KNEE PAIN / INJURY
We bend them, kneel on them, run and jump on them daily, yet few of us give them a second thought. Knees. They're one of the most complex -- and most injury-prone -- joints in your body. Why? Blame the knee's design. Unlike the more stable hip joint, which is a ball in a deeply-cushioned pocket, the knee joint is more exposed -- and more vulnerable.
Essentially, the knee is made up of the thighbone (femur), which has a bottom end made up of two rounded knobs (condyles), sitting on the relatively flat top end of the shinbone (tibia). The kneecap is a small, rounded bone that sits in the vertical groove between the two condyles and gives the joint strength.
As the knee bends and straightens, the kneecap slides up and down in the groove. A tendon attaches the kneecap to the thigh muscles above, and a ligament connects it to the shinbone below. The kneecap acts like a pulley, increasing the power of the muscles attached to it.
Think about the kneecap as a puppet controlled by "strings" -- muscles, tendons, and ligaments. As long as all of the strings pull in just the right way, the kneecap moves back and forth smoothly in its track. But if any string pulls too strongly or not hard enough, the kneecap is pulled out of its track and can no longer glide easily against the thighbone, which can cause pain and may even damage the kneecap.
Because women have wider hips, the upper-leg bone of a woman enters the knee at a greater angle, which twists the knee. This makes women more vulnerable to certain types of kneecap injuries, such as chondromalacia (in which the smooth layer of cartilage that coats the end of the thighbone becomes roughened or cracked), as well as problems with the anterior cruciate ligament (ACL).
If the large muscles in the thigh (quadriceps) are inflexible due to disuse or lack of stretching before exercise or if these muscles are overused, they can cause inflammation of the knee tendons (patellar tendinitis), or "jumper's knee." Muscle imbalances, in which one group of muscles is stronger than another and pulls harder, can cause knee problems, too.
While knee problems can result from injuries such as falls, automobile accidents, and athletic injuries or diseases like arthritis, the vast majority of knee problems are caused from overstressing the knee during running, climbing, or other repetitive, high-impact exercise. Poorly conditioned leg muscles also stress the knees.
However, if your knee problems are the result of overuse, lack of use (or "weekend warrior syndrome"), or improper training rather than injury, you can use the strategies and home remedies in the next section to improve and maintain the health of your knees and, if you do develop pain, to help ease the hurt and speed healing.
Home Remedy Treatments for Knee-Saving Strategies
Since your knees take so much of the impact of exercise and everyday living, it's important to keep them healthy. Take note of the following home remedies to do just that.
Stay trim. Being overweight stresses all the joints of the body, but carrying around those extra pounds is particularly tough on the knees, because with every step, you exert on your knees a force equal to one-and-a-half times your body weight. When you run, the force is five times your weight. An extra 20, 30, 40, or more pounds of body weight (usually from body fat) can really stress the knees.
For example, if you're only 20 pounds overweight and you jog, you're putting 100 pounds extra force on each knee with every step. So work on getting and keeping your weight within a healthy range (ask your doctor what that range is for you) by adopting a low-fat, lower-calorie diet, and getting regular exercise.
Look at your feet. A common cause of knee problems is overpronation, or rolling inward of the foot. A certain amount of pronation is normal, but too much can cause knee problems because it throws the knee out of alignment.
You can correct overpronation with supportive shoes designed to prevent pronation or with orthotics, which are special shoe inserts. You can buy ready-made, over-the-counter (OTC) orthotics, or you can get custom-made ones from a podiatrist, orthopedist, chiropractor, or sports-medicine specialist.
Buy the right shoes. Wear the lowest heel possible. The body can tolerate a heel of about one inch; higher heels throw the body forward and stress the knees. If you tend to pronate, buy a shoe that has antipronation devices or high-density material on the inner side and cushioning material on the inner side of the sole. Also, seek out shoes that have a stiff heel counter, the part of the shoe that cups the heel, because it helps stabilize the heel.
For sports, buy shoes designed for the activity -- walking shoes for walking, running shoes for running, and so on. Wearing running shoes for walking can cause pain in the shins and, in some cases, knee pain.
Then replace them. Often, knee problems are simply the result of walking or running in shoes that are worn out. Replace your athletic shoes every six months or every 400 to 600 miles.
Check your alignment. If you're bowlegged or knock-kneed, you may be at greater risk for knee problems. To check your alignment, stand with your ankles touching. If you're in alignment, both your ankle bones and your knees should touch. If your knees touch but there's a large space between your ankles, you're knock-kneed. If your ankles touch but there's space between your knees, you're bowlegged.
If you are not in alignment, activities such as swimming or cycling, in which the knees don't take quite such a pounding, might be less likely than running to cause you pain. (If you choose cycling, be sure the seat is set high enough so that your leg is almost fully extended on the downward stroke to prevent knee strain.)
Don't rely on OTC braces. Often, you see people wearing knee braces or bandages they've purchased at the pharmacy. An OTC knee brace may make you aware of the knee and remind you to avoid overtraining, but it doesn't really correct or prevent problems -- in fact, it can give you a false sense of security and might tempt you to be less cautious than you should be.
If you do use an OTC knee brace, opt for the one-piece neoprene or elastic braces rather than the elastic wraps, which make it difficult to apply pressure evenly to the knee. But keep in mind that if your knee hurts enough to brace it, you should see your doctor.
Avoid "knee-busting" activities. Deep knee bends and squats may feel like great fitness boosters, but they're too hard on the knees. So is kneeling, especially on hard surfaces.
If you lift weights, never fully flex the knee, don't "lock" your knees when you're in the standing position, and keep the amount of weight you ask your knees to lift to a minimum.
If you're gardening, washing a floor, or doing some other activity that requires kneeling, use a foam kneeling cushion or knee pads and give your knees frequent rest periods.
Don't "run through" knee pain. Many people, especially athletes, believe that it's best to "run through" knee pain -- that if they keep going, the pain will disappear. However, they are likely doing more harm than good. Pain is a sign that something is wrong, and if you push through it, even more damage may occur.
Change surfaces. If you walk or jog on a road, do so on the flattest part -- roads slant downward toward the edges so that water will drain off. If the side of the road is your only option, switch sides of the road frequently.
Hard surfaces such as concrete or asphalt can increase the beating the knees take, too. If possible, run or walk on a softer surface, such as a forest pathway, grass, or a running track. Bypass soft, shifting sand, however, which can stress the knees.
Running or walking downhill can cause knee problems, as well. The natural tendency is to "brake" with the knees downhill, which can overstress them. Slow down and, whenever possible, traverse (that means zig-zag) rather than going straight down hills. If you're already having knee problems, you should probably avoid training downhill.
Mix it up. Repetitive movements strengthen some muscles while they allow others to grow week with disuse. That's why cross-training is such a good idea. When you cross-train, you do a variety of physical activities rather than just one or two. Combine running or walking with biking, swimming, dancing, aerobics, weight training, or any other activities you enjoy.
Stretch and strengthen. For strong, flexible knees, try performing these exercises regularly:
R.I.C.E. it. Okay, despite all the good advice, you've overdone it and your knee hurts. Give it R.I.C.E. -- rest, ice, compression, and elevation. Take the weight off the knee. During the first 24 to 48 hours, use an ice pack wrapped in a thin towel (20 minutes on, 20 minutes off) to keep the swelling down. Then wrap the knee (not too tightly) in an elastic bandage to reduce swelling, and keep the knee elevated.
Take an anti-inflammatory. Aspirin or ibuprofen can reduce the pain, inflammation, and swelling (acetaminophen eases pain but does nothing for inflammation). Don't use anti-inflammatories, however, if you have an ulcer, a bleeding condition, or a sensitive stomach. For a list of precautions to take when using over-the-counter analgesics,
Avoid heat. Ice prevents fluid buildup, but heat can promote it. For the first 48 to 72 hours after a knee injury, when the knee is probably still somewhat swollen, avoid hot tubs or hot packs.
Massage it. While massage won't affect the bony structures of the knee, it does increase circulation and can loosen tight hamstrings and other tissues that may be pulling on the knee. If you've already developed knee pain, see a massage therapist or physical therapist, not just a friend, for a professional massage.
Don't let knee problems sideline you from doing the things you enjoy. Take care of this joint from the start by following the home remedies outlined in this article.
Warning: The reader of this article should exercise all precautionary measures while following instructions on the home remedies from this article. Avoid using any of these products if you are allergic to it. The responsibility lies with the reader and not with the site or the writer.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE and should not be treated as a substitute for the medical advice of your own doctor.