Strengthening exercises can help keep many joint-stress injuries from occurring


October 18, 1994|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Medical Tribune News Service

The arrival of cooler fall weather brings an increase in joggers running their daily courses through our neighborhoods. It's also the time of year when new aerobics and exercise classes form, to help combat the sedentary habits of the winter days that lie ahead.

This increase in activity brings, for novices and experienced exercisers alike, the risk of joint stress. Running and aerobics are the two most common types of exercise that can lead to joint stress, but they are not inherently dangerous. With just about any type of exercise, some degree of joint stress is unavoidable.

But injury can be prevented if the joints are stressed in gradual, planned increments. People risk excess stress when they don't heed the signals their bodies are sending them.

Q: As an exerciser, what should I be watching for?

A: Joint stress most commonly affects the knees, which absorb most of the stress -- or "road shock" -- that occurs during high-impact exercises.

The knee essentially enables the leg to bend. It accomplishes this through a "floating bone," or kneecap, connecting muscle, tendon and bone. The bottom of the kneecap is covered by cartilage that enables it to function smoothly during movement. An intricate, relatively delicate mechanism, the knee therefore is prone to problems. It is one of the body's most commonly damaged, least resilient joints. Once a muscle or cartilage is torn, it never regenerates. With sports medicine still in its infancy, definitive research has yet to determine exactly what causes knee stress.

Q: What steps can I take to prevent joint stress from occurring?

A: A few simple guidelines, consistently followed, can go a long way toward preventing serious injury. The most important thing to remember is to stop if you begin to feel pain, and give the injured area a rest.

It's a good idea to apply ice to the injured area, compress it with a bandage and elevate the knee above the chest. Persistent pain and/or swelling are signs of potentially serious injury, and signal the need to visit a doctor.

A good way to reduce the risk of joint stress is to engage in several leg- and knee-strengthening exercises.

Consider the following three simple activities: (a) Stand with the knee straight, raise your kneecap toward your chest and hold to the count of 10. (b) Sit on the floor with three pillows under your knee, and using a small ankle weight, lift your foot for a count of 10, then lower it. Repeat this three times. (c) Sit on the floor with your leg in front of you, keeping your knee stiff; then lift your leg from the hip.

Q: How can I protect against joint stress during my aerobics class?

A: As aerobics have become increasingly popular over the last 10 years, knee pain has become more prevalent because of the jumping and kicking that is an integral part of the program.

Significant improvements have been made over the years by health clubs and spas to minimize knee injuries. Increased floor padding and more absorbent floor materials reduce impact shock.

In addition, as the sport has increased in popularity and sophistication, aerobics instructors have become better trained and informed about ways of reducing joint injury. Aerobics shoes also are continually being redesigned to provide more padding and support.

Two relatively new forms of aerobics that reduce stress on the knee now are widely practiced. Step aerobics involve stepping on a raised platform or step, while doing upper-body, cardiovascular movements associated with regular aerobics. Low-impact aerobics cut the risk of knee stress by keeping one foot flat on the floor at all times, helping to absorb shock.

Dr. Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is founding director of its Institute for Women's Health Research and Policy.

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