Update: Thanks for all the concerns of well wishers, my knees are much better now and I’m back to dancing!

My knees had been aching since the competition where I danced on the uneven plywoods 2 weeks earlier. Though I have knee injuries since abt 2 yrs ago, the injury had been under good care with my constant wearing of knee-guards and glucosamine+chondroitin supplements. With the throbbing pain in my knees, I feel compelled to share whatever I know, so other dancers would not have to go through this.

Knee Anatomy

Extracted from Wikipedia:

The knee is the lower extremity joint connecting the femur, patella, and the tibia[1] and the surrounding anatomical region which includes the popliteal fossa, also known as “knee pit”. The largest and most complicated[2] joint in the human body, the knee is a mobile trochoginglymus (i.e. a pivotal hinge joint[3]), where flexion is a combination of rolling and gliding movements while some rotation is allowed in the flexed position.[4] Since in humans the knee supports nearly the entire weight of the body, it is the joint most vulnerable both to acute injury and the development of osteoarthritis.

As the knee is so injury-prone, it’s small wonder why so many line dancers have knee problems. So, no, knee injury is not an age issue, though it tends to get more frequent as you age. Here, I would like to create more awareness about our vulnerable knees and hope it will prevent your knees getting into trouble!

Possible causes of knee-pains in line dancing (wear & tear):

• Osteoarthritis – the thinning and disappearing of your knee cartilage (wear)
• Meniscus tear – tearing of the menisci (tear)

Osteoartritis (OA)

Although OA is said to be genetically linked, many of my friends who have OA are on the heavier side. The knees are bearing the brunt of the increased body weight and although line dancing is a low impact activity, however, the heavier your body weight is, the more strenuous your knees would have to hold them. In OA, your cartilage gets thinner and thinner (think about the sole of your shoes getting thinner due to friction), and so knee joint loses it cushioning. The thigh bone (femur) and shin bone (tibia) would then bang each other and thus causing pain and discomfort.

Meniscus Tear (MT)

Not many people realised they have MT as they would probably think they have OA due to aging. MT is caused by the forced rotation of the body (until the thigh) with the feet (shin onwards) firmly on the ground. So the knee joint at the centre bears the brunt of your twisting stunt. Remember that our knees (like our elbows) are designed in such a way so that our shin can move in 2 dimensions (unlike our shoulders/pelvic joints which allow a 3 dimensional movements). Here’s a good video showing how the meniscus is torn.  Video.

Symptoms of MT are feeling of weak knees and clicking and popping sounds when you straighten or bend your knees.

How to prevent Knee Problems while line dancing:

Shoes

First of all, a good pair of dance shoes is the most fundamental requirement in line dancing. Many line dancers dance in their walking shoes or sports shoes which is actually very bad for the knees. Although line dancing is a low impact activity, line dancing is still dancing and it requires dancers to turn and twirl and thus the sole of the dance shoes is very important to give us this ability to turn and twirl, to slip and to glide, but not to fall.

Just like there are track sneakers with spikes for track runners to grip the track, as there are tennis shoes, badminton shoes, aerobic shoes, golf shoes – all differently designed specifically for the nature of the game and the ground, the same goes for line dancing. It’s appalling to see line dancers refusing to invest in a good pair of dance shoes and then later complain of knee pains which would require more $$$ to treat!

A good pair of dance shoes would not only allow you to twist and turn easily but stably. With a wide range of shoes, from open toes heels and dance sneakers, easily available, every line dancer should seriously think to invest in one, for the health of your knees!

Flooring

The best flooring would be timber/parquet/laminated floors as our dance shoes would be able to interact well with them. Other smooth and non sticky floors will do too, but the hard surface may cause more impact to the knees compared to the wooden one. As a dance venue is often a headache, dancers are normally more than happy to find a space to dance on, be it on the cement badminton court, tiled floor or just plainly on the field. Just make sure that you will be able to easily twist and turn on the floor. Field is a definite NO NO, as the ground is not levelled (some parts high and some parts low). Not only you will hurt your knees, you might even injure your nerves, tendons and muscles!

Techniques

Execute your dance steps using the correct techniques to minimise your injuries. The correct frame/posture, weight placement, feet positions, momentum, preps and arm movements before executing a step are essential for balancing and letting your body know what it is going to do next. Also, dancing from your core/centre will lessen the weight concentrate on your poor feet/knees thus less impact on them!

Knee-guards

A good pair of knee-guards will also help to strengthen the knees and hold ‘everything in the knees’ in place. An absolute must if you have weak knees or suspected OA or MT especially when you dance or do other strenuous activities.

Glucosamine (+Chondroitin) – prevent, maintain & treatment

Glucosamine (C₆H₁₃NO₅) is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. A type of glucosamine forms chitosan and chitin, which composes the exoskeletons of crustaceans and other arthropods, cell walls in fungi and many higher organisms.  Glucosamine is one of the most abundant monosaccharides.^[1] It is produced commercially by the hydrolysis of crustacean exoskeletons or, less commonly and more expensive to the consumer, by fermentation of a grain such as corn or wheat. Glucosamine is commonly used as a treatment for osteoarthritis, although its acceptance as a medical therapy varies.

Since getting my knee injury 2 years ago, I’ve been introduced to this Glucosamine supplement which, I was told,  would increase the cartilage in your joints and knees inclusive. It’s in the form of capsules and readily available in pharmacies in different dosage, 250 mg, 500 mg and more recently 1500 mg, depending on the severity of your condition or just for maintainance or prevention. My doctor told me that the absorbency of glucosamine into our body system is not too high and if you take glucosamine with chondroitin, the absorbency level would be much higher and thus more effective.

And more recently, a kind of transdermal glucosamine cream has been launched into the market whereby the glucosamine is directly applied to the affected area (ie. knees) and thus absorbed directly into the knees. (Thanks Harold)

Treatment

Consult your doctor for the best available treatments.

End note

Prevention is better than cure. Once a damage is done, your knees will not be as good as new anymore. There will be moves which you will not be able to make properly etc. It is important to take care of our knees so that we may dance well into our old age. Take good care of them before it’s too late!