What is it
Your knees are put under a lot of stress, whether you’re running, dancing, playing basketball, or simply house cleaning. Just climbing stairs can put stress on each knee equal to four times your body weight. The result is that a probable 50 million Americans suffer at some point from knee pain or injuries. At least one out of every four sports wounds includes the knee. Additionally, for millions, the knee is affected by prolonged, age-associated illnesses like arthritis.
Knee is the biggest joint in the body. Working instantaneously as a lever, hinge and shock absorber, the knee is the important to your ability to walk, stand up, kick and climb. Yet it depends almost entirely on soft tissue ligaments and tendons for stability. Because of its complexity and the great forces to which it is routinely subjected, the knee is susceptible to a host of injuries, which can take weeks, if not months, to heal, even with proper rehabilitation. Here are the most common problems and their causes.
Sprain (torn ligament)
Knee links the thigh bone (femur) towards the shin bone (tibia), and the only things holding these two huge bones together are four ligaments, that are sturdy but not very elastic. If these are stretched beyond a certain point, one or more of the ligaments can be sprained.
Sprains may range in severity from slight tears to thorough breaks, in which the ligament tears away from the bone and breaks (often with an threatening popping sound). Most seriously, the anterior cruciate ligament can rupture when you twist the knee in a fall, typically while downhill skiing. Other ligaments in the knee can be injured by a violent blow to the knee or sudden wrenching or twisting, as in hockey or soccer.
Runner’s knee (chondromalacia patella)
This overuse injury is due to degeneration of the shock-absorbing cartilage (called the meniscus) under the kneecap and covering the ends of the femur and tibia. It is characterized by duL, aching pain under or around the kneecap and is usually most noticeable when you are descending stairs or hills. Nearly 30 percent of runners eventually develop this disorder. Skiers, cyclists, soccer players, and people who participate in high-impact aerobics classes are also prone to it.
Tendons below or above the kneecap (patella) become swollen, commonly through overdoing for instance, from dancing, hiking, or cycling. One frequent complaint is jumper’s knee, a form of tendinitis that afflicts basketball and volleyball players and weight lifters in particular.
Iliotibial band syndrome
If the tendon that runs down the outer side of the knee is tight, repetitive motion (as in running or cycling) can cause the tendon to rub against the bony area at the end of the thigh bone and become irritated.
This injury to the cartilage in the knee typically occurs when you twist the joint while putting weight on it. Over the years frequent squatting can weaken the knee to the point where something as minor as getting out of the car can tear the cartilage.
The knee is a common site for osteoarthritis, which involves the degeneration of cartilage at the joint and subsequent inflammation. It is the result of normal wear and tear over the years.
- Pain, swelling, tenderness, and/or discomfort in your knee.
- Difficulty moving your knee joint; possibly a cracking sound when you bend your knee.
- An inability to straighten your leg.
- Discomfort or pain while walking or running.
What causes it
Most overuse injuries such as runner’s knee and tendinitis which are the problems most amenable to self-care are often linked to the muscles of the thigh, particularly the quadriceps. This large four-part muscle group on the front of the thigh, along with the hamstrings (located behind the thigh), provide the muscular support system for the knee. In addition to helping power movement, the quadriceps also stabilizes and guides the kneecap in its groove at the end of the thighbone. Weak or inflexible quadriceps may lead to improper tracking of the kneecap and instability of the supportive tendons, contributing to both runner’s knee and jumper’s knee.
What if you do nothing
Any persistent knee pain (beyond mild dis- comfort) shouldn’t be ignored, since it may lead to chronic pain, stiffness, and swelling. Moreover, the surest way to speed recovery is to treat a recurring ache or pain right away, even if you’re able to continue the exercise or activity associated with it. If you feel pain, at the very least stop and rest.
Bear in mind, though, that rest alone isn’t Likely to eliminate the cause of the problem. To avoid re-injury, you should not only actively treat the problem but take preventive measures such as those described below.
For knee pain stemming from overuse injuries like runner’s knee or tendinitis, you can reduce aches and pains and speed recovery with the following measures.
Rice the injury site
Stopping any activity and resting is the first step in RICE, an acronym for rest, ice, compression, and elevation. Apply ice as soon as possible. Use an elastic wrap for compression, and then keep your leg elevated to reduce pain and swelling.
Take over-the-counter pain relievers
Nonprescription NSAlDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling (though they won’t speed healing); acetaminophen will help with pain.
You can reduce the likelihood of a knee injury with the following precautions and conditioning exercises.
Beware of suddenly intensifying or lengthening your workouts
This can create additional friction in the joint and increase the risk of an overuse injury.
Check your exercise shoes
If they are worn or don’t fit well, they may put your knees at risk.
Check your feet
The knee sometimes pays the price for foot abnormalities (such as flat feet), over pronation (the feet roll inward too much), or poor leg alignment (such as knock-knees), which can put greater stress on the joint. An orthotic device a custom-made arch support may help correct some foot or alignment problems. Make sure your knee is always aligned with your foot while exercising.
Minimize knee stress when cycling
To accomplish this, set your seat to the proper height and don’t pedal in high gears.
To gauge seat height, check your knee position at the bottom of the stroke: your knee should be only slightly bent. If your knee is bent too much, the seat is too short, and you will wobble and lose stroking power. If your knee does not bend at all, or if you have to reach for the pedal, the seat is too high, which can stress the knee joint.
Cycling in high gear which increases tension on the pedals also increases the pressure on your knees. Stay in low gears, which means faster, easier revolutions on the pedals. You’ll get more aerobic exercise with less stress on your knees.
Stretch your leg muscles before and after exercise
Maintaining flexibility allows you to attain maximum range of motion for your knees.
Strengthen your leg muscles
It’s especially important to condition the quadriceps. If you are a runner or walker, your quadriceps are probably much weaker than your hamstrings, so it’s a good idea to alternate cycling (an excellent way to strengthen the quadriceps) with running. Walking up stairs or hills also helps strengthen these muscles.
Be kind to your knees
If you have knee problems, hills and stairs can put stress on your knees, so you should avoid them as much as possible. Also don’t kneel or do full squats, which can greatly increase stress on the knee. And avoid “knee-unfriendly” sports such as football, running on concrete, soccer, squash, tennis, and skiing.