Runner’s Knee (Patellofemoral pain syndrome)

Runner’s knee is a dull aching pain around the front of the knee with typical symptoms like pain & rubbing, grinding or clicking sound of the knee cap.

Cartilage under the knee cap(patella) is a natural shock absorber. But when our knees are overused or injured, chondromalacia may develop ,which is damage to the cartilage under the knee cap.

Running is probably one of the best exercises to relief stress and anxiety, to reduce the risk of heart disease, diabetes and obesity; but Running is also labeled as a high-risk sport, as repeated pounding takes its toll on bones and particularly on joints such as the knee and makes it susceptible to injury. Nearly 30-50% of all runners get knee pain from running ever year which is a pretty high rate. But often it is not the “Running” which causes the pain, it’s “the way people run” causes the pain and injury.

Hence applying the correct biomechanics while running is of upmost importance. Also one has to be very clear and particular about the necessary homework to condition-strengthen the prime muscles involved in running and to prepare them to take the load of the joints while running. Some key points are listed below:

1.Avoid Heel striking

Each time runners do ground contact through “heel striking” mode, it causes impact forces to pass through the heel & up the leg, which places strain on the muscles and tendons. However , the force pattern changes dramatically with “ mid-foot strike”, because every impact immediately distributes forces throughout the foot, ankle & there is no slap-down action.

So avoid heel striking, let your legs swing rear wards and not forward. Always lean from ankle & let your stride open up behind you.

Let your feet land beneath you & not in front of you.

2.Lean forward while running

3. Run with your feet pointed in the direction you are headed

Avoid torquing your knee with every foot strike, rotate your entire leg inward towards the centerline (Medial Rotation), it will strengthen the adductors & will realign your legs. Foot splay can create inflammation to the Iliotibial band (IT band) which is attached to the Tibia at its lower end just below your knee; and this misalignment of leg could be mistaken for other knee problems.

Increase Medial Rotation of your legs over a number of weeks to give your legs time to adjust to their new direction of movement. Changing Biomechanics of your body takes time and persistence.

4.Work on the ‘form’ rather than relying on cushioned shoes

Fix your running form from inside out with correct techniques and biomechanics.Go for low profile neutral shoe and run with a shorter stride to reduce impact.Work towards a better and softer landing.

Reducing torque and impact are the two best places to work on your running form

5. Warm up and Cool down

A good warm up is extremely important before you give your muscles vigorous workout. It dilates the blood vessels & ensures a good supply of oxygen to the muscles. Also it raises muscle temperature for optimum flexibility and efficient performance.

Research shows that dynamic stretching is more beneficial than static stretching. You can start your warm up with 5-10 mins of brisk walking, jogging slowly, or even cycling on a stationary bike. Dynamic stretching like : jumping jacks, walking lunges, opposite toe touch are also very useful. Instead of starting out racing, you should start running slowly and gradually build up your speed, also you should breath easily.

For Cool Down phase, walk or slow jogging for 5-10 min once you end your running ensures that your BP and heart rate are not dropping suddenly, and prevents light headedness. Static Stretching is beneficial in cool down phase which includes : Hamstring and Quadriceps stretch, calf stretch, IT band stretch, back stretch, triceps stretch.

One should not rush and hold each static stretch for 15-30 secs, make sure stretching is not causing pain or don’t reach a point where it is causing pain, stretch both sides and don’t hold your breath.

Treating Runners Knee

While ice packs and NSAIDrugs will give relief for a short period of time, exercise regime and correcting biomechanics will cure one fully.

There is a vast variety of strengthening and stretching program to treat runners knee.

1. Quadriceps strengthening ( start with Isometric- progression with resistance)

2. Gluteal strengthening (start with isometrics- progression with resistance)

3. Stretching of tight Hamstring and Iliotibial band.

4. Calf stretch.

5. Plyometrics

6. Advanced balancing program

Whenever your knee is injured or biomechanics is poor, VMO (vestus medialis oblique) is the most common component of Quadriceps to lose its strength.

So a specific strengthening exercises program for VMO to make it strong is very essential to both prevent injury in the first place & as part of the Rehabilitation program.

7. Regular foam rolling

Foam rolling directly on the IT band will help to increase the elasticity of the fascia & return knee back to its original positioning.

8. Running with knee support is a great option as it provides compression and support to the joint and helps the runners run without feeling pain.

Taking a good care of the knees should be a high priority especially if you want to enjoy running year after year.

Tension Headache/ Cervicogenic Headache associated with neck pain- Get relief through postural correction exercises

Did you know that 20-25% of chronic and recurrent headaches are diagnosed as Cervical Headaches and are related to Bad/Faulty posture and musculoskeletal impairments.

Bad posture or postural dysfunction is when our spine is situated in an unnatural position for extended period of time due to repetitive daily activities of life. Sitting at desk all day long, looking at your computer or smartphone, while slouching in a chair, hunching the back,poor core stability , tend to develop a Poor Posture for many people. Often there is associated tension in the posterior cervical muscles leading to cervicogenic headache associated with neck pain and stiffness.

We need to activate the weak and stretch the tight muscles.

Forward Head Posture

The most commonly adapted bad posture is Forward Head Posture which is characterized by -Slouching shoulders and -Rounded upper back.

We need to activate our muscles in the posterior chain and Stretch and relax the anterior chain muscles. Some of the most effective exercises to improve this posture are listed below-

1.Chin tuck exercise

This one is an Exercise to reduce tension headache, neck pain and stiffness, helps improving postural alignment and neck flexibility.

This can be done in sitting, standing against a wall or in supine lying. Look straight ahead, place a finger on the chin, now without moving the finger pull the Chin and head straight back until a good stretch is felt at the base of head and top the the neck. Hold it for for 10 seconds and repeat it for 10-15 times.

2.Reverse Plank Bridge

Keep your arms straight, pull your shoulder back and bring your shoulder blades together while tucking your chin. Push your chest up as much as possible and extend your spine.

This exercise activate your muscles like- Mid Trapezius, Rhomboids, Erector spinae and neck flexors; which become weak due to prolonged Forward Head Posture. Also it stretches your Pectorals, Long head of Biceps, Front Deltoid and neck Extensors- all of which become tight and shorten due to faulty posture and make the neck, shoulder and upper back slouching and rounded.

3. Scapular Retraction

This is another excellent exercise to improve your posture, prevent slouching shoulder, provides excellent stretch over the anterior chain, activate muscles like Rhomboids, Trapezius etc.

4. Plank

Plank is probably the simplest form of exercise to improve overall posture and to build core strength, if done correctly. While doing this, make sure that your legs are straight, don’t allow your lower back to sink, and look down at the floor.

Text Neck

This exercise is simply to stop looking down at your phone, instead bring your phone to you at eye level.

So yes, bad posture and it’s associated problems can be prevented, if you start early. You must be disciplined and train your body to achieve good posture. Simple things to do –

1. To have the awareness of what the bad posture actually is.

2. What exercises help improve your posture

3. Identify the daily activities that worsen the bad posture and do it with a better posture.

Five super- simple Exercises to avoid Work From Home Burnout

While this Pandemic is taking a troll globally with people’s health and economic, we all can do our bit to keep ourselves sane and healthy through this tough time the world has never seen before.

No, I am not gonna use some bombarding fitness terminology here which will for sure thrill you and make a rush of adrenaline into your system; but most of you will end up adapting nothing. Instead I am gonna pin point on only five simple exercise which will cover up almost everything right from your cardiovascular system, to the musculoskeletal system along with improving your metabolic function.

1. Deep Breathing Exercise

Breathing exercise not just strengthen the lungs,increases total lung capacity, helps fight foreign particles affecting the respiratory tract but consciously practiced breathing for few minutes also improves concentration and helps you focus throughout the day. Practicing deep breathing exercises for couple of minutes is a great way to start your day.

Diaphragmatic breathing is a great example of deep breathing exercise where you place one hand on your tummy and other hand on your chest and feel the diaphragm’s upward and downward movement while inhaling and exhaling.

2. Exercise your Eyes

Eye strain associated with dry eyes, blurred vision, headaches are the common complaints people have from working on computers for long hours. Some pretty simple daily eye muscle workout works best to deal with such problems.

Palming exercise,focus change using a pen, near and far focus, making a figure of 8 with eyes, or simple upward-downward-sideways movements and squeezing the eye muscles for couple of seconds;- all these are simple yet effective ways of taking care of your eyes.

Also washing your eyes with running water in between the days work helps a lot in soothing and refreshing the gaze.

3.Stretching and Strengthening the Neck muscles

Sitting in front of computer for long hours put a lot of strain on neck muscles resulting in pain and discomfort. While a good knowledge on ergonomics and good posture takes care of the strain and pain, here are some basic stretching and strengthening exercises which will further relieve any discomfort associated with neck regions

• Simple neck movement- upwards, downwards, sideways and rotation

• neck isometric exercises to strengthen the muscles

• Gentle yet effective stretching, hold each for 15-20 secs

4. Back Exercise

Back extension exercise is considered as the best one amongst many other back exercises, to get a quick relief on pain and discomfort ( Contraindicated for person who recently underwent spinal surgery)

Here are two simple back extension exercises which can be done easily.

• Lying down on your stomach and raising your neck and chest as much as possible and holding it for 10-15 seconds

• Another great back exercise is the Cat and Camel exercise which give a great relief on back pain and discomfort by gently mobilizing the spine downward and upward

5. Gripping exercise using sponge ball

Repeated wrist and finger movements while typing causes various musculoskeletal injuries including tendinitis. Before it gets worse, it’s better use a gel or a sponge ball and do gripping exercise in between the meetings and calls. It strengthens and stretches the hand and wrist muscles as well as the lumbricals.

One can Simply make a strong fist without a ball and stretch out fingers simultaneously.

Work-From-Home Ergonomics

Since many major companies seeWork From Home’ as a viable long term plan, there is a need to understand the commonly practiced bad postures at home while working on computers, which can lead to muscle spasm or stiffness and back and neck pain in a long run with many associated health issues.

Ergonomics

Proper Ergonomic design is necessary to prevent Repeatitive Strain Injury which can develop overtime & can lead to long term disability associated with many musculoskeletal disorder or headache due to eye strain or of cervicogenic origin.

Ergonomic is nothing but applying correct biomechanical strategy in day to day activities.

Start with the desk

Slouching on the couch or bed while working on a laptop should be a big no no.

While using a real desk makes it easier to build friendly work from home environment but also dinning table, foldable tables or anything which doesn’t compromise your posture is a good alternative.

Using a small cushion to support your lumber curve while sitting is quite beneficial.Adjust backrest angle to comfort(90-110 degrees).

Seat height adjustment

Adjust chair height so that elbow is level with desk height( 90 degree angle at the elbow), wrist is in a neutral posture, shoulder and arms are relaxed and close to the body.

Even a simple chair’s height can be adjusted using cushion or pillow since height adjustable chair’s availability could be a challenge at home.

Avoid elevated or hunched shoulder. Avoid forward/backward/upward reaching.

A footrest is often very useful in prolonged sitting.

Laptop Use

Risk results from inability to adjust screen, keyboard & mouse separately.

Using an external mouse and keyboard along with a laptop stand to raise the height appropriately is highly recommended.

Keyboard &Mouse placement

Move your chair close to the work surface to minimize forward bending. Consider shorter keyboard to keep the right hand close to the body.

Use of a low profile regular mouse can minimize upward bending of the wrist. Person with pre existing wrist injuries or pain may find a Vertical Mouse useful to minimize discomfort.

Monitor Placement

Monitor should be approximately an arms length away, top of the screen should be just below the eye-line.

Avoid positions causing awkward neck posture and neck stiffness or pain. Consider dedicated computer glasses.

Glare control

Avoid placing monitor in front of windows or facing window. Consider anti-glare filters, adjust brightness & contrast setting for comfort.

20-20-20 rule

Every 20 minutes, look at something 20 feet away for 20 minutes.

Neither sitting nor standing, it’s the movement that helps maintaining and improving the health”

Vary tasks to enable changes between sitting and standing.

Calls can be attended while walking around the room.

Stretch in between the tasks.

Remember that when your are healthy, mentally and physically, for a long term period you’re gonna be an even better and efficient employee for the company.

Stretching and Strengthening goes hand in hand in maintaining and improving the musculoskeletal system. Every day a quick half an hour of simple workout session to start your day is the best practice in today’s world. While 5 minutes of simple breathing exercise is a great way to strengthen you lungs as well as for improving concentration.