I used to play sports, what happened to me?

I hear this a lot from older clients.  Heck, I’ve heard it from myself when I went through ACL rehabilitation.  Once a high level athlete, always a high level athlete.  At least in our minds we are.  The fact is that muscle takes 1-2 weeks to lose strength if it is not going through a workout program.  Muscle responds very specifically to the strains that are placed upon it.  Unfortunately as we get older, people do not exercise as often as they should.  I’m guilty of this as well.

We tend to forget all the practices and conditioning that we did in order to be prepared to play in these events.  We just remember the games themselves.  Then we skip all the preparatory exercising that is needed in order to perform at that level.  We go straight to playing pick up games.

Unfortunately, our bodies change as we age too.  Without properly exercising, the muscle fibers actually change composition.  The muscles become more use to long term activation.  They get used to just holding us upright because standing and walking are the primary exercises we do.  The muscles we use in sport require more faster activating muscle fibers.  That means if we try to do fast acting movement with slow moving muscles, we’re going to have a bad time.  

This is why it is important to see somebody educated in the performance of muscles to better prepare us for our activities.

Dr. Mark Geise, PT DPT


This is Hard

A lot of times we hear clients say that a seemingly easy exercise is surprisingly difficult.  The most common time I hear this is when I ask somebody to hold their balance while they stand on one foot.  Seems like an easy enough task right?  Go on try it yourself.

Chances are that if you don’t actively practice this then it’s going to be pretty difficult.  Wobbling back and forth are normal as long as you’re not at risk of falling over.  There are several different reasons for why this easy exercise needs to be practiced.  Every time you walk, you should be standing on one foot even if for a moment.  If you can’t stand on one foot, you’re at risk for losing balance while you walk.  If you’re not standing on one foot while you’re walking, then you’re not taking long enough strides.  An important factor in determining if a person is at risk for a fall was the speed they were walking.  Slower walking was actually predictive of falling.

Several reasons could be why this exercise is difficult.  One is that practice makes perfect.  Not trying it occasionally will make it difficult.  Secondly, there are 3 systems in play when you’re trying to balance.  The musculoskeletal system will try to keep your bones and muscles in position to stay upright.  Your muscles need to be strong enough to keep you in a proper position.  Your inner ear provides a lot of feedback to your brain which tries to determine how your head is positioned.  Lastly, your joints have joint sensors that send feedback to your central nervous system.  This keeps your brain informed of where your joints are.

So this is why we provide this exercise to patients.  It challenges several systems at once.  It helps determine if there are more than one system with problems.  If standing on one leg is too easy, try doing it with your eyes closed!


Dr. Mark Geise, PT DPT

Should I be worried that my knees are clicking?  

Joints do snap, crackle, and pop at times and this is normal.  However, if your knees click or pop EVERY time you do a motion such as going up/down stairs, standing/sitting, or squatting that is something that you need to address before it becomes a problem.

The clicking that you hear is your knee caps pushing against your knee while in motion.  This happens due to muscle imbalances in your body, either your hip is weak and your knees are caving in with bending or the arches in your ankles are weak and your knee is again caving in and causing this sound.  If you don’t start addressing these muscle imbalances soon the bones wear down and arthritis could begin to form.  

Here’s a quick test for you, stand in front of a mirror or have someone watch you, and perform a squat.  Watch (or have your friend watch) to see if your knees are staying in line with your feet, or if your knees are moving in between your feet, also listen for any clicking sounds.  If either of these are the case you may have ankle instability or hip weakness.  You should see your Physical Therapist for an evaluation to make sure that this problem does not get worse.