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I recently injured both my knee's, I don't really know how it happened but one morning I began descending the staircase and was stopped in my tracks with a terrible pain to both knee's. Not just a pain but a weakness too that caused me to 'guard' my knee's and reduce what activity I did.
As this injury was acute and I was pretty certain it was an injury that would improve over time I began (as I do) research into what the symptoms related to. Iliotibial band syndrome fit like a glove to the set of symptoms that I was experiencing and in my understanding it suggested pain that begins in the hip area and radiates down the outside of the thigh and into the knee joint - causing a 'band' of tenderness/weakness/pain around the knee joint. Importantly the syndrome is characterised by sufferers experiencing increased symptoms and discomfort when ascending and descending steps or stairs. This all tied in with my experience and so I felt confident that this was what I was dealing with.
I began the Rest/Ice/Compression/Elevation (RICE) treatment and also had to submit to administering myself a NSID (ibuprofen). The article that I had accessed indicated that this injury can take from three to six weeks to resolve if treated in the acute stage. I knew that I needed some kind of rehabilitation exercises to compliment the RICE treatment and prevent muscles from weakening. That is when I discovered this little book.
LETS GET READY TO RUMBLE!
Why the heading - well that was my philosophy, I was going into battle and I intended to do my best to come out on top. So with this in mind lets look at the book and see what it was like to work with. One aspect that attracted me to this book was it's accessibility to a layperson. I also liked the fact that even though it has lots of relevant information in it you can get started immediately with the program without having to read all about it first. Jim Jonson is a highly regarded Physical Therapist who has significant experience with patients presenting with a variety of knee problems. This in itself reassured me as I was assured that the program would be evidence based and have a good success rate. Of course Jim does advise that as this is a general book for everyone it is your responsibility to see a GP and ask about the suitability of the program for your individual injury.
The book is pocket sized, though I have to say that it certainly wouldn't fit into any of my jeans pockets but maybe a cargo pants pocket. I don't really think that I would need it in my pocket as I work with it in the home and not at any other time. I was impressed with the quality of the cover which is glossy and the pages that are thick and feel smooth to the touch. I really don't like a page with a gritty feel as it puts me off reading it.
There are only 114 pages in the book and I breathed a sigh of relief when I saw this because I wanted and needed to get on with the program and dreaded having to try to concentrate on reams of information before I could begin. You can very easily go straight to page 86 where Jim gives a clear and concise instruction of how to begin and maintain the 8 week rehabilitation program. There are simple line drawings of the exercises which are understandable. I did this as I wanted to crack on with the program in order to regain my quality of life - the pain was horrible. I picked up the exercises straight away - Jim has selected the exercises that he felt were generally the best and most effective for the majority of Knee problems and I was most impressed that the exercises can be done at home for free. You don't have to purchase any fancy equipment all that you need is a pillow! and that is it.
Having done all the leg work for us and using the latest evidence based practice Jim focuses on Four very important functions of the knee which he says are 'crititcal' for knee health. These functions are:
I knew that I didn't really need to read any of the book in order to do the program but me being me I wanted to know 'why' I was doing what I was doing, I wanted to know Jim's rationale. I can honestly say that the book was well worth looking at more fully as you really do get more out of this program when you discover the secrets behind the seemingly simple exercises. Each chapter is only a few pages long and there are only 7 and one of those is the program. So you see this is very easily and quickly read.
Chapter One focuses on and introduces the four critical abilities of the knee and its functions. It really does make sense because you soon realise, with the guidance of Jim and his years of experience and obvious thorough knowledge, that without just one of these functions the knee will be at risk of injury. There are excellent line drawings to illustrate and aid in understanding the anatomy of the area surrounding the knee.
This brings us onto Chapter Two where we learn about the most important group of muscles for the knee - the quadriceps! I really never thought about the function of this group of 4 muscles and the support that they provide to the knee. Jim really does make you appreciate how important it is to improve the strength in this group of muscles in order to maintain knee health into your older years and avoid falls! A study that he undertook demonstrated how the majority of individuals who fall have weak quadriceps - at any age. This really made my mind up that I will endeavour to create the strongest quads ever! Well within reason. We are given an overview of the first exercise here and as Jim says ' if you only do one exercise make sure it is this one'. The exercise seemed so simple to me that I wondered if it would make any difference at all? It is an isometric one that he chose because of its affordable accessibility to all and because of clear positive results from clinical trials. On average the quads will become larger within weeks of doing this simple exercise where you use the weight of the knee to increase the strength of the quads by pushing into the pillow. I can report a noticable difference in the size of my quads and that is following 7 weeks of the plan! It really does work. You can see the activation of the quads as you do the exercise and it is so easy, you just need the motivation to follow the plan and make a commitment to do it.
I am eager for more, anything to help with the battle for my knee health! So what did Chapter Three provide? Restoration of flexibiltiy to the knee - this chapter was really interesting too. With a self test that you can do to see if you knee joint is working as it should be. More line drawings - well illustrations really as they are so thorough and charts to show you how your knee should bend in degree's depending on what activity you are doing. Also a chart to see what may have caused your loss of flexibilty and what you can do to rehabilitate it. I like this idea as you can see how different injuries or disease affect the knee and treatments that may help. I feel really empowered with knowledge now and raring to go. The exercises in this section will treat tight hamstrings and tight quads and you get a choice of exercises to have a go at. One of these is familiar to me as it is used in yoga classes on the floor. Stretching forward to touch the toes and holding the position for 30 seconds - this is great as it sends messages to your brain that this muscle needs to lengthen and with each breath you will feel it relax more and more. The hamstring stretch is really nice, I enjoy the feeling of this group of muscles stretching it is blissful! I do the standing variation and hold one foot up towards my buttock, well touching the buttock, and enjoy the stretch for 30 seconds. I was eager to see what the next chapter would offer - so far so good! Achievable and cost free!
Proprio what??? What the? Proprioception is the subject of Chapter Four and I had been introduced to a new word. In essence it relates to the responsiveness of your knee. I found this a really informative chapter and now realise the importance of building up this important function. If you close your eyes can you tell what your right knee is doing? What position is it in? Is it relaxed, flexed, weight bearing? That is what this chapter is all about. What if you are falling and you need to catch yourself at speed - that is why it is so important to have an awareness of what you knee is doing in order to avoid injury. If I can develop good proprioception in my knees that will mean lightning fast communication between knee and brain which essentially could protect my knees from injury. How do we know if we have good proprioception, well Jim has provided us with a great exercise to work with and most individuals will stuggle a little initially but once you build up the practice you see improvements. Stand on one leg for 30 seconds - yes it sounds easy and for some it will be a doddle (I am used to doing this in yoga but my left knee is noticably different from my right) but just give it a go and see how it feels - you will see what i mean, I was aware of my knee and how it felt during the exercise. Over the last 7 weeks my left knee has improved greatly, this was the knee that was injured worse so I can say that this is having a positive effect. Jim wants you to try it with eyes closed too - I try that but it is rather shaky, it is fun! Come on then show me what Chapter Five has in store for me.
Chapter Five - Endurance! My first discovery in this chapter is one that fires me up and motivates me to keep this program as a regular practice rather than end it having completed the 8 weeks. You see if you injure your knee the quads reduce in strength pretty quicky and that obviously has an impact on your endurance when walking or running or whatever you plan to do. This chapter details the three energy systems that are used with doing an endurance activity which are the phosphogen system, glycogen - lactic acid system and the aerobic system. The body uses the aerobic system after you have been doing an activity for longer than approximatley 2 minutes and the body will continue to use this system until you end. The important thing is 'the more you use a system the more efficient it becomes'. This makes sense and Jim has you working on building up your quads in order to make them more efficient - you can go for longer. It is easy to see how you could pick up another injury if you didn't rehabilitate and develop endurance and I think this exercise is very important if you are a runner or a hiker or something similar. I like to go for some strolls and my knees could play me up at times but having worked on this program and developed the endurance I can happily report that I am niggle free whilst walking! That is incredible. The exercise is walking for up to 30 minutes which is free and so good for you. Alternatives are walking in water, static bike or treadmill. The choice is yours but I really like that Jim has made this program available to all and barring the small price of the book it is free!
The next chapter focuses on some things relating to the knee that you may not have thought about and includes research on arthiritis. I found this to be an interesting and relevant chapter and liked the fact that Jim has included the 'relaxation response' in his program. He discusses this treatment in this chapter and shows how the therapy can be induced and why it can be effective as part of this 8 week program.
Back where it all began! Well where I began. This is Chapter Seven and it 'Pulls it all together', Jim slots everything into place and offers an illustrrated guide to the treatment plan. All of the exercises are here in order and clearly instructed - you even get a few weeks timetabled plans with tick boxes to make life easier. I did actually work with these plans as I could easily check back to see that I had done the days exercises and make notes if I needed to. You don't do the full set of exercises every day. Weekends are rest days (Jim explains that the rest days are just as important as exercise days in order for the knee and surrounding muscles to heal and adjust to new motion and range). It can be tempting to carry on but the rest is important if you want the knee to improve it is worth sticking to the plan. Monday, Wednesday and Friday and the full program with Tuesday and Thursday having optional heat therapy, massage therapy, quad stretch and hamstring stretch and then the relaxation response.
A RUMBLE IN THE JUNGLE - HOW THE BATTLE WAS WON!
I am so glad that I bought this book. It is not a great big thick book, quite the opposite it is nice slim book that did not intimidate me. Loaded with expert evidence based practice and thorough knowledge but easy to understand and digest. I had terrible acute knee pain when I started the program, I found the exercises to be achieveable and my pain did not increase during the exercises or following them. I would say that within the first week of working with this program my symptoms where noticably reduced - Jim says that quite a high percentage of patients notice a difference within the first 2 weeks, for other it can take longer. Gradually over the following weeks the knees have become stronger and have more flexibility. My quads are getting stronger and stonger - I will soon be able to crush a melon between my thighs! Joking aside, my quadriceps are larger and toned and strong. I really didn't think that I had weak quads in the first place but it just goes to show - Jim stated that a weight lifter who did regular squats with weights had weak quads and that is how he developed a knee injury, the guy didn't believe him initially but Jim proved to be right! I thought that the book was very well layed out and all of the chapters led fluidly into the next. I found the information interesting and accessible. Importantly the 8 week plan was very easy to fit into my life, so much so that I am definitely carrying on with it, I don't want my quads to reduce in strength now that I understand how very important they are to my knees. You can break the execises up and do them throughout the day to suit you and you can ammend the program as long as you keep rest days appropriately timetabled and a less intense day inbetween the full program days. I am now enjoying good knee health thanks to this little book and it was incredibly easy and no outlay for expensive equipment! This is a winner, I am a winner - thanks Jim.
Price and availabiltiy - Amazon.co.uk currently £4.44, also available online from £5.00 upwards from eBay
Jim Johnson also has other books which include Rotator cuff and back pain.
I have had a very positive outcome with this plan. I was sensible and didn't push too far, I took my time and was patient though I didn't wait long for results. I think if nothing else this book can empower eveyone about the importance of the quadriceps and how to keep them in tip top form - the key here is strength. Prevention of falls is especially important to us all. I found Jim's style of writing very easy to read and enjoyable and I like diagrams of the anatomy so that I can see what is being described, it all falls into place more easily. If I know why I am doing something then it motivates me to keep up with it - I like to know 'why'. The 8 week plan is very easy to follow and should be accessible to all, of course we are all individual so Jim does advise us to consult a GP to see if the plan is suitable. You don't need to buy anything to do this program - that is a plus for me as that could be an obsticle. Yes, I do recommend this book, brilliant results for me.
May I take this opportunity to thank you for reading my review of Jim's book.
This review will appear on CIAO under the username Dawnymarie,