Supine heel slides with towel assist: 1. Lie on the floor with a small towel placed under one heel. — Photos: Dr SITARAMARAO NAGESWERARAV
What does a 40-year-old knee and Windows 95 have in common?
Weird start-up sounds and abrupt lagging.
Our knees are so unique and simple, yet so complex.
This major weight-bearing joint surely needs some loving attention, but instead, is often neglected.
But bear in mind what could happen if you just choose to ignore them:
Ailing knees may contribute to lower back pain.
A painful or stiff knee makes you limp, causing your pelvis to tilt to a certain abnormal degree.
This “misalignment” from altered gait can worsen your back pain.
You unconsciously overload the “good” knee to spare the bad one.
The healthy knee absorbs a portion of the extra impact with every step for years, causing it to wear down too.
Logically, these are two anatomically-identical bones bearing the same load through the same activities.
Pain makes you consciously apply less weight on the painful knee, but in reality, you end up overloading the healthy one.
You may not realise this, but a painful knee can contribute to weight gain.
Well, not immediately, but over time, due to lack of proper physical exertion (which does not only include exercise).
And here’s a fun fact for you: The knee joint itself has zero muscles of its own.
The knee only has other muscles that pass through it.
This means that you can never strengthen your knees.
You may, however, strengthen everything else that is desperately trying to keep your knees from collapsing, e.g. your quadriceps (front thigh muscles), hamstrings (back thigh muscles), gluteus medius (hip stabiliser muscles) and buttock muscles (glutes).
The good news is that a long-term clinical trial, involving 786 participants aged 45 years and above, found that a home-based exercise programme significantly reduced self-reported knee pain compared to no exercise at all over two years.
The three simple exercises shown here were selected specially for those of you who are suffering from a pre-existing osteoarthritic condition, as well as to help prevent such a condition from happening in healthy knees.
Personally, I like to use a knee-tooth analogy when explaining why our knees are important:
- Both do not show symptoms until a certain degree of damage is done, i.e. damage is slow, silent and cumulative.
- Pain often only shows up after the damage has been present for a long time.
- When the damage is severe, the interventions are more expensive.
- Both are with you for a lifetime (of course, the tooth leaves earlier) and you cannot grow a new one.
So start taking care of your knees today because they are like your parent-in-laws, you only have two of them and replacing them can be expensive.
Dr Sitaramarao Nageswerarav is a general practitioner (GP) and certified fitness trainer. This is the second of a three-part series, which will be published fortnightly. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Supine heel slides with towel assist: 1. Lie on the floor with a small towel placed under one heel. — Photos: Dr SITARAMARAO NAGESWERARAV
Supine heel slides with towel assist: 2. Slowly pull this heel towards your buttocks as far as is comfortable, then use the towel to gently pull it a little further and hold for five seconds. Slide your heel back out until your leg is straight again. Do 10-12 slow repetitions per leg. Beginner: Do three sets with two minutes’ rest in between. Intermediate: Do three sets with one minute’s rest in between. Advanced: Add a 0.5-1kg ankle weight, and do the same number of reps and sets. Why it works: Restores flexion range, ‘wakes up’ the hamstrings and reduces anterior (front) knee pressure.
Seated leg extensions with isometric hold: 1. Sit on a chair with your back straight.
Seated leg extensions with isometric hold: 2. Slowly straighten one leg until it’s parallel to the floor, then tense your quadriceps (as indicated here) as hard as you can for 8-10 seconds (as if pushing an invisible wall with your heel). Lower the leg slowly. Do 12-15 repetitions per leg. Beginner: Do three sets. Intermediate: Do five sets with one to two minutes’ rest in between.
Seated leg extensions with isometric hold: 3. Advanced: Add a resistance band tied to the chair for more load (as seen here). Why it’s great: Pure quadriceps strengthening with zero joint compression.
Standing mini-squats against the wall (Wall-sit): 1. Stand with your back against a wall with your feet 12-18 inches away from the wall.
Standing mini-squats against the wall (Wall-sit): 2. Slide down until your knees are at roughly 90°. Hold for 10-20 seconds, then return to your original position and rest for 30 seconds. Beginner: Do eight to 10 rounds. Intermediate: Do eight to 10 rounds, but hold for 30 seconds instead or reduce rest to 15 seconds. Advanced: Hold a 1-2 kg dumbbell during the exercise. Why it’s elite: Trains the quadriceps, glutes and core exactly in the mid-range where osteoarthritic knees most commonly lack strength.
