you don’t have good leg strength, you won’t control your skis properly. Close attention must be paid to the strength of the quadriceps, gluteals and calf. These exercises should mimic skiing as much as possible.

Can uncomfortable boots be a thing of the past?

The fit and shape of your ski boot can make a huge difference to the alignment of your knees and hips. The right support will also keep your feet supported and comfortable on the slopes.

At West London Physio we can now digitally scan your feet in the ski position, and prescribe custom orthotics specifically designed for your ski boot.

20% off custom ski orthotics in December and January.

If you mention this article when you book a ski foot scan in Dec or Jan, we will give you 20% off the cost of our custom made ski orthotics – usual price £260.