Knee Pain and Knee Cap Problems Between the Genders.
Women are more prone to knee pain and knee cap problems. I bet that you did not think that there were differences between the genders when dealing with knee pain and knee cap problems, oh but there is a difference. The difference is that women are more prone to knee pain and knee cap problems, because of genetic factors. Women have four major factors that make them more prone to knee pain and knee cap problems, even in non-contact sports (see Volleyball Drills for Women). The three are gender factors and are: Joint Suppleness, strength and the “Q Angle”. The non-gender factor that we all can face is knee pain and knee cap problems associated with knee cap tracking problems. I will discuss all four of these factors along with exercises to help correct them. The exercises are not only for people suffering with knee pain and knee cap problems, but for those people who want to be proactive and avoid contracting knee cap issues and knee pain in the future.
1) Joint Laxity
Due to genetics, women tend to have softer and more supple joints. This laxity is even greater during the menstrual cycle because of an increase hormone level. The laxity allows the joints to move a little more, and in the knee cap this causes instability. This is one factor that there really is nothing that can be done for to improve the joint laxity.
On the other hand, strength is a factor that is completely under your control to change. Because female tend to be less strong than males, they tend to incorporate different techniques when landing from a jump. This can be seen in the fact that women will incorporate their quadriceps when landing instead of their hamstrings and glutes. This method of landing places makes the knee cap more vulnerable by placing a lot more stress on the ACL.
3) The Q Angle
What is the Q Angle and what does it have to do with knee pain and knee cap problems in women? In simple terms, the Q Angle is the the width of the hips; and women will tend to have wider hips and larger Q Angles. The Q Angle is the measurement of the angle at which the femur meets the tibia. The measurement is done by creating to intersecting lines. The first line is from the center of the knee cap the top of the anterior crest of the pelvis. You can sort of feel it by finding the upper most part of your frontal pelvis. The technical term for this is called the anterior-superior iliac spine of the pelvis. The other line is drawn from the knee cap to the tibial tubercle. The tibial tubercle in the bony protrusion on the anterior top part of the tibia about one inch below the knee cap. The Q Angle on average is larger in females than in males. The idea is that the large angle places more stress along the knee joint and might also be a factor contributing to foot pronation.
Injuries Associated in Women with a Large Q Angle
There are three major injuries associated with women with a large Q Angle, they are: Runners Knee, Softening or Damage to the Knee Cap Cartilage, and ACL Injuries.
1) Runners Knee
The technical term for this type of knee pain is Patellofemoral pain syndrome. It is the knee pain and knee cap problem that occurs under and around the knee cap. The bad part about this knee cap pain is that it actually gets worse as your activity increases. You may also notice knee pain when descending stairs.
What causes this is that the large Q Angle will cause the quadriceps to pull on the knee cap and this leads to poor knee cap tracking. Not only will this cause knee pain and knee cap problems, it can lead to a muscular imbalance.
The three muscle of the quadriceps are the Vastus Laterallis, Vastus Intermedius, and the Vastus Medialis. All three of these muscles have their origin (considered the non-movable part that attaches closest to the mid-line of the body) along the top of the femur, and have their insertion (the part distal to the origin) on the knee cap and the top part of the tibia. With this large muscle group surrounding the top of the knee cap, you can imagine how important it is to keep them strong to help prevent knee pain and knee cap problems. However, it is equally as important to maintain strong hip muscles to help keep the knee cap tracking properly.
2) Softening or Damage to the Knee Cap Cartilage
The medical term for this type of knee pain is called Chondromalacia. This causes knee pain and knee cap problems because the cartilage underneath the knee cap becomes soft or becomes damaged. The Q Angle basically speed the wearing down process of the cartilage.
3) ACL Injuries
With women having a larger Q Angle, they tend to see more ACL injuries than men, because the Q Angle places more stress on the knee cap and cause it to be less stable. Recovering from an ACL Injury is a long process.
4) Knee Cap Tracking Problems
Knee cap tracking problems are also called patellar tracking disorders, I will refer to them as knee cap tracking problems. Knee cap tracking problems arise when the knee cap shifts out of place during leg bending or straightening. Most people that have a knee cap tracking problem will experience the knee cap shifting to far to the outside of the leg. The knee joint is very complex with all of the muscles, tendons, and ligaments holding it together.
Simply put, there is cartilage underneath your knee cap that helps guide it along a grove at the bottom of the femur. If this cartilage becomes damaged or weakened, the knee cap can rotate off track and shift out of the grove. Because the knee cap is such a complicated joint, if the muscles, ligament and tendons are too tight or too loss; this can also cause the knee cap to have tracking problems.
Exercises to help with Knee Pain and Knee Cap Problems
As I mentioned earlier, the quadriceps play an important roll in the health of the knee cap. They help keep the knee cap stable and in place. Some basic exercises for developing the quadriceps are: Leg press, lunge, leg extension, basic squat.
Low Impact Exercises
Some great low impact exercises that will help with knee pain and knee cap problems are cycling and swimming. Both of these activities reduce the stress placed on the knee cap during exercise.
Here is a list of isometric exercises: quad sets, straight leg raises, static hold exercise, knee flexion, squats against a wall, and knee extension.
Hip Strengthening Exercises
As mentioned earlier in the discussions about the Q Angle, to avoid knee pain and knee cap problems, it is imperative to have strong hip muscles along with strong quadriceps muscles. Here is a list of hip exercises; one-footed knee bends, bridging, hip extensions lying face down, abductor squeezes, hip abductors lying sideways, and hip abductors standing.
Although we now know that women are more prone than men to develop knee pain and knee cap problems, this does not mean that if you are a male you should relax. Protecting our knee and knee cap is imperative if we are to have a long and healthy fitness lifestyle. If you have, or ever develop any knee pain or knee cap problems take comfort in knowing that you can help alleviate the severity with a fitness lifestyle and proper exercise.