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The other type of cartilage is meniscus cartilage and it refers to the crescent-shaped cushions between the lower part of the thigh bone and the upper part of the shin bone.
An athlete typically suffers a torn meniscus when they take a blow to the outside of the knee, forcing it inward and tearing the structure, or by some combination of bending or compressing the knee joint, twisting, pivoting, changing directions, or decelerating. For older athletes, the meniscus often becomes weak and frayed, making it more vulnerable to both contact and non-contact injuries. The inside (medial) meniscus is five times more likely to be injured than the outside (lateral) meniscus.. The percent of meniscus tears that can be diagnosed (by a physician) with a careful injury history and physical examination.
A soccer, basketball, lacrosse, tennis, or football player who plants a foot to change directions or who takes a hit from another player is vulnerable to meniscus injuries.
Apply ice in 20-minute intervals several times a day during the first 48-72 hours after the injury. Use a pillow or cushion to elevate the knee while at rest during the day and while sleeping at night. Get medical attention if the pain persists for a week or more, or if you think you have torn a meniscus. If a tear has occurred on the outer rim, there are enough blood vessels to allow the structure to heal.
Some meniscus tears aren't preventable and might be considered an occupational or recreational risk that accompanies a sport. Work with a certified strength and conditioning coach to ensure proper lifting techniques in the weight room.
Work with a knowledgeable coach to ensure proper sport-specific technique to reduce the risk of meniscus injuries.
The ankle has strong bands of connective tissue which are called ligaments, which reinforce the joint and support the bones of the ankle.
A sudden movement or twist, often when the foot rolls in, can overstretch the supporting ligaments, causing ligament tears and bleeding around the joint.
This is a common injury, particularly in activities commonly played right here in North East Victoria.
Pain – when trying to move the ankle joint and when walking, especially when the knee steps over the foot. In more severe injuries there may be associated bone injury and it is sometimes necessary to get an X-ray of the ankle to determine whether there is a fracture. Your physiotherapist can advise you on whether or not you require an X-ray, and if required, can provide you with the referral.
Avoid exercise, heat, alcohol and massage in the first 48 hours after the injury, as these can all exacerbate the swelling.
Proprioceptive (balance) deficit – decreased capacity to judge where your foot is in relation to your leg. The use of a wobble board, mini trampoline and other exercises to encourage balance and improve the proprioceptive deficit. Early treatment and completion of a full rehabilitation program will get you back into your chosen activity as quickly as possible, and also reduce your risk of future recurrences. Please note that we are unable to respond back directly to your questions or provide medical advice. As the fastest growing consumer health information site a€” with 65 million monthly visitors a€” Healthlinea€™s mission is to be your most trusted ally in your pursuit of health and well-being.
A person with TrPs in the termedius may have a difficult straightening the knee, especially after being mobile for a period of time while sitting. Diabetics who inject insulin into the front of the thigh may inject a latent TrP in the rectus femoris or the vastus lateralis and cause it to activate.
Sudden eccentric contraction such as stepping into a hole, stepping off a curb, or stumbling.
Immobilization of the knee from a cast or brace can activate TrPs and cause a pain complaint after the device is removed.
Avoid overload by learning to correctly pick up heavy objects from the floor which will spare the quadriceps as well as the paraspinals (back muscles). Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed.
First, I wanted to be sure to mention that I'll be announcing a brand new giveaway today, so be sure to check back here later on today to enter!
Bridal Fitness on Paper is a weekly blog series posted every Monday, where I share and review a wide variety of cardio and resistance training workouts, both inside the gym and out. The hips by themselves are a fairly immobile area for most, since their prime job is to be weight bearing stabilizers, but when you consider the hip joint, where hip socket meets femur bone, then you get more action. Your pelvis is like a bowl, and to cultivate neutral alignment, you strive to keep it upright and level by not letting it tip too far forward, an anterior tilt, or backward, a posterior tilt.
Though your pelvis is less mobile, it also pays to understand the primary movements of internal and external rotation in the legs.
The dynamic movement for most hip openers is spreading the legs wide like in a Wide-Legged Forward Bend or putting one leg in front of the other like in Monkey Pose (Hanumanasana), but these are just part of the equation. This usually gets some laughs (thank you, Suzanne Somers!), but it’s easy for people to tune into those adductor muscles when they think about squeezing a ThighMaster. It might be a bit trickier to understand in Crescent Lunge, aka High Lunge, but it happens there, too. By cultivating your own resistance from within, you safely measure the depth of the hip opening and protect the same ligaments and tendons at the same time. These adjustments, though less dynamic than widening the legs, are no less important to helping yogis walk out of the room injury-free after a hip-intensive practice. Zainab has been teaching yoga since 2007 when she taught classes to stressed graduate students while completing a Master's degree in Journalism in New York City. Join the community and discover yoga together with hundreds of thousands from all over the world.
Jumper’s knee is a stubborn knee injury that can take months to heal and even once it has healed, the pain might reappear after you return to your sport.
Back when I suffered from patellar tendonitis, I was so frustrated with my lack of healing progress that I often considered quitting my sports, basketball and volleyball, altogether.
It took me years of research into knee health and a lot of self-experimentation until I finally discovered the reasons for my jumper’s knee.
In this article, I will show you the three most important secrets to successfully treating patellar tendonitis. The treatment triangle will help you address the three most common causes for patellar tendonitis. Let’s talk about why its parts are important for healing this stubborn knee injury and determine how you can take care of them. Three major causes for jumper’s knee are low ankle mobility, low gluteal strength (hip strength), and bad leg alignment during athletic activity. As you will see, all three of these causes are connected, which is why you need to address all of them if you want to make healing progress. Ankle mobility encompasses a number of ankle movements, but the most important one for our goal is dorsiflexion.
Secondly, if ankle mobility is low, you will have a difficult time maintaining good alignment of your leg. As you can see, the evidence supporting the importance of ankle mobility for healing the patellar tendon is strong, but how do we improve it? There are numerous ankle mobility exercises to choose from, but if you want to improve ankle dorsiflexion, the following drill will provide good results and direct feedback on your progress. All you need to improve your ankle dorsiflexion is a piece of furniture, a wall, or another vertical structure. The important point is to bring the knee forward on the outside of your big toe (if you’re working your right foot, bring your knee forward and then to the right). When we talk about cause #3 we will come back to ankle mobility and examine more reasons why it is so important for a healthy patellar tendon. The gluteal muscles also help you control the alignment of your knee during these movements. For a healthy patellar tendon, the three important movements your gluteals need to be strong in are hip abduction, hip external rotation, and hip extension. Hold the elevated position for a second or two and contract the working muscles as hard as possible during that time. To do clamshells, lie down on your side with your legs a bit in front of your body and your knees slightly bent. As with the other exercise, hold the elevated position for a second or two and contract the working muscles as much as possible. You should feel the contraction in your big buttocks muscles and not in your lower back or hamstrings. Hold the elevated position for a second or two and contract your glutes as much as possible. If your knee collapses inward when you move, the force transmitted through the patellar tendon will be off-axis and not parallel with the collagen fibers inside the tendon. As you can see, it is critically important that you maintain good alignment of your legs during all of your training. Avoid having your knee collapse to the inside of your foot and check for proper alignment during your training. One of the reasons why people walk with their feet turned out is because they lack ankle mobility (cause #1!).
If your feet point to the outside, your knees are much more likely to collapse towards the inside of your foot, leading us back to the alignment problem explained earlier.
Once you’ve addressed each of the hidden causes, it’s time to help your patellar tendon heal faster. If you’re still in the early stages of the injury, you can successfully help your patellar tendon heal by reducing the load it has to handle. Reduce your weekly training load to a level at which the discomfort in your patellar tendon goes away. If your pain has been there for a month or longer or if this isn’t the first time you’ve had jumpers knee, your injury has already progressed into one of the advanced injury stages.

To perform this exercise you need a slanted board (a 25-degree angle works best) and something to support part of your weight.
I talk about the research that supports this exercise and the specific methods you can use to make sure you achieve optimal progress in my book. You’ve now learned five very effective exercises that you can use to end your patellar tendonitis and to prevent it from returning.
If you suffer from patellar tendonitis or simply want to learn everything there is to know about this disease, you definitely have to check out my book Beating Patellar Tendonitis. It’s the first book about patellar tendonitis on the market and it will give you a ton of practical advice so that you can go back to enjoying your sport as soon as possible. If you really do need to stretch, remember to put your body into the position that you’re trying to improve.
As for your second question: I’m afraid I can’t be of much help here, since I’m not familiar with this stretching routine. Luckily, I injured myself a couple of months prior to season start and came across your exercises above.
On top of the exercises above, I began working out about 5-6x a week, started slow at first, then gradually increased. My question to you is, with all that above, I still experience some aches in the knees, especially when seated at my desk. Work on squatting technique – sit back as far as possible and keep your shins vertical, with your knees tracking over your second or third toe. This has helped my girlfriend mostly get rid of her popping knees and generally takes a lot of stress off the front of the knee. Somehow I started feeling the pain again during May and it got worse over period of 3-4 weeks of competitions so now I don’t train again . The isometric quad strengthening exercises are a great way to strengthen and heal the patellar tendon.
A great way to make this process more efficient is by doing the self-massage exercise and the stretches I demonstrate in my email course on patellar tendonitis (you can find it at the end of this article). As for nutrition, following an anti-inflammatory diet has produced good results for some of my readers.
However, if you stick with the exercises and carefully strengthen your patellar tendon with slow eccentric training you may be able to get rid of most of the pain. Hi martin, I had patellar tendonitis and was treating for about a month and a half with physical therapy and limited physical activity. I know that you said that returning to training too fast could add months to recovery time but I really have just recently returned to full activity and I don’t think I could of done that much harm to the tendon.
It seems to me that you don’t lack a new treatment approach, but you lack the patience to follow it until the treatment is actually complete. Follow the eccentric strengthening exercises until your pain is completely gone, even when doing single-leg eccentric squats.
I am an avid competitive squash player, and just recently have been told I have patellar tendonitis. Unfortunately, until your pain is 0 during every day activities, going back to playing your sport is highly counter-productive.
Maybe you can find some other outlet for your competitive nature until your tendonitis is healed. Of course, working on ankle and hip mobility, as well as foam rolling the legs and the hips is just as important.
So concentrate on the slow strength training for your knees and the dorsiflexion drills for your shin splints.
Hi,I have jumper’s knee,should i buy total knee health or beating patellar tendonitis? The Total Knee Health course is much more comprehensive than the book Beating Patellar Tendonitis. In the research I read for my book Beating Patellar Tendonitis, the researchers did not recommend PRP injections for patellar tendonitis because there’s conclusive evidence in favor. I’m an author and personal trainer based in Berlin, not a physical therapist or doctor. NSAIDs can wreak havoc on soft-tissue adaptation to training so in other words, taking NSAIDs while training is asking for trouble.
Except for surgery, the slow weight-bearing activities like eccentric exercises or isometric exercises (Wall sits) are the best treatment option according to all the research I read about the subject.
The only thing I know is that plantar fasciitis can be caused by tight calf muscles and low ankle mobility. Articular cartilage is the smooth, semi-rigid tissue that covers the ends of bones and allows the knee joint to move freely. Without the menisci, the bones of the upper and lower leg grind against each other, which may cause short-term pain and long-term arthritis. It isn’t unusual for a torn meniscus to happen simultaneously with another traumatic injury, such as a torn anterior cruciate ligament (ACL). Something as simple as the up and down motion of squatting may cause a minor meniscus tear.
If the tear is in the central area where there isn't a good supply of blood, the tissue may not ever heal and may need to be removed through arthroscopic surgery. Both of which will support, guide, and inspire you toward the best possible health outcomes for you and your family.
This person will have not be able to step up onto the next stair step then straighten the knee or walk without a limp after arising from a seated position.
Then when I learned how to work with my body more intelligently, I discovered I had a lot more flexibility than I’d originally thought. The knees, somewhat less limited in mobility than the hips, function primarily in flexion and extension but do have a slight range in rotation.
When you have a firm grasp of where neutral is, you can better shift the alignment to suit the needs of your body in a particular pose; in this case, when hip openers call for a forward bend like the fold in One-legged Pigeon pose (Eka Pada Rajakapotasana). For example, Pigeon asks for more external, or outward, rotation in the front leg and corresponding hip joint, and more internal, or inward rotation in the back leg. And for Wide-Legged Forward Bend (Prasarita Padattonasana), there is more emphasis on internal rotation through the legs.
You can apply this contraction in most poses, but you can more easily cultivate the action in Garland Pose, Crow (Bakasana), and even lunges like Warrior 2 (Virabhadrasana II).
Hugging your legs toward each other will prevent you from sagging into hips’ surrounding ligaments and tendons, which means fewer strains, pulls, or tears. You can also achieve the same action by thinking about curling your tailbone towards you pubic bone. Stretching, warming up thoroughly, quad strengthening exercises, knee sleeves, no matter what I tried, the pain always kept coming back.
I can do extremely demanding leg exercises, such as deep single-leg squats, without any problems. Up to that point, I had completely ignored these hidden factors, but once I addressed them, my pain slowly disappeared.
I’ve called this the jumper’s knee treatment triangle, because if you ignore one of its parts, the whole thing collapses. I came up with the idea for the triangle during the research for my book Beating Patellar Tendonitis and while I deal with many other causes of this knee injury in the book, the three causes addressed with the treatment triangle are the most important.
If you want to make sure you stay pain-free in the future, this is where you need to start. Unfortunately, these hidden causes are commonly ignored by athletes, trainers, and physical therapists, which is why the injury will reappear eventually after it has seemingly healed. Additionally, they all have strong research supporting their importance for preventing jumper’s knee.
Low ankle dorsiflexion range of motion has been linked to patellar tendonitis in a number of research studies, for example (Malliaras et al. You dorsiflex your ankle when you pull your foot up towards your knee or when you bring your knee out in front of your toes, with your foot planted. First, if you lack ankle mobility, the body will compensate for it by increasing mobility at the neighboring joint, the knee. This is how ankle mobility is connected with the third major cause for jumper’s knee (Cause #3 leg alignment). Place one foot perpendicular to the object and the other foot a little more than shoulder width behind it. Once you can barely touch the object, switch sides by placing the other foot at the same distance. If so, you’ve discovered an asymmetry between sides, which you need to correct as quickly as possible by improving the mobility of the weaker side. For now, let’s talk about the second major cause for patellar tendonitis: low gluteal strength.
These muscles are used when running, jumping, landing from a jump, and many other athletic movements. Therefore, if you have weak gluteal muscles, your legs are more likely to end up in a position in which you place excess load on your knees. If you are strong in these movements, it will be easy for you to maintain good leg alignment in your sport. If you let them rotate outwards (your foot points towards the ceiling instead of being parallel to the ground), other muscles of the leg will take over, and the exercise will be less effective, so pay attention to your technique. To improve bad leg alignment, you need your gluteal muscles to be strong, so that they can successfully resist forces that are trying to push your knees into bad positions. For this reason, we’ve trained gluteal muscles that create external rotation and abduction, the opposite movements. This is problematic, as it puts undue load on your patellar tendon and on other passive stabilizing structures of your knee, such as the ACL.
It’s much like opening and closing a zipper by pulling it off to the side, instead of straight up and down. Make sure your knees are tracking above the second, third or fourth toe and make sure your thigh is parallel to your foot whenever your knee is bent. The following picture illustrates that concept (left) and a more optimal foot alignment (right).
Additionally, your arch will collapse a bit more, lowering your ability to transfer as much force into the ground as you could with a proper arch.

Depending on your situation, you can use two different methods to improve tendon healing through exercises. In this stage, you need to stimulate the cells inside your tendon to increase collagen synthesis again, so that your tendon can become stronger. You can improvise the slanted surface by standing on something elevated with your heels (wear shoes). The important thing is that your pain slowly decreases from day to day, as you do this exercise.
Start doing the exercises today and begin monitoring your pain, so that you can modify your activity level. I’ll also send you the two most important chapters of my book Beating Patellar Tendonitis as a gift. It contains a detailed 3-phase training plan to address every single cause of jumper’s knee and it will help you get your knees healthy and strong again. As for your question: whether or not the adductors contribute to internal rotation depends on how much hip flexion you have. You should get yourself a small notebook and put down daily pain scores on a scale of 1 to 10 (10 being the worst pain possible). There’s not clearly-defined anti-inflammatory diet, but generally it revolves around decreasing food intolerances (avoid gluten (in grains), alcohol, excessive coffee, dairy, excessive grains, and increase cold water fish or omega-3 supplementation). If you have pain, drop your regular training, take a 5 to 7 days of rest, and then start with the isometric (or eccentric) strengthening exercises until your pain is gone. It did not seem to work very well, the swelling went away and it was relatively painless, but pain returned as soon as I returned to training for soccer.
If this three step process does en up fixing the underlying cause do you think that as soon as I address that problem I will be able to return to activity? Most tendonitis-sufferers end up taking the 2nd route and then regret it years later because rehab will no longer take just 2 or 3 months, but 6 months and (much) more. So you should definitely prioritize getting rid of the tendonitis over hypertrophy, especially considering that the intense training in boot camp will most likely undo all gains anyways (especially if you’re a hard gainer, which it sounds like you are). Either of these resources is a great starting point, but if you prefer to have follow-along workout videos and video demonstrations of all exercises plus the option to easily get in touch with me if you have questions, the Total Knee Health course is the better option. Rest doesn’t do anything to help the tendon heal (the tissue damage will just stay the same and once you return to activities, pain will come back too). It can be torn away by impact during contact sports like football or hockey, or it can gradually wear thin with age, causing arthritis in the knee joint.
There are two menisci—one (lateral) on the outside of the knee joint, the other (medial) on the inside. A tear where a portion of the meniscus becomes detached from a bone and forms a flap is called a bucket-handle tear.
Men are more likely to tear a meniscus than women, but that may be because of the number of men that participate in sports as opposed to a gender-specific cause. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. When not icing the ankle, bandage it firmly, extending the compression up the calf and down the foot.
The hip joint is supported and stabilized primarily by three ligaments around the joint, one ligament inside the socket, and by the muscles around the hip and pelvis (see images below). However, as I wrote in my column last fall, flexibility does not always mean better, and in fact, hypermobile yogis need to work hard to not overextend or injure themselves when they try for their favorite bendy poses. A complex network of muscles, ligaments, and tendons connects the pelvis, thigh bones and knees so we can stand, sit, walk, run, jump and yoga. When you approach your next hip opener, ask yourself if you’ll need to cultivate external or internal rotation through the legs or both. This movement can help in asymmetrical, or one-sided, poses including lunges, one-legged standing balances, seated hip openers like Pigeon or Monkey Pose, and supine hip openers like Reclining Big Toe Pose (Supta Padangusthasana). Zainab's teaching style draws from several styles of practice including Vinyasa, Ashtanga, Prana Flow, Power Yoga and Viniyoga and integrates a practical focus on anatomy and alignment. I can play my favorite sports without having to worry about aching knees and I know how I can train my legs to become even stronger without risking a return of the injury. For these reasons, the exercises introduced in the following paragraphs need to become a staple in your training regimen.
The opposite movement, plantarflexion, occurs when you point your foot away from your knee or when you push yourself up to stand on the balls of your feet. This increased demand of mobility will slowly overload the knee, which in time leads to pain and injury.
Don’t bring the knee towards the inside of your foot and don’t turn your foot out, as this would lead to the arch in the foot collapsing. You’ll know when your mobility has improved, as you’ll be able to move the foot farther away from the object. Research has also uncovered low gluteal strength as a risk factor for patellar tendonitis (Ireland et al.
Knees collapsing to the midline of the body are the main cause behind ACL-tears, especially among women.
It will slowly break down the zipper and you need to expend more energy to get it done because it’s less effective. Oh, and you’re wasting energy when you move that way, which means that if you learned to move properly, you’d be able to jump higher and run faster with the same amount of energy expended. If you repeat the drill under cause #1 with your feet turned out, you’ll notice that you seemingly have more range of motion.
All these factors combined essentially lower your athletic potential and set you up for a number of injuries such as ACL tears, Achilles tears, and patellar tendon degeneration. Once you’ve done this, increase your weekly training load by 10%, until you’ve reached your previous level of activity. You can do this by utilizing different exercises, but the one with the most scientific evidence in support of its efficacy are eccentric squats on a slanted board. In the picture, I’ve supported my weight by using a stick, but you could also place chairs next to the board for example.
If your pain stays constant, you need to experiment with the repetition count and execution.
At this point it doesn’t matter that one knee is worse, you have to work on both knees anyways.
That being said, stretching the adductors will not necessarily carry over to help you better create hip external rotation.
I guess I have probably done the thing that you specifically said not to do in returning to full activity too soon.
I know it is hard for you to say because you can’t actually see my knee but any advice is appreciated. My legs muscles became super well developed with their exercises but the patella pain never fully went away. I am extremely frustrated with this and the reason it occurred is because I had been lifting legs pretty frequently. You can sign up when enrollment opens up again in a few months (It’s close right now). Also, a lot of folks take NSAIDs like Ibuprofen for health issues other than tendonitis, but then end up with tendonitis because of how NSAIDs affect the soft-tissue adaptation. The inside meniscus is the one most frequently injured in sports and the type of injury discussed below.
He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation. In this week’s column, I’m focusing on hip openers, or deepeners, if you will, since when one thinks flexibility, the hips tend to be among the first areas we circle. She is certified as a Registered Yoga Teacher at the 200 hour-level and is currently completing her certification at the 500-hour level.
Now, pull your feet up into the air so that only your heels touch the ground and elevate your hip until there is a straight line through your knees, hip, back, and shoulders.
This is exactly what the body tries to accomplish by turning your feet out and to prevent this we need to work ankle mobility. So, I changed doctors, got an MRI 6 weeks later, and then my orthopedic specialist put me in a walking boot to immobilize the ankle. I have been running through minimal pain now for a couple of days now, but the pain is slowly getting worse and my knee is back to being swollen at the patellar tendon area. My question for you is even if I am experiencing pain from just walking, is it okay for me to continue with these exercises? Zainab has trained with New York teachers Charles and Lisa Bennett Matkin, Prana Flow creator Shiva Rea and her senior trainers Twee Merrigan, Simon Park, Maria Garre & Coral Brown. I don’t really want to repeat the same process I went through before because It was so time consuming, and I am going to give the three step process described on this page a try and see if that will provide better results. When she is not on a yoga mat, Zainab also spends her time as a freelance writer and editor. Her work has been published in Fit Yoga, Women’s eNews, Zink, & Living MySore online magazine. After years in New York City, she is embracing country life in the Finger Lakes region in upstate New York. Anyways the reason Im so worried about this problem Im having is because Im scheduled to leave for the marines boot camp in exactly 58 days.
Ive become extremely worried that this will affect my performance and ultimately my health in the long run. This has mentally crushed me, I have become so frustrated with all of the problems I’ve been having with my running performance.
I would really appreciate, as I am extremely desperate with trying to get this problem fixed.

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