Your knees are supported by a variety of bones, cartilage and ligaments. They are the anatomical pulleys connecting your thighs (quadriceps) and shins (tibia).
Talk to your doctor to rule out knee pathology. Chondromalacia is a progressive fissuring or softening of the patellar cartilage. Osgood-Schlatters disease is common in young teenage males where the bones grow faster than the muscles and there is irritation of the connection between the patella and the tibial tubercle.
Tendinitis and bursitis are uncommon in the quadriceps, but may occur in the musculotendinous junction high on the hip of the hamstrings. The iliotibial band which stretches from the top of your hip to your knee may become irritated because of running on the same side of the road with an uneven cant. Try running on the other side of the road to even out your gait. Improved footwear and shoe inserts (orthotics) may help. Patellar tendinitis is caused by running down hill and jumping.
Within your knee joint is cartilage which protects the ends of the thigh bone (femur) and tibia. When you step down, you squish fluid out of cartilage. When you relax, fluid rushes back in. As you age, your cartilage does not absorb as much water. It dries out. Your Aquajogger allows you to move your leg repeatedly in a circular range of motion promoting circulation and muscular endurance.
Ligaments save your joint when you slip sideways off a curb. But if the outside (lateral) portion of your knee was hit hard, you may have "blown out" your lateral and medial collateral ligaments, and your anterior cruciate ligament.
Women sometimes have more trouble with their knees because of wide hips. The "Q" angle between their hips and knees is larger. A normal Q angle is 10 degrees. If the Q angle exceeds 10 degrees the knee cap (patella) becomes unstable. That is probably why you rarely see women with wide hips running marathons in the Olympics. Intense mileage for such events have selectively eliminated them from competition.
If your doctor performs surgery, you may find yourself in a cast or splint. Soon after your operation, you will be required to practice quad-setting which is simply flexing your quadriceps for several seconds. This is an isometric contraction used to prevent atrophy of the muscles surrounding your knees. In addition, you will increase the range of motion (ROM) of your knees with stretching. Stretch all of the muscles in your legs from the ground up. Stationary cycling can help maintain your cardiovascular endurance while you increase the circulation in your legs. After your knees are rehabilitated, prepare yourself to begin a lifetime of strengthening and stretching exercises. Perform single leg open kinetic chain movements. Open chain activities allow you to isolate specific muscle groups without having to balance or stabilize them. To strengthen your quadriceps, sit on the edge of a table with your knees bent at 90 degrees. Hold a bucket on the top of your foot. Raise the bucket by extending your leg 180 degrees. Hold your leg straight for two seconds. Slowly lower your leg to it's original position for a count of 4 seconds. Add a few cups of water to the bucket each week until you can do ten repetitions with a bucket of water. Perform this exercise three times per week with both legs.
If you can get to a gym work your hamstrings using leg curls. Your quadriceps are generally stronger than your hamstrings. Leg curls may help prevent further muscle imbalance. Perform leg extensions (the bucket exercise) for your quadriceps with a limited ROM (terminal knee extensions) depending on your doctor's prescription. Then work the muscles on the inside of your thighs (adductors), and the muscles on the outside of your thighs (abductors) using a seated ad-abductor machine.
When your legs become stronger, begin double-leg closed kinetic chain exercises. These simulate movements in the real world. Start by sitting against a wall with your knees bent at 90 degrees. Slide up and down the wall strengthening your quadriceps and hamstrings. When you can comfortably perform ten repetitions of wall slides, step away from the wall and perform quarter and half squats. Be sure your knees do not extend over your toes. Execute half lunges and diagonal lunges to increase your balance. When your legs are strong enough, try one-legged half squats to prepare to return to competition.
After your balance improves, challenge your neuromuscular system. The simple act of walking may be demanding. Between steps their is a momentary loss of balance. When walking becomes effortless, try standing on one leg like a stork. After you have mastered the stork pose, close your eyes and keep your balance on one leg for 30 seconds. Soon you may begin jogging, running, hopping, and jumping. When all of this is easy, experiment with agility drills. Running back, Walter Payton missed very few games in his football career. He owes part of his outstanding durability to off-season training. Payton spent summers running in sand. Sand running improves balance, stability, and agility. Your knees are amazing joints. You stand on them all day long. But they are very much exposed. Knee joints are shallow, one bone does not fit tightly into another. Consider them similar to hinges.
But when you bend your knees to ninety degrees, unlike a hinge, they can rotate too, making them even more complicated. Let's briefly review anatomy before we address your knee pain.
The lateral collateral ligaments are on the outsides of your knees. Each connects your thigh bone (femur), to the small bone in your lower leg called your fibula.
On the inside of your knees you have your medial collateral ligaments. Each ligament links your femur to the large bone in your lower leg called your tibia.
Behind your knee cap (patella), two ligaments cross. The one typically injured is your anterior cruciate ligament (ACL). It connects your femur to your tibia. Your posterior cruciate ligament (PCL) unites these same bones.
Ligaments attach one bone to another. They help to stabilize your knees. Consider them tent ropes. If one is slack it weakens the integrity of your entire knee joint. Your doctor may test for stability in each ligament by using manual manipulation.
Tendons join your muscles to your bones. They are strong, fibrous material. Tendons must be strengthened along with their muscular attachments, or they may weaken your power chain. The tendons that bind your thigh muscles (quadriceps) to your knee joints are appropriately termed your quadriceps tendons. Just below each knee, your patellar tendon joins your knee to your tibia.
A tough, long tendon that extends down the side of your leg from your hip past your knee joint is your illiotibial band. You have several sets of muscles that surround your knees. Your thigh muscles (quadriceps) are powerful and are located above and in front of your knees. The purpose of each quadriceps muscle is to extend your knee downward on your pedal stroke. Your hamstrings are also very strong. They are located on the back of your upper legs. Your hamstrings flex your knees so you can pull-up on your pedals. Knee flexion enables you to spin tiny little circles in smooth, rhythmic revolutions.
Cartilage is the cushion between your bones. You have two semi-lunar cartilage (meniscus) in each knee that act as shock absorbers. These menisci are filled with synovial fluid. There is also articular cartilaginous material that protects the ends of your femur.
