Working on muscle groups that support the knee and shoulder helps prevent common mountain-sports injuries year-round.
Tearing an ACL or ripping a shoulder tendon doesn’t have to be the inevitable progression of a weekend athlete as he or she ages. Dr. Jared Lee, who practices orthopedic sports medicine at The Steadman Clinic (thesteadmanclinic.com), sat down with us to talk about common injuries that he and his colleagues see most often and how they can be prevented. And Lee knows sports—before medical school at the University of Washington, he played football collegiately at Brigham Young University and professionally for the Cincinnati Bengals.
What are the most common sports injuries you see?
In the winter, skiing injuries rule clinics, and knee injuries are king among these. The knee is susceptible to injury [ACL and MCL], predominantly due to the long lever arm of the ski on a relatively fixed boot that, for the most part, eliminates the ankle and transfers deforming forces to the knee. In the summer, gravity continues to contribute to injury. Shoulder injuries become more prevalent as mountain biking and cycling seasons ramp up. Holding onto the handle bars while going downhill typically leads to the shoulder being one of the first points of impact.
What can we do to prevent leg injuries, particularly the knee?
One verified method of preventing serious knee injury is working on neuromuscular control of the legs. Often the weakness is [among] a powerful group of muscles at the hip called the gluteus medius and minimus, which help stabilize the trunk and pelvis over the leg. Preseason work on muscle groups surrounding the knee—in addition to those of the hip— has been shown to decrease ACL injuries in athletes, especially [women].
What about injury prevention for the upper body, particularly shoulders?
The pretty muscles of the shoulder complex―the pectoralis major and biceps―often get the glory, but it’s the smaller muscles of the scapula that are the unsung heroes to prevent injury. These include the rotator cuff muscles and the periscapular muscles, such as the rhomboids, the levator scapulae, the serratus anterior and the latissimus dorsi. Strengthening these muscles can prevent dislocations, tendinitis and bursitis around the shoulder.
Are there preventative measures that are great for any age?
Cartilage loves compression. Cartilage doesn’t have a blood supply, and thus the cells that live in cartilage obtain nutrients and relieve themselves of waste through compression. As long as the cartilage is smooth and healthy, activity through the full range of motion is generally [beneficial]. However, if the cartilage is starting to fray, then it still loves compression but doesn’t enjoy shear forces―moving along another surface under compression. This can cause clicking or a sensation of grinding in a joint. In these instances, exercises that provide compression but not range of motion can be beneficial for the health of the cartilage and to maintain strength. These [include] isometric exercises such as wall sits or planks. An effective exercise that works with isometric holds and improves balance is yoga. We recommend [yoga] if joints are no longer happy with traditional weightlifting or running.
Any sports myths you’d like to dispel? One common misperception is that running causes arthritis. There are many recent studies comparing long-distance runners to agematched controls, and they found no significant difference in cartilage wear or arthritis development. Now, a knee or joint that’s injured may not tolerate running, but other exercises that maintain motion and limit some of the force can be beneficial to the joint and the overall health of the patient. Common examples are cycling, elliptical training or cross-country skiing.
Photography by: Courtesy of Hayley Kim