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Fitness Injury Prevention Series Part 2 Examining Knee injuries for Police Recurits and Officers

By David Wehrenberg

In part 1 Fitness Injury Prevention Series Part for Police Recurits and Officers we discussed the defenition of strains, sprains, bruises and other common injuries if you didn’t read it check it out part 1.

In Part 2 we will Examine the Knee and injuries. Increasing numbers of police recruits and officers have been paying the price of physical fitness training in the academy with increased knee injuries. For some recruits -particularly those who are pushed hard and overdo or who don't properly train or warm up-these benefits can come at a price: Severe knee injuries.

Fortunately, most police recruit and officers training academy knee injuries can be treated effectively, and most police recruits and officers who suffer injuries can return to a satisfying level of physical activity after an injury. Even better, many police fitness knee injuries can be prevented if recruits and officers take the proper precautions.

Knee Injuries

Because of its complex structure and weight-bearing capacity, the knee is the most commonly injured joint. Each year, more than 5.5 million people visit orthopedic surgeons for knee problems. Knee injuries can range from mild to severe. Some of the less severe, yet still painful and functionally limiting, knee problems: Police fitness training recruits have there share of knee injuries.

Runner's knee also known as chondromalacia (pain or tenderness close to and under the knee cap at the front or side of the knee), The cause of this pain is due to poor knee cap alignment (tracking), the knee cap is constantly rubbing over side of the femur (thigh bone) where there is no cartilage. Thus causing the cartilage under the knee cap to wear away causing bone to bone rubbing and pain. The reason for the poor knee cap tracking is the inside (medial) thigh muscle is weaker than the outer (lateral) thigh muscle. This is the most common tracking problem, however on rare occasions it can occur that the knee cap is pulled to inside. Once the cartilage is damaged under the knee cap it can not be repaired, a surgeon can clean up the and smooth out the cartilage. But this alone will not solve the problem because the knee cap is still tracking improperly.

SO what do police fitness training recruits to do?

There are two solutions:

  1. Start conservatively-Strengthen the medial muscle - by performing a quad leg extension. This is important key. When performing the exercise your feet MUST be pointed toward the outside of your body, then start with legs at 45 degrees and extend to 1 degree never completely lock your knee it will cause undue stress on the joint. Ok, so isolating the medial muscle will strengthen it and as the medial muscle gets stronger it will pull the knee cap back into its correct alignment and if you haven’t shredded the cartilage the pain will go away.

    I have 59 year old male client who was having knee pain for years and his doctor told him what the cause was but did nothing to help him. Once I evaluated him showed, him how to perform the exercise correctly in four weeks the pain was completely gone from both knees.

    To start the police fitness correction exercises and solve this problem you can implement this workout. Note check with your doctor before rehabbing your self. Week 1 perform leg extension 1 set of 15 repetitions (times) week 2 perform 2 sets 15 reps and week 3 three sets 15 reps. Use a weight that will not hurt your knee when it is easy to get 15 reps increase the weight by 5 pounds .

  2. Surgery would be the next step if strengthening the medial muscle does not work. The most common surgery is called lateral release. That is where they cut part of the lateral quad tendon to allow the knee cap to track properly. This should be a last resort. In some cases medial muscle gets stronger but the knee cap still will not track right. This was such the case with my wife, I trained her but two no avail, she ended up have a congenital knee problem which caused her pain and after the surgery she still has some pain. She takes supplements to help keep knee lubricated to ease the pain.

Police fitness recurits should Always, always use surgery as a last resort.

Patella tendonitis, also called tendinosis (marked by degeneration within a tendon, usually where it joins the bone). This is an inflammation of the tendon, cause is usually due to overuse not allowing the knee to rest enough between work outs.

Answer: Rest and Ice See RICE method as described in part 1

More severe police recruit fitness training knee injuries can result from a blow to or twist of the knee or from running to hard, too much, or without proper warm-up.

More severe injuries include bone bruises or damage to the cartilage or ligaments we discussed what bruises were in part 1. There are two types of cartilage in the knee. One is the meniscus, a crescent-shaped disc that absorbs shock between the thigh (femur) and lower leg bones (tibia and fibula). The other is a surface-coating (or articular) cartilage. It covers the ends of the bones where they meet, allowing them to glide against one another.

Tearing of cartilage will usually require what I consider minor surgery only because recovery time is quicker usually weeks not months. Remember use R I C E method then see your doctor. As far a prevention there really isn’t much you can do to prevent a tear except keep the knee muscle around the knee strong to minimize the occurrence and good support work out shoes.

The four major ligaments that support the knee are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL).

The most common knee (sprain) remember the definition of sprain is a stretching , tearing or complete rupture of a ligament which is attaches bone to bone. Anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are the common knee sprain, they occur when there is a blow to the outer part of the knee and the knee is in slight flexion stabilizing the knee or a quick twist if the knee foot planted in a stable position. The force then causes the tear.

A grade 1 tear is slight stretching little swelling and you recover with in a few weeks. Grade 2 is partial tear and Grade 3 complete tear these require surgery and you are out of action up to a year or more. The posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL) is not that common of an injury except in the rare cases of such forces that all ligaments and cartilage are damage.

Important I can’t stress this enough when injury occures use R I C E method and see the DOC.

Okay as I said before the best way to prevent injuries is to keep the muscles strong so here is a police fitness training routine to start working out the knee.

Exercise number #1

This exercise does not require any equipment. Wall squats are easy to perform and it will increase strength quickly plus there safe. So find your self a wall slide down the wall to 90 degrees like your sitting in a chair and stay in that position for 1 minute, you probably will not be able to hold hit that long, you may have to work your way up but the best you can.

So do 3 sets of 10 repetitions one minute in position and thirty second rest between each rep. In between sets move off the wall and give your self 1-2 minute rest than move onto set two and three.

3 sets x10 reps x 1 minute hold. Do these for three weeks, if you have knee pain give your self a little more angle for less pressure on knee by stepping a few more inches away from the wall.

From this exercise move to leg presses I do not recommend squats not only can it damage your knees but also injure your back. Start with a weight you can lift 15 times for three sets. Then in three weeks use a weight you can lift 8 times for three sets.

Ok that’s it for PART 2 watch for PART 3 of our series the ANKLE.

If you missed part 1 here is the what RICE means.

The RICE method stands for:

R=Rest

I=ICE, place ice on injury for 20 minutes than off 40 minutes DO NOT put ice directly on skin use a damp towel.

E=Elevation, of the injured body part the lower limbs, I.E. ankle, knee

C=Compression, wrap the injury with an elastic bandage: Note do not wrap the bandage to tight and cut off circulation or sleep with it on.

About the Author:

David Wehrenberg is a certified Athletic Trainer and Former Police Officer located in Maryland, District of Columbia, Northern Virginia. His website is http://www.policefitnessbootcamp.com