How to protect/maintain the knees?

MichaelChang

Hall of Fame
I am middle aged a little out of shape man who plays tennis 2-3 hours a week. Never had much issue of my body but recently right knee starts to act up a little bit, feels a little uncomfortable and makes me hesitate whenver I try to move to my right-hand side. I am a right-hander and I feel it is probably related to my forehand technique, and probably many other factors.

Overall, any suggestions to maintain healthy knees? I love the sport so hope to be able to play it for many more years :)

thanks!
 

TennisCJC

Legend
Exercise for strength and flexibility. Google ACL or meniscus rehab exercises and you should get a list of things to do. I do heel raises, squats, and leg lifts (in all directions: front, back, inside & outside), and several stretches. You can add free weights in hands and ankle weights. Do them 3-5 times per week.

Also, play on clay. The old guys say "I would rather have bad bounces than bad knees" so they play on clay.
 

Fintft

Legend
Glucosamine, Omega 3, Vitamin D, small aspirins + going to the beach each second year or so.

Shoes with good suport (Nike Lunars) + insoles (Dr. Scholl's active).
 

tennisfreak

Semi-Pro
My knees are not 100 percent but they are now much better than the mess they were in a couple of years ago.

1. Increase strength and flexibility. I started with rehab exercises (the kind you see for meniscus injuries), and upgraded to squats. I do a full stretch after every workout. I found that weak quads and hamstrings were contributing to my knee issues.

2. Try not to take long layoffs that could weaken the legs. I tried playing after a month long layoff and ended up re-injuring knee. I had to stop playing and had to go through the exercises to strengthen the legs again.

3. Change shoes more often.

4. Supplements (GSM)

5. Take a day off between sessions.

6. I lost 10 lbs of weight which has made a huge difference in movement, and probably the knee pain too.
 
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sureshs

Bionic Poster
Reduce your running by improving your racket skills and anticipation skills.

Don't believe in the "get one more back" philosophy. I suspect that research will show that it is a loser even at the pro level, statistically speaking.

On Tuesday, I hit a sharp angled Smart Targets (TM) shot to the forehand and my opponent was running past the sidelines trying to get it back, and twisted his ankle. He already wears a knee brace. Don't be like him. Be the one hitting the smart shots.
 

fuzz nation

G.O.A.T.
I keep a very busy tennis schedule in the warmer months with playing, teaching, and coaching. When I'm riding my bicycle twice a week, it keeps my knees substantially more happy. I'm 49 and riding, even using one of those trak-stand gizmos in the garage during winter, has been a fountain of youth for my legs.
 

MichaelChang

Hall of Fame
thanks guys, will look into these and try some!

regarding clay, that is not possible, I live in US northeast area, haven't seen any non-hard court within 50 miles :D

regarding weight, I think I am average weight for my height, 160lb. but yeah, I definitely want to lose another 10lb if I can.
 

Chas Tennis

G.O.A.T.
There are many long discussions mostly on knee injuries, but with conditioning also, in the Health & Fitness forum.

Strengthening is good for healthy knees. But if you have an unknown injury who knows what should be done? It takes a good diagnosis and a well-qualified Dr.

For long term knee health, look into posture. Especially the posture of the hips is important as the hip muscles there get tight, weak, out of balance, etc., and affect the knee posture and risk of injury. To start search: posture piriformis gluteus medius

Always add the terms "pictures" or "images" to your searches for quick orientation.
https://www.google.com/search?q=glu...u-H4eeggTu2YHQDQ&ved=0CB4QsAQ&biw=916&bih=573

Become familiar with the terminology and structures of the knee. One main issue is that the knee is really two joints with separate injury issues. First, the joint between the femur and tiblua, understand the meniscus and articular cartilages, etc. and, second, the joint under the knee cap (patella). The one under the knee cap is a very common source of early arthritis. I have tight/short rectus femorus muscles (the only quad muscles that attaches above the hip joint) and they have contributed to bad alignment of the patella despite many years of running during tennis. The sitting life style contributes to the shortness of the rectus femorus because it attaches above the hip joint (the RF is a two joint muscle).

This is my tight/short rectus femorus issue.
https://www.mrtherapy.com/articles/article3.html

In my opinion, this stretch could be stressful to the back for some people...?

Knee ligaments are a common source of knee pain. Search: medial collateral ligament lateral collateral ligament

Add the term "pictures" to your searches to see the body tendons, ligaments, cartilages, etc.. Click on the pictures to go to the websites.

The most important thing is to realize that you take a risk by stressing a new injury and doing so increases your risk of getting a chronic (and permanent) injury. Tennis Elbow becomes chronic because people don't stop stressing the torn tendon immediately when first injured.

Study tendinitis (with inflammation) and tendinosis (with defective healed tendon tissue). Search TW thread: Tendon Injury Nuthouse

Study healing times and realize that some common injuries take months to heal and the very short time right after the injury can be very important for healing.

Google: common tennis injuries
Find several comprehensive references. Use to educate yourself and not for diagnosis.
 
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Sander001

Hall of Fame
Yes, definitely strengthening the muscles around the knee helps tremendously. Even strengthening the foot helps as you'll be able to run on your toes more, absorbing impact.

I'll also add that changing the insoles frequently helps too. I just buy the cheap drugstore ones and often have multiple insoles in a pair of shoes. When they get squished, I leave it in and put a new one on top.
 

mikeler

Moderator
Yes, definitely strengthening the muscles around the knee helps tremendously. Even strengthening the foot helps as you'll be able to run on your toes more, absorbing impact.

I'll also add that changing the insoles frequently helps too. I just buy the cheap drugstore ones and often have multiple insoles in a pair of shoes. When they get squished, I leave it in and put a new one on top.
Agreed. When my knees start aching I get a new insole. The only difference is that I throw away the old one versus what you do. I may have to try your way next time.
 

sez

Semi-Pro
I'm only 140 pounds, 5'7 and I do squats and leg presses but I've recently been testing sliding on hard courts and it has helped keep me in points, but is it something that long-term I could regret?
 

TennisCJC

Legend
I'm only 140 pounds, 5'7 and I do squats and leg presses but I've recently been testing sliding on hard courts and it has helped keep me in points, but is it something that long-term I could regret?
Unless you have realistic chance of playing pro tennis, I would not make sliding on hard courts part of your game. Some of the best pros don't do this - for example, Federer very, very rarely slides on a hard court and I would offer that it is something that just happens when he does and is not something that he consciously uses. OK to work on sliding on clay if you want but I wouldn't advice it on hard courts. For 99% of the tennis players in the world, I would wager there are 100s of things that would be healthier and have a bigger return on investment toward winning matches than learning to slide on a hard court. For example, time spent practicing serves and returns far eclipse sliding on hard courts in return on investment as does practically about everything else I can think of.
 

LeeD

Bionic Poster
If the "too far away" ball is hard hit, solid, and something the opponent tried to do, I don't run after it, and say "nice shot".
If the "too far away" ball is a mishit short angle, or a drop shot, meaning disrepect, I run like a breeze to make an attempt to get there and angle or drop, or lob into a sideline.
You're welcome and get respect by hitting winners and forcing shots.
You get no respect by drop shotting, or using weak short angles to make me run in order for you to win.
 

mntlblok

Hall of Fame
If the "too far away" ball is hard hit, solid, and something the opponent tried to do, I don't run after it, and say "nice shot".
If the "too far away" ball is a mishit short angle, or a drop shot, meaning disrepect, I run like a breeze to make an attempt to get there and angle or drop, or lob into a sideline.
You're welcome and get respect by hitting winners and forcing shots.
You get no respect by drop shotting, or using weak short angles to make me run in order for you to win.
So, it's the "direction" that yer made to run that determines respect? :mrgreen:

Interestingly, the loss of the ability to slide even on clay was a large part of what motivated me to have the knee replacement surgery. It's looking like it won't be long before I find out whether I'll be able to, again. . .
 

LeeD

Bionic Poster
Direction? Or intent.
Intent, you made a good shot, kudos to you.
If you just hit short to run me, or angle to run me, that implies NO respect, so I"m going to make the effort to run it down and hit a good reply off you "slight".
Of course, I often can't get there, nothing I can do about that, except hit the next ball deeper and with better angles, harder and with more varied spin.
I mainly play against guys 20-40 years younger than me. Respect is still important.
 

sez

Semi-Pro
If anything the ones who beat you from the baseline are showing you even less respect because they are showing you that your strength means nothing. The ones who dropshot are taking advantage of your weaknesses because they respect your strength.

TennisCJC:Good point, will try to phase it out then.
 

LeeD

Bionic Poster
I don't really have to worry about that, because only top 4.5's and guys like Matt Lin can really beat me from the baseline WITH GOOD SOLID SHOTS.
Sure, I lose a lot of sets and match's, probably more than most on here because most of my opponent's are well over 20-40 years my junior.
But baseliners who win against me seldom win by hitting winners or forcing shots, rather, they win by getting the ball back until I get tired and frustrated, and I try something I'm not capable of.
 

mntlblok

Hall of Fame
I don't really have to worry about that, because only top 4.5's and guys like Matt Lin can really beat me from the baseline WITH GOOD SOLID SHOTS.
Sure, I lose a lot of sets and match's, probably more than most on here because most of my opponent's are well over 20-40 years my junior.
But baseliners who win against me seldom win by hitting winners or forcing shots, rather, they win by getting the ball back until I get tired and frustrated, and I try something I'm not capable of.
Ahh. So, yer saying it's actually a beauty contest. I woulda thunk you knew more about tennis than that. :mrgreen:
 

movdqa

Talk Tennis Guru
Get the extra weight off and then use proper footwork so that you don't put additional strain on your knees by reaching instead of using footwork.
 

mightyrick

Legend
I am middle aged a little out of shape man who plays tennis 2-3 hours a week. Never had much issue of my body but recently right knee starts to act up a little bit, feels a little uncomfortable and makes me hesitate whenver I try to move to my right-hand side. I am a right-hander and I feel it is probably related to my forehand technique, and probably many other factors.

Overall, any suggestions to maintain healthy knees? I love the sport so hope to be able to play it for many more years :)

thanks!
I'm fairly big, too. Mid-40s, 5'10" (152cm) and weigh almost 220lbs (100kg). So I'm carrying at least 40lbs extra for my frame.

Losing weight is an obvious answer to reducing knee stress. That's a given.

However, if you are like me and the weight stays on, then strength-training is another answer. I do only three strength-training exercises: dead lifts, power cleans, and squats. Doing this has kept my legs, core, and back very strong.

If you are going to carry extra weight, then you either need to lose it through diet or build additional muscle to support it. No free rides. I like to eat what I want, so I choose to the strength-training approach. :)
 

movdqa

Talk Tennis Guru
I'm 5'10" and was 245 several years ago. I took off 75 and have kept it off. I used to wear knee braces and aftermarket insoles to play tennis. I don't anymore.

Your 40s are your last, best shot to get the weight off before chronic joint issues make it hard to maintain the exercise portion of weight loss. If you can get it off by 50, then you can enjoy decades of life with fewer health issues overall and feel good looking good. The downside is that you'll have to change your wardrobe.
 

snvplayer

Hall of Fame
Don't neglect hips and ankles, either. A physical therapist told me "Knee is often innocent by stander between hip and ankle."
 

SystemicAnomaly

Talk Tennis Guru
With open-chain exercises (leg extensions, hamstring curls), keep the weight fairly light. Good for warming up the knees and leg muscles. With closed chain exercises (leg presses, squats), start light before moving on to heavier weights. More details:

http://www.bodybuilding.com/fun/knee_injury_prevention.htm
http://healthyliving.azcentral.com/prevent-knee-problems-leg-presses-16198.html
http://livehealthy.chron.com/leg-press-machines-safe-knees-5431.html

Some sources consider squats superior to leg presses for leg development. Either way, proper technique is a must. See 2nd and 3rd links (above) for proper leg press techniques. Fore more info about squats, check these links below:

http://www.verticaljumping.com/how_deep_should_you_squat.html
http://breakingmuscle.com/strength-conditioning/how-deep-should-you-squat-science-compares-partial-and-full-squats
 

mntlblok

Hall of Fame
Knee stuff

Maybe some of you engineering types can help me understand how building up those leg muscles "supports" the knees.

Seems to me the leg muscles often tend to pull the big leg bones "towards" each other. Pulling them towards each other whilst the menisci have been smushed to almost nothing and the hyaline cartilage that used to cover the ends of the femur has nothing but red, raw bone remaining would maybe not be the ideal thing to do.

Not an engineer, myself, so maybe I'm just not seeing things clearly.
 

movdqa

Talk Tennis Guru
The old theory on knee problems was that there are two muscles above the knee on either side and that these muscles keep the kneecap aligned with the bone underneath it. There's a layer of cartilage between the bone and the kneecap and the kneecap pulling to one side or the other will wear away at the cartilage until it's bone on bone and you'll feel pain.

I don't know the theory of making the stuff higher up stronger but the usual exercises for getting the muscles above the kneecap are leg raises (you can do these while sitting on a chair in your office typing away).

Obviously there are lots of other problems that can go wrong with the knees but this is a fairly common one.
 

mntlblok

Hall of Fame
The old theory on knee problems was that there are two muscles above the knee on either side and that these muscles keep the kneecap aligned with the bone underneath it. There's a layer of cartilage between the bone and the kneecap and the kneecap pulling to one side or the other will wear away at the cartilage until it's bone on bone and you'll feel pain.

I don't know the theory of making the stuff higher up stronger but the usual exercises for getting the muscles above the kneecap are leg raises (you can do these while sitting on a chair in your office typing away).

Obviously there are lots of other problems that can go wrong with the knees but this is a fairly common one.
I now have a little plastic "cap" covering the under side of my knee cap with my new knee. Interestingly, I can hear it squeak when I come up from my deep knee bends. :) I'm envisioning myself actually bending my knees for many of my tennis shots in the near future. :)
 

mightyrick

Legend
Maybe some of you engineering types can help me understand how building up those leg muscles "supports" the knees.

Seems to me the leg muscles often tend to pull the big leg bones "towards" each other. Pulling them towards each other whilst the menisci have been smushed to almost nothing and the hyaline cartilage that used to cover the ends of the femur has nothing but red, raw bone remaining would maybe not be the ideal thing to do.

Not an engineer, myself, so maybe I'm just not seeing things clearly.
IMHO, it isn't really an engineering problem, although I can see how it could be viewed that way. It is a question of stability of the entire leg structure when it is bearing a load. When the joint bears a load, you want the joint to be stable as it bears that load. You certainly don't want it unnecessarily (or unintentionally) extending, overextending, or rolling-in-place. The muscles supporting the joint can bear the load and prevent the joint from moving unnecessarily when the leg is under load.

Think of a gymnastics high-bar.



Consider that the "joint" is where the high-bar leg-poles meet the floor. But the "muscles" which support the entire structure are actually the thick steel tie-down wires. So regardless of what directional load is being placed on the bar itself, the joint hardly moves at all because the support wires are bearing a huge amount of that load. The joint stays largely immobile. And this concept holds for not only knees, but any other joints in the body including shoulders, hips, and even the spine.

In woodworking vernacular, you support the joints of a structure with cross members/bracing to prevent "racking" (flexing of the joint itself).

A big reason that a lot of athletes (distance runners are probably the worst about this) end up with knee (and other joint) injuries is that they focus on conditioning, cardio work, and endurance training only. If athletes would dedicate more time doing hard-core strength training... a lot of injuries would be prevented.
 

mntlblok

Hall of Fame
IMHO, it isn't really an engineering problem, although I can see how it could be viewed that way. It is a question of stability of the entire leg structure when it is bearing a load. When the joint bears a load, you want the joint to be stable as it bears that load. You certainly don't want it unnecessarily (or unintentionally) extending, overextending, or rolling-in-place. The muscles supporting the joint can bear the load and prevent the joint from moving unnecessarily when the leg is under load.

Think of a gymnastics high-bar.



Consider that the "joint" is where the high-bar leg-poles meet the floor. But the "muscles" which support the entire structure are actually the thick steel tie-down wires. So regardless of what directional load is being placed on the bar itself, the joint hardly moves at all because the support wires are bearing a huge amount of that load. The joint stays largely immobile. And this concept holds for not only knees, but any other joints in the body including shoulders, hips, and even the spine.

In woodworking vernacular, you support the joints of a structure with cross members/bracing to prevent "racking" (flexing of the joint itself).

A big reason that a lot of athletes (distance runners are probably the worst about this) end up with knee (and other joint) injuries is that they focus on conditioning, cardio work, and endurance training only. If athletes would dedicate more time doing hard-core strength training... a lot of injuries would be prevented.
Thank you! I suppose that the muscles could help with that sort of thing, but I would have thought that those ligaments around the knee joint would be primarily responsible for holding things in place and keeping them from moving under load.

But, once the arthritis is already in place - the nastiness with the various cartilage problems - I don't understand how doing something with muscles, tendons, and ligaments can have much effect on those painful areas lacking good cartilage. I guess I would see the muscles as functioning more like a bunch of duct tape wrapped around the bars.
 

movdqa

Talk Tennis Guru
Thank you! I suppose that the muscles could help with that sort of thing, but I would have thought that those ligaments around the knee joint would be primarily responsible for holding things in place and keeping them from moving under load.

But, once the arthritis is already in place - the nastiness with the various cartilage problems - I don't understand how doing something with muscles, tendons, and ligaments can have much effect on those painful areas lacking good cartilage. I guess I would see the muscles as functioning more like a bunch of duct tape wrapped around the bars.
The cartilage grows back though very, very slowly. So rest and support will help you recover (those knee sleeves) but to be able to be active without support will require some proper muscle support.
 

mightyrick

Legend
But, once the arthritis is already in place - the nastiness with the various cartilage problems - I don't understand how doing something with muscles, tendons, and ligaments can have much effect on those painful areas lacking good cartilage. I guess I would see the muscles as functioning more like a bunch of duct tape wrapped around the bars.
I'm only talking about preventing run-of-the-mill joint/ligament/tendon injuries. Strong muscle surrounding the joints will definitely go a long way towards preventing those kinds of injuries.

Arthritis is totally different. That is a disease and once you have it, you have it for life -- rheumatoid or otherwise. For arthritis, all you can do is treat and manage the symptoms of that disease. You can't cure it.
 

movdqa

Talk Tennis Guru
There are different kinds of arthritis but if you have the form where your body is in essence, attacking itself, then I don't think that modern science has a solution yet.
 
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