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Knee pains: How to prevent and recover

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Knee pains are becoming very common.  Most of the orthopedic surgeons in professional football and hockey are specialists in the knee, leaving others to look after the rest of the bones in question.  In looking after sports injuries in my clinic, I can attest to the high rate of knee injuries among part-time athletes as well. 

Some logical questions follow:

1. Why is the knee so vulnerable to sports injuries?  The main reason is its range of movement is only in one plane.  Other joints can swivel, but the knee is just like a single hinge that straightens or flexes the leg, and is integral in our ability to walk, run, and jump.  However the knee has virtually no protection to a side impact.  Nor does the knee do well with twisting or rotational forces.  With the popularity of contact sports, especially ones with  helmets and hard pads, we are seeing more collisions resulting in serious knee injuries.  

2. Even in non-contact sports, such as running, we are seeing more gradual erosion of the knee structures.  While running is one thing the human body was well designed to do, the knee is not a great shock-absorber when one runs on pavement.  

3. Paradoxically, the inactivity of the modern work place also contributes to the rise of knee injuries.  With movement, the synovial membrane around the knee produces fluid, which not only lubricates the joint, but provides trace quantities of oxygen and food to the cartilege cells.  But today, we don't move our knees at work, we fold them under us like a deck chair.  At the end of day, it gets ugly, watching people trying to force their stiff legs into the standing position.

 

If you have injured your knee, here are some important action items:

1. Apply ice to ease swelling and pain, for about 10 minutes every half hour.  Make sure you have a layer of cloth between your skin and the ice, to protect from freezer-burn

2. See your doctor if you are not improving.  Images of Xray, Ultrasound, and MRI can help identify pathology.

3. When bending the knee, there is never any need to go beyond 90 degrees, unless you are just stretching. 

 For example, when you are doing a squat in the gym, just bend as far as if you were about to sit in a chair, then back up.  

Never bend the knees so far you can sit on your haunches if you are loading the joint with weights, or even your body weight.  If bending to pick something off the ground, bend just one knee to touch the ground, so both knees are at 90 degrees.  Its much easier to stand up, and much less likely to hurt the knee.

 

4. Watch your leg posture at the desk.  If your knees are hyper-flexed all day under your chair, they you will have a host of issues from dry knees, including stiffness of the surrounding muscles.  Try to set a timer to remind you to bend and flex the knee every fifteen minutes, even if you have to cradle it in your hands to get it started.  

5. Consider a soft knee brace when standing or doing activities.  

Not great for sitting with bended knee, as they tend to cut off the return blood flow if they crinkle behind the knee.  But when the knee is more straight, it can provide support, and may help reduce some of the swelling.  At the very least it will remind you which one is the sore knee, so you won't accidentally land on the wrong foot when running down the stairs for a train!

6. For rehabilitation, seek exercises that don't hurt, and that don't create impact.  Eliptical machines, bikes, swimming, skating etc are all good suggestions, along with controlled weight lifting and stretching exercises.  Make sure you seek professional guidance to make sure your ergonomics are good.  

 

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