Knee problems: are they inevitable?

Preventing knee injuries is possible with proper diet and exercise
How often do you think about your knees? Some of us complain about their appearance, be they bony, knobby or wrinkly. Others may joke that their knees ache in the cold.
 
But our knees are vital to our everyday activity. Knees help to propel us across the finish line of our first half marathon, to tend to the fruits and vegetables growing in our garden and to teach our children how to jump rope.
 
Caring for your knees should be a central part of your overall healthcare routine, through exercise, diet and awareness. Daily care now, and every day moving forward, can save you from pain or injury in the future.
 

Common Issues & Injuries

Minor knees symptoms develop from everyday wear and tear, overuse or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks or even home projects.
 

The most common types of knee injuries include:

  • Patellofemoral dysfunction: kneecap tracking issues which are more typical in younger patients (ages 15-30) and respond well to exercises to improve strength and alignment.
  • Meniscal tears: these issues tend to happen with loaded twisting forces, which happen when the knee is bent and/or making a twisting motion such as when planting the foot and then moving (either to the left or right) in sports like football, soccer, basketball and tennis; they can respond well with exercises but if they are larger or impede motion causing locking they may require intervention by an orthopedic surgeon.
  • Ligament sprains or muscle strains: these also happen with loaded sudden forces, such as in sports, and benefit from physical therapy rehabilitation during the healing process; if a complete tear occurs, you would require intervention by an orthopedic surgeon.
  • Arthritis: this is most common with aging and is often seen earlier in a knee that has had previous injury; arthritis responds well to exercises to maintain motion and improve strength but as the process continues patients often begin getting pain at rest and pain that limits activities at which time they need to see and orthopedic surgeon.
“It’s important to remember that we can’t always control what happens to our body. You may develop arthritis in your knees no matter how healthy of a lifestyle you live,” said David Cotteleer, a physical therapist for PeaceHealth in Longview. “That being said, you can give yourself the best chance by maintaining a healthy level of activity, eating a diet rich in antioxidants and watching your weight.”
 

Stay Active

Most healthcare providers agree that getting 30-45 minutes of low to moderate activity each day is key to both our cardio-vascular health and the health of our knees and joints.
 
“Running, cycling and swimming are all great forms of exercise, if your joints are healthy,” says Cotteleer. “Walking is vastly underrated and it’s a great way to stay healthy.”
 
The key here is low-impact exercise to build healthy muscle tone and create good joint mobility, allowing your body to stay loose and limber.
 
“Yoga is an ideal form of low-impact exercise, as is a stretch and strengthening class,” says Tobin Hanson, OD, an orthopedic surgeon for PeaceHealth in Florence, Oregon. This type of class can enhance body strength, balance and flexibility by using light to moderate weights, bands and your own body.
 
In addition to cardio-focused exercise, strength training is also important. Scientific studies have shown that keeping the muscles around the knee joint strong will reduce the force and wear on the knee joint.
 
“Lunges, squats and step-ups are a pillar of healthy activity. They are easy exercises to strengthen the muscles around your knees and to increase or maintain flexibility,” says Cotteleer. “You don’t have to join a gym. All of these activities can easily be performed at home. For example, I might recommend to a patient to perform a series of exercises three to four times a week, such as three sets of 25 airs squats or three sets of 10 lunges.”
 
Just be sure not to over-do it and “keep strength training activities to no more than 30 minutes,” adds Cotteleer.
 
While it may sound simplistic, don’t forget the importance of wearing proper foot ware while exercising; sure footing can help to avoid missteps or falls.
 
The key is to exercise safely and choose sports, activities and movements that reduce your risk of injury. This will make exercise an enjoyable part of your daily routine. 
 

Move Safely

While it’s important to stay strong and active, it’s also vital to use good body mechanics to maintain best joint function and avoid overuse injuries.
 
“To help prevent knee problems, practice good alignment of the lower extremity by keeping the knee lined up over the toes and not allowing the knee to deviate inwards or outwards,” says Sylvie De Rham Tortorelli, a physical therapist for PeaceHealth in Bellingham. “Facing what you are doing also helps reduce twisting through the knee and is helpful in avoiding injuries or overuse problems. Keeping good range of motion, strong muscles and good proprioception (or joint position awareness) helps the body avoid problems and injuries.” 
 
Don’t forget to stretch and be sure to warm up first. Hanson cautions that “cold muscles can easily pull.” Focus on all the muscle groups in your lower body including your hip flexors, hamstrings, quadriceps and calves. Be sure to stretch after exercising, as well.
 
Stretching can help with flexibility. “As we age, our bodies naturally become more stiff,” says Hanson. “Lack of flexibility is a common contributing cause of knee injuries.”

 

Maintain a Healthy Diet & Weight

Although there is no diet cure for joint pain or arthritis, some foods have been shown to fight inflammation and strengthen bones. An ‘anti-inflammatory’ diet (similar to the so-called Mediterranean diet) can be ideal, with an emphasis on fish, fruits, vegetables and olive oil, among other food staples. *
 
“Although the scientific data is still to be determined, there is merit to an anti-inflammatory diet,” said Hanson. “In particular, eating fish like salmon, which is high in omega-3 fatty acids and can help reduce inflammation and joint pain.” 
 
Omega-3 fatty acids also play a role in keeping your joints healthy by restoring and supplementing joint tissues, reducing the friction between joints and helping to minimize pain and strains.
 
When choosing fruits and vegetables, aim for a variety of colors: red, orange, yellow, green, blue, purple and white. Each color carries its own set of unique set of vitamins, nutrients and anti-oxidants.
 
Weight is also a contributing factor to both common and series knee issues. When you walk on level ground, your knees bear the force of your body-weight.
 
“For every pound we carry on our body, three pounds moves through our knees,” says Hanson. 
 
If you have questions about your diet or a healthy weight range based on your gender and age, talk to your healthcare provider.

 

Signs of Injury

If you have started a new workout routine and experience marginal pain, don’t worry.
 
“Minor joint pain in the knees with new or unusual activity is not uncommon and typically resolves on its own,” says De Rham Tortorelli.
 
Be mindful of changes to your body during or after exercise, with attention on added intensity or frequency. Your body needs proper time to rest and recover.
 
“It is not in the scope of physical therapists to recommend medications, pharmaceutical or otherwise. We do recommend ice for knee injuries, applied on for 20 minutes and off for 40 minutes with a barrier such as a towel between the skin and the ice. Patients with arthritis often find benefit with heat application applied with the same parameters,” adds De Rham Tortorelli.
 
“Compression, such as an ace bandage, is good for the knee, in addition to elevation and rest,” adds Hanson. “I can’t stress enough how important rest can be.”
 
Continued knee pain can indicate something more serious than temporary pain from overuse. 
 
“Signs to watch for would include pain progression, the knee is not getting better,” says Hanson. “If you can’t put weight on your knee or you can’t full extend your leg, if you are unable to bend or straighten your leg. These are signs that you should contact your healthcare provider.”
 

Be Kind to Your Knees 

We often take our knees for granted because they are such a natural part of our everyday lives. 
 
Depending on your level of activity, your knees move thousands of times each day. They literally move every time we step, bend or jump, when we run, kick or dance, while we are at home, work or play. Our knees keep us independent and living life to the fullest.
 
So, get moving! Whether it’s a walk around your neighborhood or a beginner’s yoga class, the important thing is to get started and keep going. And when you’re shopping for groceries, envision a ‘rainbow’ and fill your basket or cart with a variety of colored fruits and veggies. Your knees will thank you.
 
We’ll end where we began: Is knee pain inevitable? Common, yes. Inevitable, no. There are steps you can take – both literally and figuratively – to keep them safe…knobby or otherwise.
 
*Source: Arthritis Foundation | arthritis.org