Depending on the person, therapy might include a hamstring stretch that can be done sitting or lying down (stretching muscles helps increase joint flexibility). In that move, a belt is looped around one foot and the straightened leg lifted until a stretch is felt along the back of the leg. This can be repeated three times and held for 30 seconds on each leg. External hip rotators, which are part of the kinetic chain that supports the knee, can be strengthened by lying on one side with knees bent, the top leg raised like a clamshell. (Note: No exercises should be attempted before consulting with a physician or licensed physical therapist.)
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Take a load off
In examining movement patterns during walking or running, Christopher Powers, associate professor of biokinesiology and physical therapy at USC, looks for "dynamic misalignment," checking to see if knees fall inward or if there's an abnormal rotation at the hip or foot. These, he says, can put undue torque and stress on the ligaments, joints and cartilage. Therapy, he adds, can take some of those stresses off the knee joint.
Because biomechanics vary from one person to the next, therapy programs need to be tailored but may include working with patients to change their gait -- not always an easy task, considering that walking is something most people do automatically. "The patient has to be aware of what they're doing and why they're doing it," he says.
"Your muscles are kind of like shock absorbers," Powers adds, "and when they're not working well, you start to rely on your passive shock absorbers, like your cartilage and bone."
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jeannine.stein@latimes.com
Patients may be able to get referrals for licensed physical therapists from their doctors or hospitals. The American Physical Therapy Assn. also has lists of members on its website, www.apta.org.
