Author: Dr Patrick Goh
Date: August 2011
As more adults approaching middle-age become ‘second wind’ exercisers who take up running or other land –based exercises for health, fitness or challenege, the knee is subject to a multitude of forces which may result in short-term or long-term problems. While many may have been former athletes in their teenage years, a long sedentary period may render them overweight, with poor musculoskeletal conditioning as they embark on their exercise programme. Some may have had previous trauma to the knee, or other parts of their body which may result in increased loads to the knee.
Gradually worsening anterior knee pain is the most common complaint in this group. The causes range from maltracking of the knee, to wear-and-tear issues involving joint cartilage, meniscus or tendons, and reactive inflammation within the knee. Combinations of these causes are common. A painful knee results in inhibition of the quadriceps which further compounds the problem. Treating it in a holistic manner would entail:
- Avoiding impact damage through modification of activities, or modifying running style
- Specific stretches to structures such as the ilio-tibial band, gluteus, piriformis, hamstrings, quads, and calf
- Specific strengthening exercises to the medial bundle of the quadriceps and the gluteus. Exercises related to functional balance and control of movements such as lunging.
- General measures such as dieting to lose weight if obese
- Anti-inflammation measures and pain control where needed
- Further biological stimulation of healing through measures such as platelet-rich plasma (PRP) injection
- Surgical measures such as arthroscopic debridement and micro drilling, and meniscus repair where needed
Early intervention, and even preventive measures are important in keeping the problem at bay, so that he or she can continue to reap the benefits of regular exercise.
