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If there was ONE area of the body I would have everyone dedicate time to, regardless of issue and even if you dont have ANY pain, it would be the quads.
You can probably guess why
We are a HUGELY quad dominant society . We sit at desks all day starting in 1st grade all the way through college and most jobs in America are desk jobs. All this sitting sets us up to have tight fascia in our quads no matter how active or inactive we are.
On top of that, most of our sports are quad dominant: soccer, football, gymnastics , cycling, dancing, running
The Biggest Key To Recovery
The biggest key to recovering from quadriceps pain is appropriate loading.
If it hurts every time you run 13 miles, stop running 13 miles! For overuse injuries, modify loading. This approach keeps muscles and tendons strong and allows aggravated areas to heal.
In quad pain rehabilitation, the goal is to load the irritated area without exacerbating symptoms. As pain levels diminish, its crucial to strengthen the quad muscles, along with the nearby hamstrings and hip muscles to facilitate a safe, pain-free return to activity.
I love working out. I experience the mental and physical benefits of regular exercise first-hand. So I never prohibit exercise for my active patients.
Its negative for their physical health, mental well-being, and stress levels. Instead, we collaborate to modify their exercise program. We select exercises they can perform without hampering their recovery.
For example, runners often injure leg muscles. In the short-term, reducing weekly mileage and running frequency is required to allow healing. Instead of pounding the pavement 6 days a week, runners can bike, swim, or use the elliptical instead.
These cross-training options allow injured runners to maintain fitness without prolonging the recovery process.
How The Hamstrings Are Structured
If you are only familiar with only one muscle in the human body, its probably actually a group of muscles known as the hamstrings. They are the upper-leg muscles that tend to get tight when they are overworked or stiff when they arent worked enough. The hamstrings, just like all other structures in the body, are just one powerful link in the full body chain.
They dont function individually they function as an interconnected part of the entire body.
As such, at the basic anatomy level, the hamstrings anchor via tendons to the butt bone at what is called the ischial tuberosity . From there they stretch the full length of the upper leg and insert just below the knee.
With the hamstrings and the knee living in the same space, its easy to assume tight hamstrings may be causing knee pain or vice versa, and there are cases where this may be true. For example, a hamstrings tear or injury behind the knee could certainly be the source of pain behind the knee. However, with an injury ruled out, the next place we would want to look for the source of hamstrings tightness and knee pain would be the back.
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Recovering From Quadriceps Tendonitis
Most cases of acute quadriceps tendonitis knee pain will settle within 6-12 weeks with non-surgical treatment. Chronic quadriceps tendinosis may take longer, typically 3-6 months. The sooner treatment begins once you notice symptoms, the quicker you are likely to recover.
You will probably need 6-8 weeks of physical therapy alongside your daily programme of strengthening and stretching exercises.
As your strength, flexibility and endurance improves, you will be able to progress on to more challenging exercises and increase your activity level.
As the symptoms of quadriceps tendonitis begin to settle, you can gradually start returning to sport specific training, but start with low frequency, low intensity and short duration. Start slow and gradually build up, being guided by your knee pain if it starts to hurt, thats a sign youve done too much so back off a bit.
It is really important to avoid activities that aggravate your quadriceps tendonitis knee pain, and to continue you treatment until you have regained full range of motion, flexibility and strength in and around the knee. Failure to do so is likely to result in the symptoms coming back again.
Data Analyses Using Imputed Data
There were 620 knees with either missing baseline or 60-month follow-up WOMAC pain scores. This included one knee with missing baseline data and 619 knees with missing follow-up data from participants who either attended the 60-month follow-up visit or were lost to follow-up . Because those missing follow-up data significantly differed from those with complete data, missing WOMAC pain scores were imputed. Those with missing 60-month follow-up WOMAC pain scores were similar in age and knee extensor strength , but had greater baseline knee pain , higher BMI’s and lower physical activity scores compared with those with complete data. In addition, there were more women with missing data . This brought the total number of knees included in the analyses from 4,648 knees up to 5,268 knees . However, results were similar to those from analyses using only complete data.
There were a total of 444 knees from 339 men and 824 knees from 631 women that experienced worsening of knee pain at 60-month follow-up. Results are shown in . In men, lower compared with higher strength was not associated with an increased risk of knee pain worsening . Lower compared with higher baseline quadriceps strength was still significantly associated with an increased risk of knee pain worsening in women .
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Strengthen Glute Medius To Avoid Common Knee Pain
Here is an article written by a friend of mine who understands common overuse injuries with athletes as well as special operations training programs with regard to knee tendonitis that can shatter a military persons Special Ops dreams. Learn how to strengthen the legs / hips to help prevent nagging injuries such as Illiotibial Band and add some lateral leg movements to your training.
The most common complaint of pain for a BUD/s candidate it pain stemming from the Iliotibial Band . The ITB starts at the crest of the pelvis above the hip joint and runs to the outside of the knee. Attached to the ITB are the Gluteus Medius, Quadriceps and Hamstring muscles. Common issues with the ITB lead to lateral knee, hip and low bak pain. A common issue with tight quads is pain under the knee cap and tight hams often lead to low back pain.
The main cause of knee, hip and low back pain is well developed and tight quadriceps, hamstrings and glutes. These muscle groups become tight due to increased development from high frequency of running, running on unstable surfaces like sand and weight lifting. These movements allow the hip to move forward and back but not side to side. The lack of side to side hip movement leads to muscle imbalance in the ITB and Glute Medius. The Quads and Hams are strong but the ITB and Glute Medius is weak.
Abductor Stretch link
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What Causes Hamstring Tightness
The hamstring muscle plays an integral role in most leg movements. They are an important muscle group because they balance the actions of the quadricep muscles, keeping the pelvis and spine neutral when moving the hips and legs. The three most common causes of hamstring tightness include:
- Anterior Pelvic Tilt: Means that the top of the pelvic bone is tilted to face the front of the body. The quadriceps attach to the front side of the pelvic bone , while the hamstrings attach to the back side of the pelvic bone . Therefore, when an individual has an anterior pelvic tilt it forces the hamstrings to work extra hard to counter the forces causing the anterior tilt. Because the hamstrings are on overdrive, they are basically always ON and therefore always contracted or tight.
- Nerve Entrapment: The bicep femoris muscle runs over top of the sciatic nerve, and sometimes the sciatic nerve can get trapped under it.
- Lumbar Disc Herniation: Like with nerve entrapment, a disc herniation can causes hamstring tightness. If a patient has a disc herniation, the hamstrings and other muscles around the lower back will go into overdrive. They do this to protect the area of the spine that is injured. This is called protective tension.
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How Do You Stretch The Front Of Your Hip
Lunging Hip Flexor Stretch Kneel on your left knee. Place your right foot flat on the floor in front of you, knee bent. Lean forward, stretching your left hip toward the floor. Squeeze your butt this will allow you to stretch your hip flexor even more. Hold for 30 seconds to 2 minutes. Switch sides and repeat.
Dehydration And Electrolyte Imbalance
Dehydration and electrolyte imbalance may also contribute to muscle cramps, spasms and tightness. Without adequate water, electrolytes like sodium and potassium can become unbalanced, and the flow of oxygen and other nutrients can be slowed to the quadriceps.
A healthy blood flow is needed for the cells of the muscle to create energy, and without these important nutrients, the muscle may contract and tighten to conserve nutrients.
General guidelines for hydration include drinking 16 to 20 ounces of fluid four hours before exercise, drinking according to your thirst during exercise and consuming 16 to 24 ounces for every pound lost during exercise, according to an article published by the American College of Sports Medicine in July/August 2013.
Read more:Damaging Effects of Tight Quadriceps
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The Lying Quad Stretch
The best quad stretches are those that address not just the quadriceps, but all aspects of your leg, from the hip to the thigh, to the foot. The lying quad stretch is great for people who suffer from knee pain, as well as those who prefer reclining to standing up.
How To Treat Tight Hamstrings
The simple answer to eliminate hamstring tightness is to loosen them through exercises including stretching. There are many helpful stretches for the lower body to prevent tightness that attributes to knee pain. Some more specific and effective stretches include:
Lunging Hip Flexor Stretch:
- Kneel on one knee. Place the opposite foot flat in front, with the front thigh parallel to the floor.
- Lean forward, stretching the hip toward the floor.
- Tighten the butt to allow a deeper stretch.
- Reach up with the arm on the same side as the knee on the floor. This will help deepen the stretch.
- Switch sides and repeat.
- Cross the left foot over the right quad, and bend the right knee.
- Hold the back of the right leg and gently pull it toward the chest.
- Switch sides and repeat.
Standing Hamstring Stretch:
- Stand on the right foot with the left foot in front, heel on the floor, toes up.
- Hinge forward at the hips and bend the right knee sitting back a bit.
- Bend the right leg, keep the left leg completely straight with the weight on the edge of the heel.
- This stretches the hamstring of the straightened leg.
- Switch sides and repeat.
- Lunge out to one side, bending the knee and keeping the opposite leg straight.
- Try to keep the foot of the straight leg on the floor.
- Place fingertips on the floor in front to balance.
- This stretches the hips and inner thighs.
- Switch sides and repeat.
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Why I Use The Squat & Single Leg Exercises To Release Stiffness
The squat is an interesting movement for as much as it is a great way to develop strength into the all of the muscles around the knee and prevent injury and pain it is also one of the reasons people get into trouble. The problem is not with the movement itself but the way it is taught. One of the worst coaching techniques that is still used today is where people are told to keep the knees behind the toes.
This cue came about to prevent knee problems as it significantly reduces the stretch on the patella which we discussed earlier. Unfortunately this short term solution creates a multitude of long term problems as it prevents the quadriceps from developing strength relative to the posterior chain for they are in such a poor mechanical position to get any work. But, even worse is this instruction distributes more of the load into the lower back exposing the lumbar spine to severe damage.
However, if you spend the time to really learn this exercise you will see that you can teach your body to control full flexion of the knee and regain any lost strength into the quadriceps relative to their synergistic partners of the hamstrings and glutes. I do not suggest you squat to full depth as not many people are mobile enough at the hips to do this but I would be using tools like heel plates, ramps, micro bands on the knees, and even TRX straps to assist people in learning the correct positions and technique.
Watch the video below to see an example of squat technique.
You May Also Want To Stretch Your It Band
Your iliotibial band runs along the outside of your leg, and it can become tight with overuse particularly in runners, cyclists, and hikers. IT band tightness can cause your kneecap to be pulled towards the outside of your knee, leading to pain.
How to stretch your IT band:
“Heavily working your muscles during exercise can lead to tightness, but the muscles that support your knee can also become tight just by sitting for prolonged periods of time, especially if you’re sitting with poor posture,” Dr. Brooks adds. “This means even if you’re not running or cycling, stretching these five muscles is still an important component of improving and maintaining your knee health.”
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Causes Of Quadriceps Tendonitis
A majority of quadriceps tendonitis injuries are due to overuse from playing sports such as volleyball, running or soccer. Quick turns, starts, stops, jumping and running contribute to quadriceps tendonitis.
Other factors that contribute to quadriceps tendonitis:
- Excessive frequency, intensity or duration of training
- Inappropriate footwear
- Misalignment of the foot, ankle or leg
The Anatomy Of The Quadricep
Your quadriceps muscle group is made up of 4 muscles that attach to your patella and your tibia bone in your lower leg through two tendons quadriceps tendon and patellar tendon.
If one of the quad muscles on the inside of the thigh is too tight, it can pull the patella medially toward the inside of your knee and cause pain because the patella is not tracking properly its not sitting in the groove right and rubs the bones and tendons the wrong way. The same can happen on the outside of the knee if the quad muscles on the outside of the thigh is too tight.
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Muscles Weak And Strong
Maintaining flexible muscles around your knee that are strong enough to support your body may help to alleviate or prevent tightness in the knee area. Strong legs, hips, and buttocks are thought to reduce knee tightness.
Research surrounding the benefits of strong leg muscles in relation to knee tightness varies. According to a 2010 study that looked at over 2,000 knees of men and women who had or were at risk for osteoarthritis, neither hamstring nor quadriceps strength predicted frequent knee symptoms such as pain, aching, and stiffness.
Still, having strong quadriceps may help to reduce the risk of knee problems, since stronger muscles can help to support the knee joint.
A 2014 study that was conducted over five years with 2,404 participants who also had or were at risk for osteoarthritis, found that weak quadriceps were associated with an increased risk of worsening knee pain in women but not in men. Researchers acknowledged that their longer study built on similar studies of shorter duration , and smaller group sizes, to support the link between leg muscle strength and knee pain. Their study suggests there may also be sex-specific differences in risk factors for worsening knee pain.
A Back Problem May Cause Tight Hamstrings And Knee Pain
If something has irritated a low-back nerve, you could feel pain, tightness, numbness, or other issues anywhere in the legs, including the hamstrings or knee. How is this possible? Because, as we mentioned, the nerves that branch off of your spine in the lower back supply the lower extremities all the way down to your toes and, therefore, irritation can be felt anywhere along the nerve supply chain.
What if your back doesnt hurt? When your back is the source of the pain, you may or may not have discomfort in your back, so not having back pain doesnt rule you out from a lower-back nerve irritation that may be causing your leg symptoms. In other words, your back may feel perfectly fine, yet, as the video below shows, your tight hamstrings and knee pain could be due to, for example, a pinched nerve in your back.
The upshot? If your hamstrings are chronically tight and/or you also have knee pain, make sure your doctor checks the low-back nerves that supply your hamstrings muscles as well. Its not hamstring knee pain, after all. Incidentally, also worth mentioning, just because an MRI shows a meniscus tear, unless there has been an obvious traumatic injury, this doesnt mean the meniscus tear is the source of your knee pain. If attempting to strengthen your hamstrings doesnt improve your hamstrings tightness and your knee pain, its time to focus farther up the kinetic chainyour back may be the real problem! hamstring knee pain
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