Injuries are a part of being an athlete. When you compete and train at the outermost edge of your skill, you increase the likelihood of sustaining an injury. We are fortunate, in our box, to have a shining record when reviewing injuries related to training. I boast about this fact because one of the biggest gripes about CrossFit training by nay-sayers is the increased injury rate. Fortunately, CrossFit HQ has published information discrediting the fraudulent research supposedly supporting this heightened risk of injury. Our box injury level, or lack there of, I believe is related to the extensive mobility training and thorough warm up that our athletes endure.
As athletes, it is critical to "know" your body and understand what it is "telling" you at all times. I preach the concept of "Owie vs Injury". Let me explain. You just finished "Karen" and you've got some residual soreness in the neck and upper back from completing 150 wall ball shots in 6:15. This is an owie. You put your body in a situation that is not normal or frequently encountered in your daily life and your tissues start to bark. With proper hydration and recovery time, your body works its magic and within a short period of time, often minutes, the barking is gone. On the other hand, the clock is winding down and you're trying to get 5 more box jumps in to beat the guy next to you and you lose focus causing you to land on the ground wrong and you roll your ankle. This, is an injury.
One of the joints of the body that is very susceptible to "owies" is the knee. Because of the complex nature of this hinge joint and the incredible amount of force it encounters, the knee can be easily "tweaked". It receives thousands of pound of force during a normal WOD and one bad position during a movement can result in a tweak. I want to briefly review a couple of the predominant "tweaks" that we all deal with and address the proper care and correction to recover from and prevent future tweaks.
Lateral knee discomfort: Some athletes will experience positional discomfort in the outside part of the knee. There can be a host of causes, but two of the most common are a posterior displaced fibular head and hypertonic IT Band. Because of the amount force applied to the fibular head at the knee joint during flexion, it is common to see the joint subluxate posteriorly. When this happen, the tibiofibular joint is compromised and loses normal joint motion. After repeated use, inflammation occurs which is soon followed by discomfort. This "tweak" is best corrected by the skilled hands of a chiropractor, adjusting the joint back into proper alignment. In most cases, one simple maneuver solves the problem immediately. To prevent reoccurance of the "tweak" the athlete must spend time with soft tissue work on the hamstrings and gastrocnemius. This is best accomplished with a foam roll or a lacrosse ball, using the modality to break up adhesions in the sliding surfaces allowing for the tension to leave the tissue.
The second common cause of lateral knee pain is from a hypertonic IT Band. The IT band is a pelvic stabilizing structure that begins at the hip and travels down the outside of the leg, inserting on the outside of the knee joint on the lower leg bone. This means that it crosses the knee joint and and has a secondary role of assisting with knee flexion. When an athlete takes on new movements, the IT band is worked hard. Many times too hard as it compensates for other structures that are weak and deconditioned. The result of the over working is inflammation and adhesions in the tendonous insertion at the outside of the knee. This is easily corrected by, again, using the foam roll or a lacrosse ball to break down the taught tissue allowing the tension to leave the tissue restoring normal motion to the joint. This "tweak" is best prevented by frequent rolling out of the IT band pre-workout and lacrosse ball work post workout.
The moral of the story: don't let a "tweaky" knee keep you from performing your best. Ask for help or guidance if you have this problem. Try a couple of these simple strategies for care and prevention. And, of course, when in doubt, seek professional advice. Oh, yeah, I'm a professional. So just ask!
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