Did you make a New Year’s resolution to get fit and start working out? Do you want to get in shape for gardening or spring clean up activities? Maybe you have been noticing some knee pain and stiffness, popping around your kneecap, a giving way sensation with walking, squatting, or stair climbing? Have you noticed pain with kneeling, lifting, or carrying?
Women and girls often have knee problems, especially pain around the kneecap. Another common name for this is chondromalacia patellae. Anatomically, women may be more susceptible to knee problems because the female’s pelvis is wider than the male’s, increasing the angle from the hip to the knee. This angle is called the “Q” angle, and it can affect the angle between the knee joint and the lower leg. If there is a large “Q “angle, there may be increased stresses across the kneecap and the knee joint itself, resulting in knee pain, kneecap tracking and alignment problems. Some women bowlegged or knock-kneed, and this can cause inner or outer knee pain, kneecap pain, or cartilage injury.
Women also tend to have more ligament laxity in their joints than men, which may lead to a higher incidence of injuries like MCL (medial collateral ligament) and ACL (anterior cruciate ligament) strains or tears, especially in female athletes. Hormonal changes in women at various times of the month may also have a role in affecting the laxity of ligaments.
Other contributing causes of knee pain may include: loose ankle and foot ligaments and joints, flat feet, muscle imbalances between the muscles on the front of the thigh (quadriceps femoris) and the back of the thigh (hamstrings), tight Achilles tendons, and inflexibility of the calf muscles.
Physical therapy can help alleviate or prevent knee pain in women and girls! Physical therapy intervention may include: 1) education in proper stretching of short, tight muscles, 2) strengthening of weak muscles, 3) functional activities to improve muscle performance and balance between muscle groups, 4) proper warm up and cool down for exercise or sport, 5) education in joint protection techniques and injury prevention for activities of daily living and sport, 6) sport performance enhancement activities, 7) foot orthotics to improve joint alignment and function, and 8) taping or bracing for functional activity or sport.
A few very basic stretching exercises that specifically address the knee and may offer you immediate relief from minor pain or muscle soreness are pictured here, and include 1) the quadriceps stretch for the front of the thigh and knee, 2) the hamstring stretch for the back of the thigh and knee, and the calf stretch for the back of the knee and lower leg. In order to achieve the best benefit from stretching, you should move gradually into the position until a minimal to moderate pulling sensation is felt, then stop and maintain that position without bouncing for at least ten to twenty seconds. Rest a few seconds, then repeat the stretch three to four more times. The stretch should not be hard or forceful, nor should it cause pain. If it does, then you may be too aggressive with the stretch, leaving your muscles more sore or painful. A few well-done stretches will give you better therapeutic benefit than many poorly done exercises.
If you have knee pain, you may be a good candidate for physical therapy. A skilled physical therapist with expertise in working with women and female athletes may provide a comprehensive evaluation and assessment of your condition.
Ann Sundgren, PT offers eighteen years of experience in treatment of orthopedic and musculoskeletal conditions. She is employed by:
Palmer Physical Therapy for Women