The knee is not the most frequently injured part of the body, but it is the weakest and most demanding joint, because it often bears all the weight of a person, and because of its large range of motion, its structure makes it more vulnerable to injury than hip and ankle joints under impact.
The knee joint connects the femur of the thigh with the tibia and fibula of the calf, and there is a kneecap (patella) on it. There is a groove suitable for placing the patella at the front and lower end of the femur, which can make the patella move up and down in the groove very satisfactory. The cartilage on the surface of these joints can absorb vibration and bear pressure until problems occur.
There are two large cartilage discs between femur and tibia, which are called medial meniscus and lateral meniscus respectively. Cartilage, especially meniscus, is the most vulnerable part of human body during exercise.
The bigger problem is that the patella itself has no blood and lymph supply, so it recovers slowly after injury. Knee injury is because cartilage, meniscus and other tissues that are not easy to regenerate are injured or damaged. Unlike muscles, these tissues can grow rapidly. To help them grow, they need to eat a lot of glucosamine (glucosamine salt, not calcium), which has limited effect and is almost non-renewable. So when we realized this, it was too late.
Because the posterior surface of patella is mostly cartilage structure, it forms patellofemoral joint with femoral condyle and intercondylar fossa. When the knee joint is straight and the quadriceps femoris is relaxed, the lower part of the patella gently touches the femoral intercondylar fossa; When the knee joint flexes to 90, the upper part of the patella contacts the intercondylar fossa; When the knee joint is fully flexed, the whole articular surface of the patella is close to the intercondylar fossa. During the long-term flexion and extension of the knee joint, the patella and thigh repeatedly rub and collide, causing cartilage surface wear and patella strain. After a long time, it will cause abrasions and injuries, such as inconvenient movement, degeneration, lameness, disability and so on. If you press the patella in front of the knee joint with your hand, you will often feel particularly dull pain and friction.
Patella strain (chondromalacia patellae) mostly occurs in young people, such as track and field, mountaineering and dancing. The incidence rate is 36.2%, especially for women aged 30-40, and the incidence rate is as high as 50%. And if not treated and controlled early, it will cause further degenerative diseases.
Patella strain attacks slowly. At first, I felt dull pain and fatigue in my knees. Later, I felt pain around the patella, which aggravated after fatigue. It is difficult to go up and down stairs, which seriously affects walking. Pathologically, patellar strain first causes or superficial chondrocyte necrosis, which destroys the function of cartilage to absorb nutrients from synovial fluid, but there is no obvious change in early X-ray examination. Because the cartilage loses elasticity, the periosteum adjacent to the patella is secondary to chronic inflammation, and edema, vasodilation and hyperplasia will occur around the patella, leading to patella softening. If the disease continues to develop, a series of degenerative changes such as cracking and peeling will occur in the patella. X-ray film can also reflect the phenomenon of joint stenosis, rough patellar articular surface, hyperosteogeny at patellar margin and narrowing patellofemoral joint space.
There is lubricating fluid between the soft tissues of the knee. When the leg is straight, the distance between the thigh bone and the calf bone is the largest, and a certain space can be created between the soft tissues. Legs are lifted by force, the essence of which is muscle strength, so lubricating hydraulic pressure can be put in the soft tissue gap of the knee to supplement nutrition to the soft tissue, which can strengthen the wear resistance of the soft tissue for a long time.
You can't practice your knees. We can only reduce the burden on the knee joint, protect the knee joint and improve the nutritional status of the joint by increasing knee lubrication and strengthening leg muscles.
Lose weight, change load, run and jump to swimming and cycling activities. Avoid climbing mountains and stairs and other sports that aggravate the symptoms of the disease.
First, increase night lubrication.
Rub the lower edge of your knees with your fingers before climbing the mountain to promote the protection of your knees at night.
Sit on the bed with your legs straight and flat. When your legs are straight, lift them forcibly and repeat them a hundred times. Attention! Not two legs at the same time, but apart. The reason and function of this method:
Stretching the elongated hamstring muscle and patellofemoral joint is beneficial to reduce the chance of knee injury.
Second, strengthen leg muscles.
Many injuries occur when physical strength is weak. When the thighs are tired, people will unconsciously lock their joints when walking. Locking the joint is to straighten the leg, which can reduce the burden of thigh muscles and temporarily relax the muscles, but it is easy to cause knee strain, which will lead to knee impact injury, ankle strain, ankle sprain and lumbar muscle strain.
Muscles with well-developed muscle training, especially quadriceps femoris, can reduce the pressure on the knee and minimize the damage to the knee under certain circumstances. Usually do more leg muscle exercises to minimize the tolerance to the knees. Consciously strengthen the exercise of quadriceps femoris (anterior thigh) and cruciate ligament, strengthen the muscle strength of quadriceps femoris and thigh (such as weight-bearing squat), and combine muscle stretching, walking, riding or sticking to the wall to pave the way for the smooth movement of patella in the femoral end fossa. However, the inflexibility should not exceed 90 degrees and should be guided by a fitness instructor.
The following seven kinds of exercise have rehabilitation effects:
1 Weight-bearing lift heel (toe) mainly exercises the soleus muscle of the calf. When the lift heel is put down, the thigh muscles tighten, and it is also practiced on the thigh muscles, so that the thigh muscles stretch and lengthen.
2 Lie on your back, straighten your legs, lift off the bed for about 30 degrees, and hold for 10 second, and train every 10-20 times/group until your muscles feel sore. You can also tie a sandbag with a proper weight to your calf for straight leg lifting training.
3 standing pile practice: holding the ball pile, holding the stump, knees slightly bent, like standing or not, hips slightly heavy, like sitting or not sitting, half an hour a day; "Ma bu" or "Ma bu" or "Ma bu", bend the knee and hip joint, but not less than 90 degrees, and do semi-squat for 3-5 minutes. Use 1 group every 2-3 times, twice a day.
4 Joint range of motion exercise: Because osteoarthritis often has obvious flexion limitation, flexion training is very important. Take the supine position, one lower limb is straight, the other knee joint is bent, and the hip joint is bent, so that the thigh is as close as possible to the chest wall, and then practice the other lower limb alternately. You can also bend your knees and hips by hand to increase joint mobility.
Swimming and walking are the best exercises, which can not only increase the bearing capacity of the knee joint, but also exercise the muscles and ligaments around the knee joint. Exercise in water: Water has buoyancy, which can reduce the load of weight on joints, and water has resistance, which is beneficial to muscle exercise. Walking training and swimming in water are recommended. Swimming is also an excellent aerobic exercise, which can enhance physical fitness. Walking slowly: Walking slowly is a simple and practical form of exercise, which is beneficial to cartilage metabolism and prevents muscle disuse atrophy.
6 sit-ups, push-ups, bridge arch, repeated practice of lifting and retreating on the supine bed, and imitation of pedaling bicycles are all the best exercises for patients.
7. Isometric and isokinetic muscle strength training: Go to a hospital or rehabilitation center and train the muscle strength of the corresponding parts with special equipment. If conditions permit, isokinetic muscle strength exercises can be carried out, which will help to restore muscle strength better and faster.
Targeted muscle exercise does help, but it is only "help".
Third, reduce the wear and tear of the knee.
Sometimes you can't wear your knees when you go out to play seriously, but it's too expensive to wear them when you exercise; Do some exercises that help protect your knees, some exercise muscle strength and symmetry, and some stretch.
When the leg is bent, the soft tissue in the knee is in close contact, and the lubricating liquid can not protect the knee well. Mountaineering with heavy load for a long time, resulting in hard friction of knees and aging of soft tissues. All prolonged knee flexion will lead to soft tissue aging.
1 Losing weight is the first choice for obese people to protect their knees. Overweight weight hurts their knees all the time.
Pay attention to the posture of walking and working, don't walk and work with your body twisted, and don't land on one side. Flexion and extension of knee joint under load should be avoided as much as possible. Acute and chronic soft tissue injuries at the knee joint must be avoided, especially when lifting heavy objects. People who are engaged in semi-squatting work or often bend over and stand with loads should be careful not to work continuously for too long. Avoid squatting for a long time, because the weight of the knee joint when squatting is 3 ~ 6 times its own weight. At work, it's best to squat (such as car mechanic and sand Turner) and sit in a low position (sitting on a small bench), sit and stand for a long time, and often change posture to prevent the knee joint from fixing a posture and exerting too much force.
Walking skills
It can be found that mountaineers in all regions are flying around on the grass when walking. In fact, we can find that when they walk, their feet are flat on the ground, their feet are not high, their knees are not bent, and they rely on their thighs and bodies to lean forward, so that when their center of gravity moves rapidly, they can ensure smooth and light progress with little vibration.
3. Wear soft-soled shoes with thick and elastic soles to reduce the impact on the knee joint and avoid the wear of the knee joint. Women should choose comfortable flat shoes, wearing high heels will cause a heavy burden on the knee joint. If you choose jogging, you must choose a good pair of running shoes. High-intensity trainers should change a pair every 2-3 months, and moderate-intensity trainers should change a pair of shoes every six months.
Warm up before every training. Walking and stretching 15 minutes is a good way to warm up. When practicing leg press, don't suddenly lift your legs too high to prevent your knees from overstretching. When practicing Tai Ji Chuan, don't squat too low, and don't play several sets in succession to prevent knee joint overload injury.
Cycling rarely hurts the knee, but racing and mountain sports increase the injury. When riding a bicycle, it is necessary to adjust the height of the seat, so that it is appropriate to sit on the seat with two pedals, and the legs can be straight or slightly bent. Too high or too low when riding uphill or pedaling hard will have adverse effects on the knee joint.
When the knee joint is cold, the blood vessels contract and the blood circulation becomes worse, which often aggravates the pain. Therefore, when the weather is cold, we should pay attention to keep warm, and wear knee pads when necessary to prevent knee joints from catching cold, especially in summer.
Soft land, gravel slopes and snow are all knee-friendly; Avoid running on hard ground such as cement, and the treadmill should adjust some slopes. When the foot touches the ground, it should follow the foot, and the sole of the foot should follow the toe, so that the whole foot can roll across the ground smoothly and avoid jumping. People with knee osteoarthritis should go up and down stairs, climb mountains, stand for a long time and lift heavy objects as little as possible to avoid overloading the knee joint and aggravating the condition.
8 crutches, knee pads, trekking poles and straps also have certain therapeutic effects on arthritis. It is best to use two trekking poles, one with vibration isolation and the other without vibration isolation. There is no vibration and it can be used as a support for backpacks.
Anti-vibration trekking poles are the main buffer support when going downhill. The impact of going downhill is very heavy, including ankles, knees and lumbar vertebrae, so I am used to stretching poles. When I went down the mountain, I supported the road ahead with a pole, just like walking on four legs, with my hands stretched out into two legs. The key is to use the strength in place, let the vibration force be shared on the wrist and arm, and reduce the impact of the lower limbs, so the trekking pole with anti-vibration can reduce the fatigue of the wrist and arm.
Fourth, reasonable burden.
If the load exceeds 1/4 of the body weight, the rhythm should be controlled from the perspective of protecting the knees; If it exceeds 1/3, we should consider how to reduce the impact. Consider using trekking poles and braces.
People who like to carry big backpacks and abuse themselves may break through the endurance of their carefully maintained knees in a few days, leaving behind the root of the disease that has not healed for many years.
Five, a reasonable diet
You should eat more foods containing protein, calcium, collagen and isoflavones, such as milk, dairy products, soybeans, bean products, eggs, fish and shrimp, kelp, black fungus, chicken feet, pig's feet, leg of lamb, beef tendon and so on. These can not only supplement protein and calcium, prevent osteoporosis, but also grow lubricating fluid for cartilage and joints, and also supplement estrogen to make bones and joints better.
Researchers at the University of Sheffield in the United Kingdom found that there are two compounds in green tea: EGCG (translated as "epigallocatechin gallate") and ECG (translated as "epigallocatechin gallate"), which can hinder the production of enzymes that destroy cartilage and help prevent osteoarthritis.
Six, traditional Chinese medicine oral method
Take 60 grams of clove, 60 grams of banksia rose, 60 grams of dragon's blood, 60 grams of catechu, 60 grams of cooked rhubarb, 60 grams of safflower, 30 grams of tree peony bark and 20 grams of licorice root, grind them into fine powder, refine honey into pills, and take yellow wine 10 grams every morning and evening. This prescription has the effects of promoting blood circulation, removing blood stasis, promoting qi circulation and relieving pain.
Xiao Huoluo Dan, a Chinese patent medicine, can be taken orally, 3g each time,/kloc-0 each time in the morning and evening. Has the effects of warming and cooling, resolving hard mass, promoting blood circulation and dredging collaterals.
Traditional Chinese medicine believes that kidney dominates the waist and knees, and weakness of knees is closely related to kidney deficiency. Guilingji, Bushen Shen Qiang Pill, Jingui Shenqi Pill and Liuwei Dihuang Pill can be selected. It is best to consult a doctor and treat it dialectically.
Seven, external treatment of traditional Chinese medicine
Take Notopterygium Rhizoma, Radix Angelicae Dahuricae, Radix Angelicae Sinensis, Asari, Daphne genkwa, Radix Paeoniae Alba, Fructus Evodiae and Cortex Cinnamomi, and add appropriate amount of onion. First, grind the first eight herbs into fine powder, take an appropriate amount of powder and onion each time, mash and mix well, fry in vinegar, wrap in cloth and iron the affected area, once a day/kloc-0. It has the effects of warming channels, dispelling cold, expelling wind and relieving pain.
Take 60 grams of Angelica sinensis, 60 grams of frankincense, 65,438+05 grams of Sanguis Draxonis, 60 grams of Catechu, 65,438+05 grams of Notopterygium Rhizoma, 30 grams of Radix Angelicae Dahuricae, 30 grams of Cortex Moutan, 90 grams of Rhizoma Drynariae, 60 grams of Carthami Flos, 60 grams of Rhizoma Corydalis and 60 grams of Radix Saposhnikoviae. Grind the medicine into fine powder and mix it with vaseline to make paste, and apply it to the affected area every day. Has the effects of relieving swelling, removing blood stasis, relaxing muscles and tendons and relieving pain.
Eight, massage massage method
① The patient takes a sitting position and keeps it from the affected thigh to the knee joint for several times. First, relax the muscles, then massage the pain, from light to heavy, and finally massage gently, and massage slowly for 3 ~ 5 minutes until the joints are not hot.
② Click Xue Hai, Yanglingquan, Yinlingquan, Weizhong, Weiyang, Heyang, Jincheng and Chengshan of the affected limb.
③ The operator holds the center of the affected knee with one hand, the medial and lateral gaps of the knee joint with his fingers respectively, and the ankle joint with the other hand to slowly straighten the affected limb.
④ Flex the affected limb so that the heel is as close to the hip as possible, and then straighten it for 3 ~ 5 times.
After the above massage, muscle spasm can be relieved, local blood circulation can be strengthened, and swelling and pain can be reduced, tendon adhesion and muscle atrophy can be relieved.
Nine, hot compress leg muscles after exercise.
Examination method of knee soft tissue
Lie flat on the bed (if you sit on the bed with your legs straight, your legs must be straight, otherwise you won't feel anything), aim your hands at your knees, hold them, make sure your knees can't move back and forth, and then apply force to your thighs. If you feel obvious pain, it means knee soft tissue injury. If the pain is severe, it means that the soft tissue is aging.
Eleven, once there is pain in the knee joint, it is necessary to actively treat it and take simple treatments such as hot compress and physical therapy massage to control the symptoms. If the pain still persists, you should see a doctor.