For a joint-gentle workout: Fitness tips for knees and back – Knowledge

dr Sven Ostermeier: “No other joint is subject to as much stress and strain as the knee.” Photo: Teerasan Phutthigorn/

So that the joints, knees and back are not overloaded during training: Orthopedist Dr. Sven Ostermeier explains in an interview which sports are best suited.

At the beginning of the year, the motivation for sport is particularly high for many. Professor Dr. Sven Ostermeier, senior orthopedist and sports doctor at the joint clinic in Gundelfingen, to optimize training with coordination exercises and take it easy. He reveals his most important tips in an interview with the news agency spot on news.

What advice do you have for beginners so as not to overload their back, joints and knees during training?

Professor dr Sven Ostermeier: The WHO recommends two and a half hours of moderate sport per week, such as cycling, for adults up to retirement age. Certainly, the preferred sport also plays a role in the optimal duration. Of course, there’s nothing wrong with doing a daily round on the bike: optimal resistance training keeps you fit and easy on your joints. The same applies to jogging, but running on a daily basis is usually too good, especially for beginners. Because not only the circulation has to get used to the training: the joints, ligaments and tendons also need some time to adapt to the new loads. It is recommended to stretch for 20, 30 minutes or a little more two or three times a week. Moderation is also more effective when it comes to speed: if you take it slow, you promote your health in a gentle way. In particular, blood pressure and the immune system benefit. So please don’t keep running to the point of gasping.

It is particularly recommended at the beginning to continually switch training from running to walking. Don’t forget to warm up beforehand and then always gently stretch your muscles: calves first, then calves and thighs. Very important before the start: suitable running shoes that guide the foot well and avoid injuries to ligaments and joints caused by sprains. Here it is better not to look at the price, but to pay attention to the quality.

Whether running, cycling or walking: Basically, it’s never too late to start, assuming doctor’s approval before the first training session. A sports medical check-up clarifies which activities are allowed by the state of health and which type of sport is the most suitable. Always pay attention to the sport appropriate for your age. For example, tennis as a full body exercise is unbeatable in terms of health. However, due to the risk of accidents and the effort of muscles and joints, it is not recommended to do it in advanced ages. Due to the frequent stopping and rotating movements, people with back problems should also practice their sport differently.

Not just for beginners, but for all athletes, intensive pre-workout warm-up exercises should be a matter of course. These favor the elasticity of the ligaments and tendons and the supply of nutrients to the muscles. The risk of injury 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 every day as the knee. It’s not just running or skiing that you have to withstand enormous pressure: with each squat, the largest and most complex of our joints supports seven to eight times our weight. Actually, it is not surprising that sooner or later the joint cracks.

In addition to monotonous and prolonged stress, being overweight often leads to severe knee pain, especially in untrained runners. By the way, even for well-trained runners, daily running is an unnecessary challenge to ligaments, tendons, and joints.

If the knee pain lasts more than three days, it is a warning sign. The cause may then be an inflammation in the knee. If the pain is accompanied by swelling and heating of the knee joint, a visit to the orthopedist is urgently required.

Our ankles also have a lot to endure: ligament strains or sprains are just some of the typical injuries following sports accidents, falls or other traumatic events. The dilemma: These complaints not only put those affected out of action for a long time, but often have serious long-term consequences. As a result of this “previous damage”, so-called secondary osteoarthritis often develops slowly but surely over an average period of 20 years. In more than 90 percent of all cases, ankle wear is the result of injuries that occurred a long time ago.

How can joint pain and injuries be prevented?

Ostermeier: To avoid injury, it is recommended to optimize training: Coordination exercises, such as walking on a mat or balance exercises on a therapy board/wobble board, stabilize the ankle apparatus and prevent torsional trauma. Support wraps also protect vulnerable ankles from twisting.

Disc herniations do not only “torment” those who do not move, as many people think. People who play sports are often affected. If there is no acute paralysis or sensory disturbances, a combination of analgesic therapy and physical therapy, as well as thermal applications, usually help.

You can only prevent it to a limited extent, for example by regular back and abdominal training. Single back circuits are good, where not only are the deep muscles strengthened, but they are also brought back into balance. After a herniated disc, gentle sports such as cycling or swimming should be preferred.

What are the effective but also gentle exercises for the back, joints and knees?

Ostermeier: Good mobility is the basis for a healthy and pain-free back. However, due to our modern lifestyle, many people suffer from one-sided, monotonous stress and lack of exercise. This can be actively counteracted, for example, with the “rotation” mobilization exercise. The starting position is a wide stance (about hip width). The arms hang loosely at the sides. Now swing your arms to the right and left with momentum. The movement should come primarily from the spine. Make sure your legs and pelvis move as little as possible. Twist just enough to feel a non-painful final sensation in the movement. Do this warm-up exercise for about a minute or two.

Fitness exercises like “knee swings” are also practical and efficient. just please let your knee swing while sitting (alternatively possible with or without ankle weight). This favors the formation of synovial fluid and has a preventive effect against osteoarthritis. Patients with knee osteoarthritis should do this exercise whenever their knee feels tired or sore. The pendulum movement without load favors the nutrition of the cartilage.

Even small steps are usually enough to counter fatal physical idleness: an occasional short “walk” around the apartment is as good for your back and circulation as spending 15 minutes standing after every hour of sitting. And if there are stairs in the apartment, they should be used as often as possible. Also, change your sitting position at your desk or on the couch more often and switch between upright, leaning forward, and leaning back.

How important is it to take care of your back, knees and joints when exercising?

Ostermeier: We recommend sports that are age-appropriate and stress and strengthen the joints and back as evenly as possible. After all, articular cartilage can and should be loaded, but in the right way. If it is repeatedly tightened in one place, damage will occur. Hard and sudden impact loads and sports that leave the joint in one position for too long are unfavourable.

Swimming is an excellent example of a sport that is easy on the joints. Reduces own body weight, relieving joints. If you like jogging, it is advisable to pay attention to the right surface. With asphalt, for example, the spring effect is missing, which puts a lot of pressure on the knee joints. A dirt track that offers suspension but without too many obstacles would be perfect.

Endurance sports such as hiking are particularly suitable for strengthening the back muscles. Not only muscles, bones and joints benefit. The brain is also activated positively. Even at an advanced age it is possible without any problems, as long as there are no health problems such as significant joint problems or acute inflammation. Osteoarthritis patients should avoid steep paths and forced marches.

Cross-country skiing is also particularly advantageous. Hardly any other sport moves so many muscles. Even at the right speed, 95 percent of our muscles are activated during this outdoor fitness training session. Full body training doesn’t just benefit your back and legs. Thanks to the use of poles, the muscles of the arms, abdominals and shoulders also benefit.

The more or less uniform load on all muscle groups is particularly positive. As a result, this winter sport, unlike downhill skiing, is also good for people with osteoarthritis.

I recommend discussing and defining the individual exercise program together with the specialist, ideally an orthopedist or sports medicine specialist.

What is the worst possible long-term damage?

Ostermeier: Sport is healthy, as long as you don’t overdo it and give your body time to regenerate. In addition to excessive ambition and overly intense training, technical errors often lead to serious injuries. The best example of this is tennis elbow, the most common tendinitis of all. To avoid this, high-risk tennis players should review their technique. Because mistakes with serious medical consequences are often made here, not only in tennis, but also in other racket sports.

As already mentioned, the ankle is particularly susceptible to injury. An important source of danger is sports where short sprints and stopping movements are important. For example, in addition to tennis, soccer or volleyball. The main way I can protect myself from this is by doing this. optimize training. Coordination exercises, such as walking on a mat or balance exercises on a therapy board/wobble board, stabilize the ankle apparatus and prevent torsional trauma. A support bandage is helpful in protecting a vulnerable ankle from twisting.

Instead of striving for utopian (and unhealthy) superior performance, it’s better to set moderate and clear goals. This increases the enjoyment of the sport and protects the joints, ligaments, tendons and muscles.

professor dr Sven Ostermeier is a specialist in orthopedics and accident surgery, sports medicine, chirotherapy and special orthopedic surgery. The shoulder and knee expert works as a senior orthopedist at the joint clinic in Gundelfingen. He is also an instructor for the German Arthroscopy Association.


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