So you fell on your knee and you want to know how to help yourself to become reVITALized. Part 1 of this series helped you to understand how the knee works and the relationship to your knee pain. Today, I will write about self-treatment techniques. Let’s get technical and dive into the medical science.
The pulley system was discussed in relationship to the patellofemoral (knee cap) joint. Our main goal is to obtain normalcy of the pulley including the user itself. If you analyze a pulley system, the condition of the groove and rope with its direction of pull impacts the mechanics of the pulley. The size of the circular shape pulley and the strength of the user determines the effectiveness of the pulley. I just laid out four variables to control, the condition, direction of pull, size of the pulley and the user.
The condition of the groove and rope is equivalent to our knee cap, quadricep (front thigh muscle), and the patella tendon, which is located below the knee cap. The amount of “rust” within the groove impacts the sliding of the rope. When the rope does not slide well over an extended period of time, the friction leads to compressive forces. There are tons of techniques that addresses this sliding and compression phenomenon.
Our member fell and I believe this resulted in a compressive injury to the patellofemoral joint. The trauma may have stiffened up the quadricep muscle and the patella tendon. In chronic front knee pain, the buildup of tension will negatively affect the condition of this rope metaphor. There are a variety of patellar self-treatment techniques designed to decompress the knee cap and get it moving in all direction so we can be dynamic in the way we move. You follow up this with techniques to improve the integrity of the rope to stretch.
The direction of pull factor is something that is getting a lot of attention in the rehab and fitness setting. A pulley is less effective when the line of pull is out at an angle from the pulley groove. When this is done repetitively or when the load being pulled is heavy, the compression concept can be promoted and degenerate the pulley system faster. The “magic” treatment for this is to keep all three parts of the pulley system pointing in the same direction when we move. Whether it is a squat, lunge or stepping down pattern, keep your knees from buckling in and foot facing forward will address this line of pull factor.
The size of the pulley analogy is in regards to the strength of the quadricep and the tendon. You cannot change the size of your patella so that is out of the equation. “Beefing” up the quadriceps and the tendon has been the primary method in most rehab and fitness settings. Even though this method is old science, it is still relevant to address.
Lastly, we need to address the user factor. A pulley system is designed to provide someone or something LEVERAGE, not power, to perform an activity such as lifting. This sounds good, but if the pulley and rope are not a decent size to lift something big, then we need to rely on a stronger user. An example is that a “scrawny” person will not be able to lift a grand piano off the floor if the pulley is a too-small-for-the-job size pulley. We get Arnold Schwarzenegger to help out and your chances of getting the grand piano off the floor are greater. Our gluteal muscles, Medius and Maximus, together are your “power” muscles that will help decrease the burden to our knee “pulley” system. Get a rear like Serena Williams and you have nothing to worry about.
In summary the tricks are to decompress the knee cap and tendon, improve the flexibility of the quadriceps muscle, move with good leg alignment, and strengthen the quadriceps and gluteal musculature.
How to ReVITALize your front knee pain.
1. “RECONDITIONING” the knee pulley system.
Technique 1. Patella decompression
Grab a plunger the size of your fist (actually go buy a plunger). Place it on your knee cap. Make a letter “C” with your index and thumb which you will use to SEAL and get suction from the plunger. Plunge. Repeat few times. You can press the plunger down then follow it up with some knee bends. This maybe uncomfortable but should be tolerable. Be careful if you bruise easily.
Technique 2. Quadriceps “Reset and Release” stretch
Lay on your stomach. Grab your ankle, back of your socks or shoes, which ever is more comfortable. Instead of pulling hard (which you should never do with a stretch), I prefer you to CONTRACT your buttock muscles (Gluteus Maximus) firmly. Hold 30-60 seconds and repeat 1-3 times. You get more of a reset phenomenon as your hold your contraction longer. You may cramp. Bend your knee less and try again. If you CANNOT grab your ankles, you can strap a belt around your ankle to help you bend your knee.
2. “LINE OF PULL” exercise.
Technique 1. “MINDFUL” sit down exercise
Place your feet hip width apart and facing straight. Making sure the chair is in good position behind you, SLOWLY sit down and pay attention to where your knee is moving. Your goal is do perform this movement with your trunk, knees, and feet facing forward.
3. Quadriceps and Gluteus Maximus muscle strengthening.
Technique 1. “Pillow Smashing”
Lay down and place a pillow under your thigh. CONTRACT your front thigh muscle AND buttock region at MAXIMAL intensity with the intention of smashing the pillow. DO NOT squeeze your legs together. That is a bad habit that we don’t want to reinforce. If your thigh begins to tremble, this is GOOD and keep it going!
There are tons of techniques and these are just a few to get you started on ReVITALizing your knee. If you are interested in more techniques, contact me via email to get TEN more patella mobilization, quadriceps soft tissue work, and movement based exercises. I will send a BONUS top five most effective gluteal exercises based on the most recent research.
Please share my blog and post if you know anyone with knee pain. ☝❤️