T Nation

Suggestions For Knee Health


#1

I was standing on one foot, twisted, and tore my MCL (the tendon on the inside part of the leg). At least from the charts i looked at online, its the MCL. I'm not sure how bad i tore it. When i did, it just kinda hurt, and then has been feeling weird ever since. this was about 5 months ago. It does not feel weak or anything, just uncomfortable by the MCL region if left in one possition.

Anyways, most of you will say see a doctor, but that is just not an option for me right now as i am leaving the country soon.

But, this brings me to this question:
What is good for over all knee health?
supplements? exercises? not running down hill?

anyone have any good suggestions?

yours truely,
T-Nation noob


#2

You may want to try a good glucosamine/chondritin supplement. Won't do much for the MCL, but when knee ligaments get hurt, the alingment can get thrown off caussing abnormal wear on the cartlidge (meniscus). GC/C can help cartlidge. I would not do any knee movements until there is no pain. Just rest for awhile. If you keep pushing it, you are likley to make it worse.


#3

if only it were that easy! to not be physically active with your knee


#4

Of course, yes, the best thing is to see a doctor. You need someone who knows how to do all those laxity tests, and maybe an MRI. Testing for knee stability would just take one office visit. If you have even an afternoon available, it might be worth doing. Have you been able to do a valgus stress test on your knee and figure something out from that?

The reason those diagnostic test are important is to tell you whether or not you do have ligament damage or cartilage tears and to what degree. The MCL has several different attachment points that you could have injured. Generally, anything less than a full tear is not usually reconstructed, as the MCL has better blood supply than the other cruciate ligament (ACL, PCL, LCL) and can heal better.

Another issue that could be mistaken for MCL pain is Pes Anserinus Bursitis. The Pes Anserinus is right in the same area of the MCL, almost right on top of the distal insertion of the MCL I believe. It is the spot where the tendons from several hamstring and groin muscles insert. Bursitis or tendonitis in this area is very painful and easily mistaken for MCL or meniscus pain. It also responds much like your pain does, where it is painful after long period of time in a flexed position (when the hamstring has tightened and is then asked to stretch out upon standing).

I had this exact thing happen to me. Post-knee surgery, i was having a lot of pain in that area and was convinced that I had MCL or meniscus damage. So much so that I requested an MRI from my doctor about a year after my surgery. It came back clean, and the pain eventually went away, after my hamstring and groin muscles regained some of their pre-surgery strength and flexibility.

Some general things to do muscularly are to rehab the muscles in the area, like the VMO (inside tear-drop muscle of the quad, most important muscle for medial stability), and the medial hamstring and groin muscles. Also concentrate on flexibility of the hamstring and groin muscles.

Some regular ice cup treatment to the inside of the knee post-workout may help alleviate any tendonitis/bursitis causes as well.

As far as supplements, any anti-inflammatories are probably good. There are the normal NSAIDs, or you could get into some of the more enzyme supplements for reducing inflammation.

Glucosamine and Chondroitin, as mentioned in another post, is a good one to, to help if there is any cartilage damage.

I never found any supplements directly recommended to help ligament recover. i think the best think to enhance that is to just have good nutrition and make sure that the area is getting good, regular blood supply through regular workouts/rehab.

Hope this helps.


#5

Oh, another general point about rehabing/working out your knee. try to stay away from athletic, explosive, or pounding type of movements until your knee feels better.

Keep movements slow and controlled. I saw this because you mentioned running downhill. I would not try to any kind of running until you've been able to do some directed rehab at those muscle areas mentioned in my last post. Strengthen your knee with lots of controlled movements first. Stay on low impact excercises, like biking, elliptical machine, or swimming, until your knee is feeling better.

And of course if your knee still feels weird after all that, then definitely see a doctor before you get back in to running or athletic activities.


#6

thank's a lot for the replies

i have been experimenting with some controlled workouts, like hindue squats. My knee feels OK after something like that.

Also, i'm wearing a knee brace.

But as far as overall knee health and ligament strength (and other joints as well) goes (apart from my injury) what are some good exercises to do? Low volume high rep? or high volume low rep? etc.


#7

If you have a mini or average stretch band TKE's will go a long way towards knee health.


#8

Whether you do low volume/high weights, or high volume/low weghts totally depends on what goals your going for.

For athletic, explosive strength, I personally tend to go for low volume/high weights. I find this keeps my strength high and my explosive strength high, but doesn't pack on too much mass. I play soccer, basketball, and compete in track meets. I'm 5'10", 175, and I've found that if I get up higher than 180, my short-term explosive strength might improve a bit (like for a 100M dash), but my sprint endurance goes down a bit (like for a 400M, or a soccer match), just because I don't have the time to run the necessary interval workout to keep my sprint endurance up at a higher body weight.

So I've found that higher weight/lower reps gives me the optimum benefits with out adding too much mass on me.

If you're going for mass, then you definitely have to mix in some cycles of high volume work to get that hypertrophy in the muscles.

As far as excercises, squats (preferrably all full squats) and deadlifts are the main ones. Of course there are tons of variations on both of these to hit different aspects, but they are the main ones. Generally, squats are quad-dominant and deadlifts are hip dominant. You need both quad and hip aspects in your workouts.
Variation Examples:
-Back Squats with narrow or wide stances
-Single leg squats
-Single leg squats with leg back on a bench (Bulgarian split-squats I think?)
-Front squats
-Overhead squats
-Regular DL's
-Romanian DL's
-Sumo Dl's
-Straight leg DL's
-Single leg DL's
-High step-ups
-Good mornings

For knee health, I find that single leg variations help keep your legs balanced and prevent you from favoring one side over the other, expecially if you've injured one side. Single legs activities help your abductor/adductor musculature stay balanced.

TKE's, as mentioned, are good ones, especially for the VMO, which is crucial to medial stability. Another key I've found to make sure you hit the VMO, is to do full ranges, like you do in full squats and hindu squats. For some reason, it seems that work in that full flexion range of the knee hits the VMO harder than most other ranges.

Another good one for quads is wall sits. Do about six different stops, holding each one about 10 secs, on your way up and down, and your quads will be on fire.

Knee Flexion strength is important too. Hamstrings don't usually need too much curl work, but if you've had an injury to them, or are deficient in them, them definitely throw in some hamstring curl work. Hamstrings can get weak after a knee injury because they're not worked as regularly as the quads. If you're taking a lot of time off due to an injury, your hamstrings may be pretty weak.