Review: The Curious Human Knee

 The Curious Human Knee is a book about the knee. I borrowed it from the library expecting to learn about the knee's architecture, why they are so easily damaged, and how to prevent injury and what the process of fixing a damaged knee is. Instead I got a curious mis-mash of knee information and weird fashion segmentations. The author feels like she suffered from a case of ADHD, jumping from one random topic to another.

I've long thought that the human knee was a particularly good example of poor engineering. Han Yu instead explains that the reason the knee is so easily damaged is because it's so flexible and offers so many degrees of freedom of movement:

Dynamic freedom comes at a terrible cost. The knee is flexible because it is fundamentally unstable. It is, essentially, a few pieces of rigid, ill-fitting bones bound up by rope-like soft tissues. Nothing is fused in place, so the knee can move in just about any direction. For the same reason, it can also twist, misalign, overstretch, or simply fall apart. (kindle loc 508)

Ok, so what can we do? She mentions  that there are training programs that can help prevent injury:

In one program, female high-school volleyball players were drilled in various jumping tasks: broad jump, vertical jump, single-legged jump, squat jump, and more.98 The emphasis was placed on maintaining good techniques: keep the spine erect and shoulders back, point the knees forward, jump with the chest over knees, and land softly with bent knees and toe-to-heel rocking. After six weeks of training, the participants were able to reduce valgus collapse stress by about 50 percent, increase hamstring power by up to 44 percent, and reduce landing force by 22 percent.99 In another successful program, female soccer players completed, among other things, leg stretching, jumping tasks, and strengthening exercises.100 Similar emphasis was put on correct landing techniques. Compared with soccer players in the same league who did not enroll in the program, those who were enrolled saw an 88 percent reduction in ACL injury in the first season and 74 percent reduction in the second season. (kindle loc 1826)

Details? How to do it yourself? Nada. That kinda sucks. She does debunk several myths. For instance, icing does nothing, and neither do prophylactic braces. In fact, both might cause more problems:

 Compared with using a stationary bike to cool down, immersing legs in cold water after strength training reduced muscle mass and strength.34 Researchers have speculated that this is because muscle protein synthesis depends on blood supply, and icing, by reducing blood supply, suppresses protein synthesis. In other words, icing can negate the benefits of exercise and reduce long-term muscle development, quite the opposite outcome for people who ice for sports recovery. (kindle loc 2506)

 prophylactic braces were not able to reduce knee injuries; in fact, they seemed to make players more likely to hurt themselves.81 Alarmed, the American Academy of Pediatrics Committee on Sports Medicine issued a statement in 1990 recommending that these braces “not be considered standard equipment for football players.”82 (kindle loc 2709)

 Then suddenly the book would switch into a discussion of skirt length and fashion. It would then come back and tell you interesting things about Osteo-Arthritis:

Despite their relatively lower body mass index, Asian populations have more knee OA than Western populations.58 In Malaysia, for example, an estimated 25 percent of people over the age of fifty-five suffer from knee OA.59 In Korea, 38 percent of people over the age of sixty-five do. (kindle loc 3488)

It turns out that many Asian cultures do a lot of kneeling, and that's not good for your knee. The book then jumps back into fashion and discusses ripped jeans and other distressed clothing that are part of fashion nowadays. Sure, I'm concerned about the environmental impact of fashion and the irony of rich people wearing clothes that are deliberately made to look worn out (my wife had to tell me to throw out swim shorts because they were starting to develop holes in all the wrong places), but does that really belong in this book?

I really wanted to like this book, but I think in this case the author needed a much better editor than the one she had.