Friday 20 January 2012

Quality over quantity

Yesterday I saw again Fearghus Ó Conchúir a dancer/choreographer that I've been looking after for a while following a knee arthroscopy and partial meniscectomy. Fearghus had a progressively worsening knee problem that eventually stopped him dancing. He was successfully operated and returned back to his full function following several months of rehabilitation. His rehabilitation consisted of close kinetic chain (CKC) exercises, such as leg press, squats, step-ups etc and progressed to very functional exercises relative to his dancing routines. Once Fearghus was back to dancing I kept seeing him every few weeks and he would tell me what activities he would struggle with and we'll find exercises or ways to stop the pain. That led to advising on exercises from the thorax down to the toes, which shows the influence of all the body parts on the knee function. We worked on his hip control, pelvic control, low/upper lumbar control and they all had a positive influence on the function of the knee. The purpose of yesterdays visit was that Fearghus started experiencing some symptoms on his knee again. That followed a period of not doing a lot of his "rehabilitation" exercises, dancing a lot more, and travelling. When we went through again the exercises Fearghus himself saw that the quality of his exercising dropped and he was now abnormally loading his patellofemoral joint in certain positions. It was easy enough to correct it as he done all this before. By the end of the session he was able to do everything without any problems. What I'm trying to emphasise is that there's no "rehabilitation" exercises or "normal" exercises. There's EXERCISES the normal way the body moves and functions relevant to the activities that the individual is doing. The other point is that the quality that the exercises are performed is far more important than the volume of the exercises. If the quality is poor then the loading patterns of the joints change and that can lead to dysfunctions and eventualy pain.

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