FITNESS & NUTRITION
CONTINUED
back to the starting position. Repeat for
the recommended amount of repetitions,
and then do the other leg. Start with light
weights to perfect the technique and
avoid injuring the hamstrings or lower
back. Start with two to three sets and 1520 repetitions.
LEG PRESS: This exercise primarily
strengthens the quadriceps and
hamstring muscle groups with some
partial benefit to the calf muscles. Using
a leg press machine, sit down on the
machine and place your legs and feet at
shoulder width directly in front of you on
the platform. Slowly and carefully lower
the safety bars, holding the weighted
platform in place and press the platform
all the way up until your legs are fully
extended in front of you. Your upper
body and legs should make a perfect
90-degree angle. As you inhale, slowly
lower the platform until your upper
and lower legs make a 90-degree angle.
Pushing mainly with the ball of your foot
and using the quadriceps, go back to the
starting position as you exhale. Perform
three to four sets of 20-25 repetitions
starting with moderate weight and slowly
increasing as strength and stability
increase.
DUMBBELL LUNGES: This exercise
strengthens the quadriceps, hamstring
and gluteal muscles. Initially begin doing
lunges without holding dumbbells to get
a feel for the exercise and to perfect the
technique and develop strength. Start
52
with 1-2 lbs. in each hand and slowly
increase the amount of weight. Pick up
the pair of dumbbells while standing
upright with your feet facing forward,
shoulder width apart and the arms fully
extended. Lunge the right leg forward
about 3 feet in a stepping motion until
the knee joint forms a 90-degree angle.
The right thigh should be parallel with the
floor and the leg should be perpendicular
to the floor. The back knee should almost
be touching the floor. Contract the right
leg muscles and return to the standing
starting position. Repeat this exercise
utilizing the left leg. Perform three to
four sets of 20-25 repetitions depending
on fitness level and goals.
ASSESSING, TREATING &
RECOVERING FROM KNEE PAIN
Knee pain generally develops
slowly and is usually precipitated by
trauma, overuse injuries or a change
in the exercise regimen. Do an honest
assessment, looking for any changes or
factors that may have initiated this onset
of new symptoms.
Avoid significant changes in your
exercise regimen, such as playing in
cold weather without knee protection,
worn-out or improper footwear, reduced
stretching, not warming up properly and
resistance training with excessive weight.
The biggest problem with any injury in
an athlete is the hesitation to take time
off and rest, for fear of losing skill and
fitness. Initially, take a few days off from
playing and begin a regimen of topical/
oral analgesics, compression, elevation
and frequent ice application.
NSAIDS (non-steroidal antiinflammatory drugs such as Ibuprofen,
Naproxyn and aspirin) help reduce pain,
inflammation and swelling. Athletes with
a history of ulcers or GI problems should
consider using Tylenol, (Acetaminophen).
The application several times daily of
topical analgesics such as Capsaicin, bioFreeze or Cryoderm is another effective
way to help reduce pain, swelling and
inflammation.
If there is swelling, elevate the knee on
pillows and wrap the area in an elastic or
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Ace bandage while applying ice. To reduce
pain, inflammation and swelling, apply
ice or a cold pack to the area for 10-20
minutes, 3-5 times/day. Wrap the pack in
a cloth or paper towel to prevent direct
contact with the skin. After 48-72 hours,
if the pain and swelling have decreased,
begin applying heat several times a day to
the area for 10-20 minutes.
You can now begin to do easy workouts,
walking, swimming, elliptical or cycling
with a gradual return to pickleball. After
a week or so, if the pain has subsided,
you can return to your normal playing
regimen. If the pain persists for more
than two to three weeks or returns after
rest and other conservative treatment,
it is time to visit a qualified health
care professional for diagnosis and
treatment. The first step will likely be a
comprehensive examination followed by
diagnostic studies to assess the location,
type and extent of the injury.
Hopefully, the problem or injury can be
treated using conservative, non-invasive
treatment. Corticosteroid injections
directly into the joint can dramatically
reduce pain, inflammation and swelling.
Unfortunately, the injections only
provide relief for a limited time and
more than three injections over the
period of a year can be harmful. Cruciate
ligament and meniscus tears are common
injuries that can usually be treated with
arthroscopic surgery. Before submitting
to any surgery or invasive procedures,
obtaining a second opinion is always a
good idea. •
Alan Bragman is a
chiropractor living in
Atlanta, Georgia. He is
a former Cat 3 cyclist
and nationally ranked
table tennis player and
inline speed skater.
He was on the medical
advisory board at Bicycling
magazine for 10 years
and has written for
numerous other sports
publications.