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IniciGeneralQue passa quan tenim dolor de genoll?

Que passa quan tenim dolor de genoll?

Hi ha diferències temporals en l’activitat muscular del vast medial (VM), vast lateral (VL), semitendinós (ST), i el bíceps femoral (BF) que es correlacionen amb dolor fémoro patel·lar (SFP) en el ciclisme.

El vast medial i el vast lateral s’activen més tard si es té el SFP.

El vast lateral s’activa amb més força quan es té el SFP que en condicions normals, en canvi el vast intern s’activa amb menys força quan es pateix SFP. Degut això veiem clarament un desajust en la intensitat de contracció favorable al vast lateral respecte al vast medial.
També durant la pedalada el Semi tendinós s’activa molt poc si patim SFP; hi ha més activació del biceps femoral per compensar aquest desajust.

Les gràfiques ens indiquen que els ciclistes que han entrenat amb dolor fémoro patel·lar (SFP) tenen alterats temporalment els patrons d’activació muscular en comparació amb els ciclistes entrenats sense dolor fémoro patel·lar (SFP); els del grup control CTL.

 

 

Les diferències temporals en l’activitat muscular s’han comprovat rodant en bici estàtica 10 min durant el qual mitjançant electromiografia s’ha enregistrat l’activitat electro muscular de VM, VL, ST i BF (En plà sagital de genoll) les dades cinemàtiques s’han enregistrat fent servir un electro goniòmetre. (Dieter, McGowan, Stoll & Vella, 2014)

Activitat muscular del vast medial (VM), vast lateral (VL), semi tendinós (ST), i el bíceps femoral (BF) tenen relació amb dolor fémoro patel·lar (SFP) en el ciclisme.

Aquesta activitat muscular també pot provocar desajusts mecànics , sobrecàrregues i tendinopaties en músculs i tendons com ara:

 

1.Tendinopatia del tendó rotulià

  • Resulta de la repetició de sol·licituds intenses a aquest tendó per part del quàdriceps, en què les contraccions són fortes i mantingudes, com en els esprints, arrencades o accelerades violentes. El 90% de les tendinopaties d’aquest tendó seran a la inserció, sent menys freqüents les del cos del tendó.
  1. Afectació dels alerons rotulians
  • Sovint aquesta patologia està lligada a l’aparell extensor, ja que els alerons rotulians manifesten dolor, principalment, com a conseqüència d’un desequilibri rotulià.
  1. Patel·la o ròtula “astada”
  • Sol ser asimptomàtica, i es produeix per l’aparició de osteòfits en les zones d’inserció dels tendons quadricipital i rotulià sobre la ròtula.(Commandré et al., 1987)
  1. Tendinopaties dels rotadors:
  • Són força específiques dels ciclistes. Durant el pedaleig, l’extensió del genoll provoca una rotació externa de la tíbia, que disminueix poc a poc, però en ciclisme, si les cales estan mal col·locades a l’anar el peu fix, apareixerà l’afectació dels rotadors interns o externs. Una de les causes principals és la posició de l’articulació sub-astragalina, ja que depenent de la supinació o pronació del peu, la tíbia rotarà més cap a un costat o cap a un altre. També poden ser causades per la rigidesa tibio-tarsiana, el pedaleig exigeix ​​ flexió dorsal, si aquests no hi és, hi haurà una compensació de la sub-astragalina pronant el peu quan el pedal està en la posició més alta. Aquesta pronació provocarà una rotació interna de la tíbia, apareixent sobrecàrrega al bíceps crural i el tensor de la fàscia lata (TLF).
  1. Tendinopatia del tendó del bíceps crural
  • Es produeix amb freqüència en el ciclista, el dolor s’assenta al cap del peroné.

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