My Knees Always Hurt, What’s Up?

Knee pain is very common in derby, and has many causes.  The usual culprits that most skaters think of first are falls, of course.  However, there are silent culprits that most are unaware of.

1. Are you a new skater? Overuse can inflame your knees and make them ache.  Overuse is any activity that is more than 10% greater than your usual activity.  Beginning derby practice can create overuse.  Start at your own pace, and sit out if you need too.  Ice your knees after practice to reduce inflammation.
2. What is your skating form like?  Do your knees track over your toes as you skate, or do they rotate inward?  This puts stress on the knee ligaments and makes you more prone to ligament tears.
3. Outside of trauma, knee issues usually originate from problems at the hip or ankle.  The knee joint should be stable.  The knee should only hinge back and forth.  The hip and ankle joints should be mobile.  When we lock or stabilize our ankles and hips, the knee is forced to become mobile.  This creates stress on the ligaments and tendons, as well as shear stress on the top of the tibia, the large bone in the lower part of our legs.
4. The patella is meant to move in a specific tract over the knee joint.  Some skaters have “loose” patellas.  When the patella gets out of alignment it causes pain and even pinching of tendons.

Since knee pain has so many causes, it is important to go through testing with your doctor and get a diagnosis.

So how do we prevent knee pain?

1. Good posture!!!  Align your lower body as you move so that your knee cap is directly over the second toe or the middle of the ankle.
2. Do you do squats outside of derby?  Good squatting form is different than good derby form.  When squatting with body weight, or added weight, it is important to keep the shins as vertical as possible.  The knee coming forward in this type of squat puts stress on the ACL, as it is part of the ACL’s job to keep the tibia (larger lower leg bone) from moving too far forward.
3. Don’t skimp on knee pads!!! You are going to be walking around on these knees for years, take care of them!! Good pads will help your knees survive nasty falls.
4. Don’t overuse them!  Remember the 10% rule.  When increasing your activity, never increase one variable by more than 10%.  The variables are frequency, volume, intensity and time.
5. Focus on form as you are learning derby.  It is easier to learn a skill the right way than to correct bad form later.
6. Check out your hips!  Are they mobile?  Your glute (butt) muscles and a hip flexor muscle called the tensor fascia latae (TFL) insert into the illiotibial (IT) band, which is a thick connective tissue that inserts into the knee through the patellar tendon.  These muscles work together to pull your leg away from your body.  If this band is tight, or the muscles attached to it are tight, it pulls on the knee, creating pain.  If these same muscles are weak, the knee is then allowed to rotate in, also creating knee pain or instability.
7. Are the muscles on the inside of your legs tight?  These muscles work to pull your leg into your body.  They attach to the bottom of your pelvis, like the hamstrings.  Tight adductor muscles will pull your humerus (upper leg bone) inward, creating stress on the knee and therefore pain.  These muscles can also be weak, which allows your knee to rotate outwards, again creating stress and pain.
8. What about your ankles?  Are they mobile?  Do you wrap them or wear a stiff brace to restrict movement?  Stable/stiff ankles create mobility at your knees, which as you should know by now we don’t want movement there!
9. Do you have flat feet?  Or do you pronate, meaning that you roll your foot to the inside as you walk?  This changes the alignment of your knees, bringing them inward.  Overpronation forces the feet to turn out to compensate.  This can also create bunions!  Ouch!  Skaters with knee issues due to overpronation may also have plantar fasciitis, an inflammation of the connective tissue on the bottom of the foot.