Knee Injury Prevention and the Importance of a Correct Warm Up
The knee plays an incredibly important role within the lower limb. It helps communicate movement between the foot/ankle and the hip. A lot of force is generated through the knee in all sports. There are multiple muscle groups that work to move the knee. This places a greater need to take special care of the knee before exercise to help with preventing knee injury.
There are multiple groups of muscles which move the knee and also move either the ankle or hip joints. This is of particular importance when considering the kinetic chain.
The kinetic chain is the link of all joints required for movement in a specific movement pattern. We are more likely to produce more efficient forces through the body if multiple joints are able to work in unison to pass force from one area to another. If there is a disturbance in the kinetic chain at one joint, it can subsequently affect how the adjacent joints transmit force and can increase the load. As a result of this, what happens at the knee can affect what happens at the hip or ankle and vice versa. So, it’s incredibly important to help best prepare the knee for this and make sure it’s warmed up and primed before exercise. But how exactly do you warm up the knee?
The importance of a warm up
With any form of exercise, a warm up in incredibly important. Warming up before exercise has shown to increase synovial fluid in the joints (helps the joint move more efficiently), increase neuromuscular control, reduce perceptions of soreness, and improve blood flow around the body.
All of these benefits can positively affect how the knee performs when it comes for sport.
There are mountains of evidence that support the claim that static stretching should have no place in a warm up before exercise. Research shows that is can decrease muscle power and hinder performance. If you’re someone who likes to stretch before exercise perhaps we can recommend using a foam roller instead?
New research shows that using a foam roller can actually increase muscle length, increase blood flow, improve neural activation and greatly reduce perceptions of stiffness before exercise in as little as 30 seconds of rolling on each body part (Wiewelhove et al, 2019). This study also found that rolling before exercise showed slight improvements to sprint times, however, rolling did not show increases to other areas of performance, which is why it’s still important to add a dynamic warm up after rolling to prepare for exercise.
When considering the knee, there are 3 important muscle groups to adequately warm up before exercise: quadriceps, hamstrings, calves. It is also important to address the hip adductors and gluteus muscles of the hips as they also have a role in knee stability during movement. All of these muscles can be warmed up easily and by giving these muscles good blood flow we can correctly prime ourselves for exercise.
We have included a list of exercises you can do to target each of the aforementioned muscle groups and will help with preventing knee injury.
Great Exercises for Preventing Knee Injury
- These are a great exercise to help activate and prepare your glutes (Gluteus Medius) before exercise as it incorporates both abduction and external rotation of the hip joint, some important movements controlled by the glutes! It also works to prevent pelvic drop during exercise. Performing a ½ squat while doing the exercise also adds quadriceps into the exercise. We recommend 2-3 sets of 12-15 steps each way before exercise.
Wall Sit or Spanish Squat
- Wall sits are a fantastic activation exercise. They improve function in the gluteus muscles as well as the adductors and quadriceps group. This exercise targets multiple muscle groups so it’s a handy tool if you like to speed through your warm-up. To incorporate your calves in this exercise you can lift your heels off the ground and target 4 muscle groups! We recommend 2-3 sets of 45-60 second holds before exercise.
- Spanish squats are a very good knee based exercise, particularly if you’re already dealing with knee pain. It’s performed by placing a thick band just behind the knee and squatting. Make sure to keep your back up nice and tall and lean back into it, (The band gives you more ability to squat deeper). Spanish squats target the quadriceps, gluteus muscles, as well as the adductors if the squat is deep enough. We recommend 2 sets of 10.
Glute Bridges/Hip Thrusts and/or Hamstring Sweeps
- Glute bridges target the hamstrings and glutes, two muscle groups that are incredibly important in running and kicking sports. When performing glute bridges, the further your feet are away from your body, the more hamstring activation will occur. Recent research found that hip thrusts recruit a significantly higher proportion of gluteus maximus and hamstring muscle fibres compared to a standard squat. If you’re someone who struggles with glute activation, then look no more! If you also have a band, you can place it around your knees and target the gluteus medius muscle too. We recommend 1-2 sets of 30 second holds for glute bridge or 2×12 reps of hip thrusts.
- Hamstring sweeps are a good dynamic exercise for the hamstrings, and they can often result in decreased perception of hamstring stiffness. 10 hamstring sweeps per leg will do the job.
Calf Raises and Bounces/Pulses
- The gastrocnemius, which is the most visible calf muscle, works to flex the knee. This is why it’s important to warm up the calves for knee based injury prevention too. Bounces/pules are easy to perform to increase the reactiveness of the calves to exercise. To bounce, perform small, quick jumps on the spot. Pulses are almost exactly the same but the ball of your foot stays in contact with the ground during the movement. We recommend 2 sets of 10 calf raises and 10-15 seconds of pulsing/bounces.
If you would like to learn more about preventing knee injury and warming up the knee, or would like a personal program, make an appointment with us at Pivotal Motion Physiotherapy today. With a wealth of knowledge and a friendly smile, our physiotherapy Brisbane team will happily get you back on track!