Stretch to prevent injury
It is common sense that stretching before sports that require large range of movements will help to prevent injury. How about simply walking and hiking? Perhaps the very commonly seen 'degenerative' patello-femoral (knee cap) jointcondition in Hong Kong comparing with patients in Australia who involve themselves more in sporting activities that cause cartilage and ligamentus injuries may give us an insight of why stretching could be important for even just walking. The main cause of patello-femoral (knee cap) joint dysfunction could well be repetitive strain of the patello-femoral joint often from prolong walking especially stairs and hills without warm-up and stretches. The lack of stretches leads to tightness of certain muscles. The tightness of rectus femoris (front thigh muscles) and iliotibial band (outside thigh muscles) pulls the patella (knee cap) laterally to the outside, causing mal-tracking of the patella and tension to the patellar tendon and its insertion (where it attaches to), hence the supra-patellar and lateral ligaments and soft tissues of the patella are often tight. The patellar tendon and its surrounding soft tissues are often thickened and tender. Further tightness in the calf (back of the lower leg) muscles and hamstrings (muscles at the back of the thigh) tends to bend the knee and further increases the patello-femoral joint compression force, causing joint strain and degeneration with swelling/thickening and crepitus (clicking) . Such joint signs could persist for years before the patient gradually becomes aware of the symptoms or be acutely aggravated by some minor triggering incidence. All these troubles could be helped by regular daily stretches (at least the ones on the left) to maintain our flexibility and prevent muscle imbalance, whether we are going to play sports or not. Although walking is excellent for cardio-respiratory and general muscle conditioning, it can cause excessive knee and patello-femoral joint pressures if muscle stretches are not performed regularly. While we encourage patients to walk 8000 steps or 20 minutes stairs a day to maintain their general fitness, I suggest that we should remind them to stretch to prevent injury as a result of such walks as well.