LB – INJURIES & CONDITIONS – KNEE


INJURIES to the KNEE



ITBS – ILIOTIBIAL BAND SYNDROME

  • Iliotibial Band Syndrome – IBS . Physiopedia
  • ITBS – Explained .
  • Kaitlyn – Physio .
    ITBS: overuse injury due to increased friction between the IT band and the lateral femoral condyle 
    The “Impingement Zone”:  when the knee is flexed/bent at around 130º (often in heel strike for runners) the IT band is tensioned at this point due to eccentric contraction of glute max and tensor fascia latae (TFL) which decelerates/slows down the leg⠀⠀⠀⠀⠀⠀
    Most Common Causes – Glute Medius: weakness in the hip abductors causing increased hip internal rotation and increased knee adduction or valgus
    Most Common Causes – TFL: will try to overcompensate for glute med weakness; therefore, since TFL turns into the IT band, individuals will have increased tension through the band, causing more friction at the knee
  • ITB Syndrome – Don’t Roll directly on the ITB – Harden – Chiro
    –  I’m not a fan of the added pressure of foam rolling directly on the IT Band
    (1) ITBS, or IT Band Syndrome, is caused by COMPRESSION of a fat pad underneath the band at the knee
    – Usually due to lack of hip and knee strength and stability coupled with high training volumes and under-recovery
    (2) Rolling DOES NOT release fascia, realign anything, or break down scar tissue
    – It works by modifying inputs and outputs in the brain to reduce pain sensations or relieve feelings of tightness.
    – So you’re not releasing the band and since we are working on a neurological level, we don’t have to be ultra specific with where we roll.
    – So if rolling everything around the band gives us the same mechanism, why go add that compressive force?
    (3) Now, everything has context, and some will say that rolling on the band is 100x better.
    – Maybe it is for them, and if you absolutely want to roll on the band, I can’t stop you so I’ll just provide some guidelines:
    – Stay on the top 3/4 of the thigh and avoid the area by the knee. That goes for rolling the groove between the band and quad too.
    – Remember WHY we roll. It’s simply a quick way to feel looser or temporarily block a little pain.
    – You’re not breaking things down so quit trying to beat your body into submission.
    – And make sure you modify training load and do strength and stability work like I’ve shown you before to get to the root of the problem.

PT – PATELLAR TENDINOPATHY (JUMPER’S KNEE)

  • Patellar Tendinitis . Mayo Clinic
  • Patellar Tendinopathy Explained .
  • Patellar Tendinopathy DiagnosisPhysiotutors
  • Kaitlyn Physio  .
    Patellar Tendinopathy:  is a common source of pain in the front of the knee, just below the patella (knee cap)

    Sports: most commonly seen in relatively young athletes who participate in sports with repetitive loading of the knee extensor muscles (quadriceps)⠀⠀⠀
    Rehabilitation: short period of unloading the tendon (avoid of activities that are aggravating it), followed by progressive re-loading to build the strength back up
    Patellar Tendinopathy – 1 . 

    1️⃣ 2-leg squat – heels elevated: 3 x 12-15 reps (4 sec down, 2 up)
    2️⃣ 1-leg isometric pistol squat – heel elevated: isometric hold in bottom position; 3 x tolerance
    3️⃣ 1-leg pistol squat (eccentric only): 2-legs to return to top of movement; 3 x 8-12 reps
    4️⃣ Banded TKE pistol squat: 1-leg stand on step box; box leg has band attached to post for TKE; 3 x 12-15
    5️⃣ 1-leg pistol squat – heel elevated: eccentric and concentric; 3 x 8-12 reps
    6️⃣ Forward step box resisted split squat: (@strengthcoachtherapy); band around waist anchored to post in front of body; 3 x 12-15 each sidePatellar Tendinopathy – 2
    1️⃣ Box Squat: to load within a smaller range of motion (decreased depth); touch and go; 3 sets of 8-12.
    2️⃣ Box Squat/Band Squat: to load within a smaller range of motion (decreased depth); touch and go; 3 sets of 8-12.
    3️⃣ Bulgarian Split Squat – BB on back:  unilateral = increased demand on the tendon. 3 sets of 6-10 each side
    4️⃣ Bulgarian Split Squat – BB front: the front rack position puts more demand on your anterior chain (ie. quads, knee)
    5️⃣ Bulgarian Split Squat – Isometric + ball throw/catch: 3 sets of ~20 throws/catches while maintaining depth in this positionPatellar Tendinopathy – 3 .
    1️⃣ Sled Push: heavier weight slow and controlled or lighter weight with more speed and explosiveness
    2️⃣ Sled Pull: slow and controlled sitting close to 90 degrees so that quads/patellar tendon are working in a lengthened position
    3️⃣ Box Jumps/Plyos + Sprint (slow and controlled): here the focus is on proper mechanics and controlling acceleration and deceleration
    4️⃣ Box Jumps/Plyos + Sprint (explosive): this is usually very sport specific and has increased load on the quads and patellar tendon.

PFPS – PATELLOFEMORAL PAIN SYNDROME (RUNNER’S KNEE)


Kaitlyn Physio:
SOME of the main causes for this injury include:
➡️ Muscular imbalances; typically weakness in the hip abductor muscles (glute med) and/or inside quad muscle (VMO)
➡️ Tightness in the IT band/muscles connecting into the ITB
➡️ Patellar orientation and alignment (ie. valgus or knee falling inward)
➡️ Inability for the foot to function properly when moving to and from a flattened and arched position.

PFPS – 1 . Kaitlyn Physio
1️⃣ Banded Split Squat: band on outer aspect of outside knee, prevent the knee from caving inward by pushing into the band.
2️⃣ Banded Pistol Squat or Lateral Step Down: same concept as above.
3️⃣ Banded Bulgarian Split Squat: this exercise on its own is excellent at promoting glute activation; however the band will increase that even more.
4️⃣ Side Steps with Band: keep slight bend in hips and knees. Prevent knees from caving inward and try to ensure toes stay facing forward.

PFPS – 2 . Kaitlyn Physio
1️⃣ Skater Squat: maintain all weight on stance leg. Find stability in ankle, knee, and hip on that side as you bend the knee.
2️⃣ Single Leg Hip Abduction: as the one leg is moving further from the body, you activate the stabilizers on the opposite side in order to maintain good alignment
3️⃣ Reverse BOSU Step Back w/ Ball Catch/Throw: working the leg that maintains contact with the bosu. Ensure that the knee is stable throughout.
4️⃣ Banded Hockey Strides: weight distribution should maintain on the stance side. The other leg is tapping back at about 45 degrees. The focus here is on the stance side; however, you may also feel it on the side that is performing the movement

PFPS – 3 . Kaitlyn Physio
1️⃣ TRX Pistol Squat: can do the same exercise off of a box as well if you do not have a TRX
2️⃣ Reverse Lunge to Knee Drive: an exaggeration of the movement that occurs during running (loading and then stabilizing in single leg stance)
3️⃣ Walking Lunges: focusing on stabilization in a single leg stance position as you go from one lunge to the next.


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