Knee stabilising muscle exercises

[badbadger]

Hi,

I have been suffering for several years with inside knee pain. It didn't bother me too much as I had given up sport at the time, and it didn't affect my daily life much at all. However, I got the rugby bug again a couple of years ago and have been playing again but need two knee supports and pain killers to play, so thought I would ask some advice!

The problem only occurs if I try to run faster than about 85% full pace. I had suffered torn cartilage in the knee before (which I had surgery for, before injuring again!), and the pain feels very similar - a sharp pain on the inside knee which goes away after 20-30 seconds.

I had assumed the current injury was cartilage problems again. However, I have recently done a course of physio on the NHS and the lady seemed to think it was a stretched ACL that wasn't supporting my knee properly when I put pressure on it (to sprint etc). She gave me the rubber bands and a few exercises to do to help start strengthening the muscles around the knee, but I have worn out two sets of bands, and have sort of stalled my progress so I was hoping someone might be able to suggest some other exercises.

I have read of rugby players who have more or less had too much surgery and stuff on busted ligaments and have resorted to building up the muscles to support the knees. Is this possible? What sort of exercises are recommended? And to avoid?

Any help would be much appreciated.

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[Hallamshire Physiotherapy]

Hi

If you only experience pain running over 85% intensity I suspect your ACL is managing to stabilise your medial knee and you need to have your running assessed (many physios fail to assess running for lack of space/time/sense).
Concentrate on changing how you run and don’t focus only on your knee. How do you control your hip/back ? Can you correctly weight bear through the knee or are you still compensating for the pervious injury (this is very common and people often guard the knee and never really use the leg properly after an injury/surgery). Leave the knee and consider other options and see how you progress.

Steve
Hallamshire Physiotherapy

[junior_physiotherapist]

Yes, I agree with the post above,specific clinical tests are there for knee ,then proper diagnosis work out plan of treatment,,,,

to treat holistically not localistically is an important item!!


Let us know yours results of assessment and treatment.

[Canuck Physio]

Yes sir, musculature can be utilized effectively to allow one to compete in any activity. During any sport it is the musculature that effectively works together with the ligaments to provide support to joints. When ligaments are damaged, a rehabilitative protocol is usually implemented to provide extra stability (For example in Gr 1 or 2 PCL injuries treated non-operatively, the goal is to increase anterior translation of tibia on femur), and this is done through a focussed rehabilitative program.

Here are further insights from:Lower extremity muscle activation during horizontal and uphill running

Mark A. Sloniger, Kirk J. Cureton, Barry M. Prior, and Ellen M. Evans

We have shown that during exhaustive horizontal running, the muscles with the highest percentage of their volume activated were the adductor group (90%), hamstrings [semitendinosus (86%), biceps femoris (76%), semimembranosus (75%)], gracilis (76%), rectus femoris (74%), gluteal group (72%), and gastrocnemius (68%)

Our findings supplement those from EMG studies by indicating that muscles involved in hip stabilization and adduction (adductors and gracilis), hip extension (gluteal and hamstrings), knee and hip flexion-extension (hamstrings, rectus femoris, and gastrocnemius), and plantar flexion (gastrocnemius) were the most intensely used during horizontal running.

THere are various muscles that help to provide stability at the knee joint. The ideal alignment of the lower limb musculature is straight forward. Most often an imbalance, is detected during higher intensity activity that weans out these imbalances.

If this is not the issue, it is at least something worth pondering over. As below, a gait assessment, and attempting to understand if indeed, post activity muscle is involved in causing the problems around the knee. (Perhaps get an assessment immediately post activity).

Regards