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AIS ARTICLES |
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AIS, “Active Isolated Stretching”,
is the most innovative form of stretching that has proven to be
particularly effective for postural realignment.
#1: RUNNERS KNEE
Patello-femoral
stress syndrome
by Daniel Vart |
All about AIS
on StretchAsia.com |
How many of us have painful knees that
creak, crunch and grind when we wake up in morning, have been
sitting for prolonged periods or when we’re walking down hills or
stairs? I would say a fairly high percentage of us do.
 So
what causes these noises and sensations? One of the most common
causes, is a problem called ‘Runner’s Knee’.
Runner’s knee is a wearing away of the cartilage underneath or
around the kneecap (patella), resulting in inflammation and pain.
This wearing away can come in several forms, To begin with, a
softening of the cartilage occurs, progressively followed by
cracking or even tearing.
So what causes this to happen? Well, there are several reasons. One
of the major causes is overpronation of the feet, as a result of
muscle weaknesses in the thigh and hip (quadriceps, hamstrings &
external hip rotators).
Overpronation is when the feet rotate too far inward, squashing the
arches during impact. This causes the patella to twist or be pulled
inwards. In order to counter balance this, the quadriceps (front
high muscles) will naturally attempt to pull the patella outwards.
The consequence of this tug-of-war, is that it forces the patella to
rub against the thighbone (femur), causing inflammation and pain.
Another cause is a weakness in the quadriceps muscles alone. Because
the quads play a role in ensuring proper tracking of the patella,
any weakness, particularly in the inside head of the quadriceps, can
have an adverse effect on the smooth running of the patella and
rubbing can occur.
Weak quadriceps combined with
tight hamstrings (rear thigh muscles) and a tight ilio-tibial band (ITB,
lateral muscle from hip to lower leg) can have lasting, damaging
effects as the joint itself is pulled so tightly together that
normal range of movement (ROM), cannot occur without hindrance, ie
the joint structures grinding together.
There are also external causes of runner’s knee, such as excessive
hill work, extensive sprint training, overtraining, running on
sloped surfaces and incorrect or over worn footwear that doesn’t
offer adequate support.
So how can we treat this problem, or perhaps more importantly, how
can we prevent it?
For acute cases of runner’s knee, it is appropriate to employ
R.I.C.E. (Rest, Ice. Compression and Elevation), in order to bring
down the swelling and get some degree of ROM back into the joint.
Then, before strengthening can occur to address the muscle
imbalances, full ROM in each joint and muscle concerned, must be
achieved.
 With
muscle imbalances, one set of muscles is weaker, therefore it has to
work harder or contract harder, hence shorten and tighten, more than
it’s opposing set of muscles. Therefore, a lengthening or stretching
of such overworked muscles must occur, in order to begin the muscle
rebalancing process.
Active Isolated Stretching (AIS) is a safe and extremely effective
method of facilitating such muscle rebalancing, as well as
preventing the onset of runner’s knee all together. Using AIS, it is
important to stretch the gluteals, quadriceps, hamstrings and ITB,
as these are the major muscles involved with the injury. Stretching
these muscles and muscle groups, can help to decompress the knee
joint, thus preventing any further rubbing of the patella on the
femur.
Whilst maintaining flexibility in the knee and hip joints, it is
important to strengthen those weaknesses contributing to the problem
in the first place. A common weakness with runners knee as mentioned
before, is the inside head of the quadriceps (vastus medialis). The
vastus medialis is considered to be a major stabilizer of the
patella, so strengthening it would prevent any detrimental amount of
lateral/medial or superior/inferior, patella glide.
One way of doing this would be to lie on your back with the problem
leg extended and the other leg bent up with the foot flat on the
table. Rotate the extended leg outwards from the hip, lift the toes
(dorsi flex the foot) and elevate the whole leg to about 45 degrees,
hold for 2 seconds, then slowly lower to the start position and
repeat. Do about 2 sets of 10-12 repetitions and increase the sets
as necessary.
Don’t forget that the recovery process begins with Active Isolated
Stretching (AIS).
See you soon at Stretch ...
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