For a workout that is easy on the joints Fitness exercises for the knees and back
At the beginning of the year, many people are particularly motivated to do sports. To ensure that joints, knees and backs are not damaged by high-spirited fitness fanatics, Professor Dr. Sven Ostermeier, senior orthopedist and sports physician at the Joint Clinic in Gundelfingen, to optimize training with coordinative exercises and to take it slow. He reveals his most important tips in an interview with the news agency spot on news.
What advice do you have for sports beginners to avoid overloading their back, joints and knees during training??
Professor Dr. Sven Ostermeier: The WHO recommends two and a half hours of moderate exercise per week for adults up to retirement age, such as cycling. Certainly, the preferred type of sport also plays a role in the optimal duration. Of course, there’s nothing to be said against going for a daily ride on your bike – optimal endurance training keeps you fit and is easy on your joints. The same applies to jogging, but daily running is generally too much of a good thing, especially for beginners. It’s not just the circulation that has to get used to the training: Joints, ligaments and tendons also need some time to adapt to the new loads. Recommended here are stretches of 20, 30 minutes or even a little longer two or three times a week. And moderation is also more effective when it comes to speed: slowing down promotes your health and well-being in a gentle way. Blood pressure and immune system in particular benefit. So please do not always sprint until you are panting.
It is advisable, especially in the beginning, to continuously change training from running to walking. Don’t forget to warm up beforehand – and always stretch the muscles gently afterwards: first the calves, then the lower and upper thighs. Very important before the start: suitable running shoes that guide the foot well and prevent injuries to the ligaments and joints caused by twisting. It’s better to pay attention to quality rather than price.
Whether jogging, cycling or hiking: In principle, it is never too late to start – provided that your family doctor gives the okay before the first training session. A sports medicine check clarifies which activities the state of health permits and which type of sport is most suitable. Please always pay attention to age-appropriate sports. Tennis, for example, is unbeatable for health as a whole-body workout. But because of the risk of accidents and the strain on muscles and joints, running is not advisable at an advanced age. People with back problems should also change their sporting orientation because of the frequent stopping and turning movements.
Intensive warm-up exercises before training should be a matter of course not only for beginners, but for all athletes. These promote the elasticity of the ligaments and tendons as well as the nutrient supply of the musculature. The risk of injuries to muscles and tendons is significantly reduced.
Why do joints often cause discomfort?
Ostermeier: "No other joint is subjected to as much stress and strain as the knee on a daily basis. It is not only when sprinting or skiing that it has to withstand enormous pressure: With every bend of the knee, the largest and most complex of our joints bears seven to eight times our weight. That it cracks there sooner or later in the joint, is not surprising actually.
In addition to monotonous and too high continuous load, overweight often leads to severe knee pain – especially in untrained runners. Even for trained joggers, daily running is an unnecessary challenge for ligaments, tendons and joints.
If knee pain lasts longer than three days, that’s a warning sign. The cause may then be an inflammation in the knee. If the pain is compounded by swelling and heating of the knee joint, a visit to the orthopedist is urgently required.
Our ankles also have to withstand a lot: Strained ligaments or sprains are just some of the typical injuries after sports accidents, falls or other traumatic events. The dilemma: these symptoms do not just put sufferers out of action in the short term – they often have serious long-term consequences. Because due to this "previous damage" in many cases a so-called secondary arthrosis develops slowly but surely over a period of 20 years on average. In over 90 percent of all cases, ankle wear and tear is the result of long-standing injuries.
How to prevent joint pain and injury?
Ostermeier: To avoid injuries, it’s a good idea to optimize your workout: Coordinative exercises such as mat walking or balance exercises on a therapy gyroscope/ wobble board stabilize the ankle apparatus and prevent ankle trauma. Supportive bandages also protect vulnerable ankles from twisting.
Intervertebral disc herniations "torment not only movement muffle, as many people think. Often athletically active people are also affected. If there is no acute paralysis or sensory disturbances, a combination of medicinal pain therapy and physiotherapy as well as thermal applications usually helps.
Prevention is only possible to a limited extent, for example through regular back and abdominal training. Individual back circles are good, in which not only deep-lying muscles are strengthened, but rather brought back into balance. After a herniated disc, gentle sports such as cycling or swimming should be preferred.
What are effective, but also gentle exercises for the back, joints and knees??
Ostermeier: A good mobility is the basis for a healthy and pain-free back. Due to our current lifestyle, however, many people suffer from one-sided, monotonous strain as well as a lack of movement. This can be actively avoided, for example, through the mobilization exercise "Rotation, encounter. Starting position is a wide stance (over hip width). The arms hang loosely at the side. Now turn your arms to the right and left with momentum. The movement should come mainly from the spine. Therefore, please make sure that your legs and pelvis move as little as possible. Rotate enough to feel a non-painful end sensation in the movement. Perform this warm-up exercise ca. for one to two minutes through.
Fitness exercises such as the "knee swing" are also practical and efficient. Please simply let the knee swing while sitting (alternatively possible with or without weight on the ankle). This promotes the formation of synovial fluid and has a preventive effect against osteoarthritis. Patients with knee osteoarthritis should do this exercise whenever the knee feels tired or painful. The pendulum movement without load promotes the cartilage nutrition.
Even small steps are often enough to counteract fatal physical idleness: A little "walk" now and then walking through the apartment is just as beneficial for the back and circulation as, for example, spending 15 minutes standing after each hour of sitting. And if there are stairs in the apartment, they should be used as often as possible. In addition, change your sitting position more often at your desk or on the couch and alternate between an upright, forward-leaning and reclined posture.
How important it is to take care of your back, knees and joints when playing sports?
Ostermeier: Sports are recommended that are age-appropriate and that stress and strengthen the joints and back as evenly as possible. Finally, the joint cartilage may and should be loaded – but in the right way. If it is repeatedly strained in one place, damage occurs. Unfavorable are hard, unmediated impact loads as well as sports that leave the joint in one position for too long.
Swimming is a prime example of a sport that is easy on the joints. It reduces the own body weight, thus relieves the joints. If you like jogging, it is recommended to pay attention to the right surface. Asphalt, for example, lacks the spring effect, which puts a lot of stress on the knee joints. A dirt road that offers suspension but doesn’t have too many obstacles would be perfect.
To build up the back muscles, endurance sports such as hiking are particularly suitable. Not only muscles, bones and joints benefit from it. The brain is also positively activated. Even at an advanced age, it is possible without any problems – provided there are no health problems such as significant joint pain or acute inflammation. Patients with arthrosis should avoid steep paths and forced marches.
Cross-country skiing is also particularly beneficial. Hardly any other sport moves so many muscles. Even at an adapted speed, 95 percent of our muscular system is activated during this fitness training in the fresh air. Not only back and legs benefit from the whole-body workout. Thanks to the use of the cane, arms, abdominal and shoulder muscles also benefit.
The more or less even load on all muscle groups is particularly positive. This makes this winter sport – in contrast to alpine skiing – also well suited for people with osteoarthritis.
I recommend discussing and determining the individual exercise program together with the specialist, preferably an orthopedist or sports physician.
What long-term damage can occur in the worst case?
Ostermeier: "Sport is healthy – provided you don’t overdo it and allow your body time to recover. Often, in addition to exaggerated ambition and overly intensive training, technical errors also lead to serious injuries. The best example of this is tennis elbow, the most common tendonitis of all. As a preventive measure, tennis players at high risk should review their technique. Because mistakes with serious medical consequences are often made here – not only in tennis, but also in other racquet sports.
As already mentioned, the ankle joint is also particularly susceptible to injury. A major source of danger is sports that involve short sprints and stopping movements. So, for example, in addition to tennis also soccer or volleyball. I can protect myself from this primarily by optimizing my training. Coordinative exercises such as mat skating or balance exercises on a therapy gyroscope / wobble board stabilize the ankle apparatus and prevent the ankle trauma. To protect a susceptible ankle from twisting, a supportive brace is useful.
Instead of aiming for utopian (and unhealthy) high performance, it is better to set moderate and clear goals. This increases the enjoyment of sports and protects joints, ligaments, tendons and muscles.
Professor Dr. Sven Ostermeier is a specialist in orthopedics and trauma surgery, sports medicine, chiropractic and special orthopedic surgery. The shoulder and knee expert works as a senior orthopedist at the Gundelfingen Joint Clinic. He is also an instructor for the German Working Group for Arthroscopy.