Friday, April 3, 2015

Friday #Fitness 10 - Patellar Tendonitis Jumper's Knee

Since fitness is my other passion, I occasionally devote a blog post to that aspect of my life.  I've been teaching group fitness classes--mostly step aerobics but also Zumba and BodyPump--since I was 22 years old.  At the risk of allowing people to calculate my age, that makes it 24 years of teaching high impact classes with no breaks, with the exception of a few weeks around my two pregnancies.  So, it's safe to say my joints have taken a beating over such a long time of repetitive exercise.

Oddly enough, I've stayed mostly injury-free.  I may be old school, but warm-up dynamic stretching and static cool-down stretching are two elements I refuse to skip during class.  This helps to prepare muscles to perform and then releases tension after the workout.  Every once and a while I'll pull a muscle, but it's a rare occurrence, thankfully.

Tendons are a different story, however.  All those years of jumping around have led to something actually called "Jumper's Knee".  Both my knees are affected, at this point.  I could stop teaching and switch to some low impact workouts, but I love what I do.  After 24 years, I'm pretty good at it, and I have a large following of gym members who enjoy my classes.  Plus, cuing a class through an hour of complicated routines forces me to focus on one thing and one thing only: remembering what move comes next, and calling it out several beats before we do it.  This may sound stressful but it's actually almost like meditation for me.  Since I'm a writer, my mind is usually filled with plots and characters, scenes and dialog, twists and reveals, etc.  I tend to get wrapped up in my fictional world, and if things aren't going right there, I get very cranky and obsessive.  Writer's block is not something I handle well.  But if I'm teaching a class, I honestly cannot think of anything other than what I'm doing right at that moment.  It's a wonderful mental break, and that combined with the aerobic activity usually allows my mind to reset, which then allows my imagination to provide a solution to whatever's got me stuck.

So quitting isn't an option.  I have to manage my Jumper's Knee, which is technically known as Patellar Tendonitis.  The patellar tendon connects the patella, or kneecap, to the shin bone.  Inflammation and tiny tears result from repetitive actions and overuse.  In my case, it presents as an ache beneath the kneecap, especially upon bending the knee, and the sensation of weakness in the knee.  I should note here that I've been professionally diagnosed, and I've gone through x-rays, ultrasounds, and physical therapy for this condition.  Since I want to stay active--and keep my job--I use what I learned from both my doctor and PT to keep the condition under control.

Modification: I can no longer do a lot of high impact moves.  High impact essentially means both feet are off the floor at the same time.  Even if I'm instructing my class through these moves, I modify my own moves to protect my knees.  Half-jacks instead of full jumping jacks, lunges on the floor instead of off the step, a march around instead of a hop over the step, etc.  My class knows they have options as well, and they adjust high impact to low impact or vice versa as necessary.

This is the brace I works
great for my needs.

Knee Support: Various types of knee braces are made for this condition.  They all wrap around the knee at the patellar tendon and support and compress the area.  At first, I used a single strap designed with a little rubber tube to cushion the patella and distribute the pressure.  Now, I use something that provides even more support and protection - a "multi-action" brace that wraps around the top of my knee as well as below and has a thick (adjustable) padded buttress to cradle my knee.  The ones I use are made by McDavid.

Shoe Inserts: Since my feet never hurt, it was a revelation to find out I now have flat feet.  Apparently, the arch can fall as we age, and when my doctor took a look at my feet, he noted the problem could very well be contributing to my knee pain.  Many athletic shoe stores now have machines that "map" your feet and pinpoint areas that need support.  I went immediately to have this done, and it turned out my fallen arches were resulting in pronation...which can throw off the alignment of the knees.  Now I put supportive inserts into my workout shoes, and it makes a huge difference.  The ones I like are New Balance Arch Support Insoles.

Ice and Heat: Immediately after class, I take five minutes to ice down my knees.  This reduces any inflammation in the area, controlling pain (for me) without the use of medication.  Hours later, I'll use heat in the form of a cloth bag I made filled with rice.  After microwaving it for about 2 1/2 minutes, I put my feet up (great excuse to take some time out to read!) and place the bag across my knees.  This helps bring blood flow to the area, stimulating healing.

These are the things that work for me, and allow me to continue staying active and doing a job I love...especially important since my other job requires a lot of time spent sitting in front of a computer.  If anything has worked for you, I'd love to hear about it!


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