Restarting exercise after a long gap of inactivity without preparing your muscles for it could be disastrous for your knees, as they are one of the most unstable joints and are vulnerable to injury.
While it is important to do warm up, cool down and stretching before the exercise, one must also consult a fitness coach to get an exercise prescription regarding the duration, nature and intensity of the workouts. Starting slow and increasing the intensity gradually is a key to preventing your knee from all the trouble it could go through if the workout routine is re-started with a jolt and full intensity.
Dr Devashree Vora (PT) MSPT, PCS (ABPTS certified), Trained Aquatic Therapist, Founder and Chief Physiotherapist, Synergia PT explains how one should go about the exercise routine after a long gap.
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“Many of us during lockdown have been working from home and our lifestyle has become very sedentary affecting our posture which has led to some of the muscles to become tight and some weak. Your front of the thigh muscles become really tight because of the sitting position, whereas your glutes the important muscles for walking, running and stair climbing, become weak because we are not really using them. This causes a muscle imbalance which ultimately affects your knees,” explains Dr Vora.
Calling knees ‘not very stable joints’, Dr Vora says they are quite vulnerable to injury. “If you start your workout suddenly, the inactivity superimposed by bouts of super-activity will cause the knee to get injured,” says the expert.
“When you are sitting all the time, the thigh muscles will become tight, your glute, back of knee or hamstrings will become really tight. All these muscles attach to the pelvis, which is linked to lower back. The imbalances get carried upwards towards the lower back,” she says talking about the impact of sedentary lifestyle on our muscles.
Dr Vora says inactivity not only causes generalised muscle weakness but also lead us to weight gain which could ultimately put more stress on our knee.
The fitness expert also talks about the impact of sedentary lifestyle on bone density. “With inactivity, our bone density can also go down. For bones to be strong they need weight bearing. When you are not as active, bone density goes down and conditions like osteopenia and osteoporosis become common. While they are more common among geriatric population, they can also affect women who are perimenopausal and postmenopausal because the hormonal levels drop and it affects the biochemistry,” says Dr Vora.
Resetting exercise routine
Dr Vora says that if one wants to re-start exercise, a proper warm up and cool down is required. “Your muscles, your body need to be prepared for the exercise. If you had any previous injury in the past you should speak to a trained professional, get supervised exercise programme and then start your exercise,” she suggests.
“Whenever we give exercise prescription, it’s like prescribing medicines. We also have to think about frequency, intensity and duration of the programme. You have to make sure you start slow, pace yourself and then start with three-leg exercise, open chain exercise and then gradually move on to closed chain and body weight exercises,” says Dr Vora.
“Example of open chain exercise is sitting by the edge of the bed, tying weight around your ankles and straightening your leg. That works out your quadricep muscles, kee muscle etc. The same thing lunges and quads also do but they are body weight exercises which you should not attempt in the beginning,” says the physiotherapist.
The fitness expert says that one should pay attention to their alignment too and if while performing squats, your knees are dropping inwards or your back is arched, then that is going to cause undue stress on different parts of the body and also the knee, which can lead to an injury.
“Always be mindful of repetitions. Increase repetitions slowly. Be careful of durations. You can try a 20-minute programme which can be continued for 3-4 days and then can gradually increase duration. Intensity of exercise also has to be kept in mind,” says Dr Vora.
She says the best way to start is focussing on stability exercises rather than strengthening.
“Only if the control is good, you can start doing larger movement with more repetitions,” she concludes.