6 Tips for Preventing Knee Injuries

Knee injuries are a common issue for people of all ages and levels of activity. Healthy knees (and healthy joints in general) should be a high priority for all personal trainers. Helping people move better, safely, with less pain, and for longer periods of time is crucial for your client’s health and your fitness business. 

Knee Anatomy

The knee joint is the articulation of the femur (thigh bone), tibia (shin bone), and the patella (kneecap). It is held together by a collection of tendons, ligaments, and muscle attachments from the upper and lower leg. 

Knee Ligaments

Ligaments are tough connective tissue connecting bone to bone. The primary ligaments in the knee are the: 

• Anterior Cruciate Ligament (ACL)

• Posterior Cruciate Ligament (PCL) 

• Medial Collateral Ligament (MCL) 

• Lateral Collateral Ligament (LCL)

The ACL and PCL are pieces of connective tissue that limit the movement of the tibia in the anterior or posterior direction as well as some rotational movement (1). The MCL and LCL prevent side-to-side movement of the tibia.

Knee Tendons

The primary tendons in the knee are the patellar tendon and the quadriceps tendon. A tendon is a connective tissue attaching muscle to bone. However, the patellar tendon is unique in that it primarily attaches bone to bone (i.e., the patella to the tibia). But, it is often considered to be a portion of the quadriceps tendon—the distal portion. The quadriceps tendon is where the four quadricep muscles come together and attach to the patella (i.e., the insertion). 

Knee Meniscus

Each knee has a medial and lateral meniscus. Each meniscus is a small C-shaped piece of cartilage that sits between the femur and the tibia. The cartilage acts as a cushion for absorbing shock and provides stability and joint lubrication (2).

Common Knee Injuries

According to research, sprains and strains associated with soft tissue are the leading types of knee injury (3). The following list includes some of the most prevalent knee injuries. 

ACL injury

One of the most common injuries associated with the knee is ACL injury. Although an ACL tear can occur as a result of contact to the knee, oftentimes, ACL injuries are a result of noncontact or minimal contact (4). It’s important to note that although the ACL is the most commonly injured ligament, the other knee ligaments can also be injured. The PCL and LCL, however, are often a result of injury from contact.

Meniscus Injury

A meniscus tear is another common injury associated with the knee. Damage to the meniscus can be a result of a single event or wear and tear over an extended period of time. Although small, the meniscus is an extremely important component of the knee.

Osteoarthritis and Tendonitis

There are different forms of arthritis. However, osteoarthritis is one of the more common forms of arthritis associated with the knee. Osteoarthritis is degenerative. Ultimately, the cartilage of the knee begins to wear away which results in bone-on-bone contact in the knee joint. 

Tendonitis of the knee, on the other hand, is inflammation of the tendon(s) in the knee. It’s often a result of overuse.

Tips for Preventing Knee Injuries

Although there are uncontrollable factors contributing to a knee injury (i.e., age, gender, genetics, and some contact injuries), there are also many things you can do as a health and fitness professional to improve injury prevention associated with your clients’ knee joints. 

#1. Maintain a healthy weight

Clients who are overweight or obese are at risk for a variety of body complications and diseases. Excess weight puts additional stress on the joints, even while executing the simplest movements. Maintaining a healthy weight can play a considerable role in overall knee health. 

#2. Prioritize proper movement mechanics

Research shows faulty movement patterns have a strong correlation with ACL injury (4). Encouraging proper movement mechanics associated with the activities of day-to-day life (i.e., walking and stair-stepping) are crucial. But proper movement patterns associated with sport and performance are just as critical.

#3. Rest and recover

Fatigue can play a role in altered movement mechanics. Tired athletes may see decreases in their decision-making and movement execution which can lead to injury (5). In addition, rest and periodization are crucial in allowing the soft tissues to heal and recover which is vital for injury prevention. 

#4. Include proprioceptive training

Training programs that include proprioceptive and neuromuscular training have been shown to reduce the risk of knee injuries (6)(7)(8). This means that properly incorporating tools like balance boards, foam pads, or BOSU balls can support knee injury prevention. 

#5. Don’t forget strength training

It’s well known that resistance training can have positive impacts on the muscles, joints, and bones. In addition, strength training has been shown to reduce knee pain and stiffness, and improve functionality for individuals with osteoarthritis of the knee (9). 

#6. Wear proper footwear

The wrong shoes can cause faulty movement patterns all the way up the kinetic chain. Shoes that are too small, too big, too worn, not appropriate for the activity, or don’t provide the correct arch support aligned with the client’s needs can cause knee injury and injury to several other areas of the body. 

Do you love learning about the human body? Are you passionate about healthy, functional movement? Become an ISSA Certified Personal Trainer with one of the world’s leading fitness education companies! 

References

1. Andersen HN, Dyhre-Poulsen P. The anterior cruciate ligament does play a role in controlling axial rotation in the knee. Knee Surg Sports Traumatol Arthrosc. 1997;5(3):145–149. 

2. Razi, M., & Mortazavi, S. (2020). Save the Meniscus, A good Strategy to Preserve the Knee. The archives of bone and joint surgery, 8(1), 1–4. 

3. Gage BE, McIlvain NM, Collins CL, Fields SK, Comstock RD. Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008. Acad Emerg Med. 2012 Apr;19(4):378-85.

4. Boden, B. P., Sheehan, F. T., Torg, J. S., & Hewett, T. E. (2010). Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. The Journal of the American Academy of Orthopaedic Surgeons, 18(9), 520–527. 

5. Benjaminse, A., Webster, K. E., Kimp, A., Meijer, M., & Gokeler, A. (2019). Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses. Sports medicine (Auckland, N.Z.), 49(4), 565–586. 

6. Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us?. Current reviews in musculoskeletal medicine, 10(3), 281–288. 

7. Petersen W, Braun C, Bock W, Schmidt K, Weimann A, Drescher W, Eiling E, Stange R, Fuchs T, Hedderich J, Zantop T. A controlled prospective case control study of a prevention training program in female team handball players: the German experience. Arch Orthop Trauma Surg. 2005 Nov;125(9):614-21.

8. Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999 Nov-Dec;27(6):699-706. 

9. Vincent, K. R., & Vincent, H. K. (2012). Resistance exercise for knee osteoarthritis. PM & R: the journal of injury, function, and rehabilitation, 4(5 Suppl), S45–S52. https://doi.org/10.1016/j.pmrj.2012.01.019