“I did a load of squats and now I have knee pain!”

A potentially irritated structure are the menisci!

What are the menisci?!

There are actually two menisci (meniscus = singular) located within the knee, one the the lateral side (outside) and one on the medial side (inside). They are crescent shaped structures (meniskos in Greek 🇬🇷 means crescent…who knew??) made of fibrocartilage (a type of tissue in our body).

Mechanism:

➡️Usually internal rotation of tibia (foot twisted inward) with flexion (bending) of the knee (I.e. improper squatting technique or other exercises)

Characteristics:

▶️pain on the joint line (located just under the knee cap and inwards-see diagram) as well as inside of the knee

▶️locking

▶️painful clicking

▶️swelling of the knee

What can you do?

✔️improve your exercise techniques

✔️Increase hip and ankle mobility and control

✔️Electric Muscle Stim

✔️Work on balance

✔️Acupuncture

Why do we even have these menisci, you ask?

1. They allow for effective joint movement within the knee

2. They allow for the transfer of sheer and tensile loads from the soft tissue (muscles, ligaments, etc) to the bone

3. They increase the contact area and allow for a decrease of compressive forces (bone on bone contact – thigh bone on shin bone)

4. Shock absorption – which is aprx 20% less in knees without menisci

5. Stability

6. Lubrication and nutrition- the coefficient of friction of the knee joint is increased by 20% following meniscectomy (removal of the menisci)

7. joint proprioception

Clinical pearls:

-Innervation: Recurrent perroneal branch of the common perroneal nerve (free nerve ending are only present in the outer 2/3)

-Relatively avascular structure: receiving blood only to the peripheral vascular zone (outer 2/3). The inner 1/3 is non vascularized (receiving nourishment only through means of diffusion)

-3 distinct mechanoreceptors found: paccinian, ruffini, golgi tendon organs

-After the ACL (anterior cruciate ligament), the posterior horn of the medial meniscus is the most important structure resisting anterior

Kids and strength training: 

Sports injury

Children and sports injury

Should my child participate in strength training?

Throughout my years of personal training and even now as a practitioner, parents often ask this question. 🤷‍♂️

Many parents want to enroll their kids in strength training in order to give them a competitive edge in sports and not only that, parents of overweight children are often looking for strategies to combat this ever growing (dare I say, pandemic). These parents are often deterred away from weight training due to concerns about musculoskeletal injuries and epiphyseal (growth plate) fractures.

There has been a lot of research into this topic and the conclusion is that with adult supervision, proper equipment, and realistic expectations, strength training programs designed for children and adolescents are safe and effective.

https://www.instagram.com/p/BbhSgLCH7Cv/

Nevertheless, keep the following in mind:

▶️Qualified adults should provide supervision and instruction.

▶️Appropriate clothing and footwear must be worn in the training area.

▶️The training environment should be safe ⚠️

▶️Realistic goals consistent with the needs and abilities of each participant should be established.

▶️Warm up with at least 10mins of light aerobic and stretching exercises

▶️Focus on participation and technique instead of the amount of weight lifted

▶️Depending on individual needs, goals, and training time, a variety of single and multijoint exercises as well as balance, agility and cardiovascular exercises should be incorporated.

▶️Regularly review progress.

▶️When necessary, adult spotters should actively assist the participant, in the event of a failed repetition

▶️2-3 nonconsecutive training sessions/week are appropriate.

▶️ Increase the resistance gradually as strength improves

▶️The strength-training program should be systematically varied over time to optimize training adaptations and prevent boredom.

▶️Participants should be encouraged to maximize their athletic potential by optimizing their dietary intake (e.g., adequate hydration, proper food choices).

—

Dr. Talha Farooq

Chiropractor

Medical Acupuncture Provider