But you don’t have to be an athlete to experience knee pain. Automobile accidents commonly involve knee injuries. So do falls. Some knee pain stems from overuse or age-related wear and tear on the joint. The most common cause of knee pain is osteoarthritis, a degenerative wearing down of the cartilage cushions in the joint, causing bones to scrape painfully against each other. Part of the problem is design, or rather the inability of knee design to change whenever human beings place new demands on it. “The knee, without question, is ill suited for the jobs we ask it to do,” says James M. Fox, MD. It wasn’t designed for football, soccer, automobile accidents, carpentering, plumbing, or squatting and kneeling all day long. If you have knee pain because of overuse or abuse, here are a few things you can do to make amends.
Take A Load Off
Body weight is a major contributor to knee problems, says Fox. For every pound you weigh, that’s multiplied by about six in terms of the stress placed across the knee area. If you’re 10 pounds overweight, that’s an extra 60 pounds your knee has to carry around. (Here’s how to start walking when you have 50+ pounds to lose.)
Don’t Bother With Knee Braces
Knee braces can be purchased at just about any sporting goods store, but the experts say to leave them on the shelf. Some braces are meant to unload pressure that’s affecting a specific area in the knee, but these are typically cumbersome, expensive, and require a prescription from your physician. “The wraps or braces you buy off the shelf at a sporting goods store shouldn’t be used for anything more than to remind you that you have a bad knee,” says Fox. Some of them can do more harm than good, by pushing your kneecap into the joint, says athletic trainer Marjorie Albohm.
Try An Insert
Some patients find relief from knee pain with shoe inserts called orthotics, says Fox. When they are placed in the shoe, they can redistribute pressure and reduce impact on the knee. There are a variety of orthotics available in drugstores and doctors offices. They can also be custom made just for your knee ailment. Start with the commercially made ones at your local pharmacy. If they don’t help, try the orthotics available through your physician or a physical therapist before springing for an expensive custom-made one, suggests Fox.
Go Homeopathic
Arnica, an herb that comes from a European flower, has natural anti-inflammatory properties. German scientists found that it reduces swelling of the knee from surgery. Use homeopathic arnica as an adjunct to ice or conventional medications you may be using for knee pain, suggests Jane Guiltinan, ND. Rub arnica ointment on bruises or strained muscles, or take it up to six times a day in the form of 3 pellets placed under the tongue.
Reach For A Nonprescription Medication
Ibuprofen is the over-the-counter painkiller of choice recommended by our experts. It reduces inflammation and provides pain relief without causing as many stomach problems as aspirin. Acetaminophen is fine as a painkiller and causes fewer stomach problems, but it does little to reduce inflammation. Studies have also shown ibuprofen can significantly improve joint mobility in people with acute knee ligament damage.
Try An Alternative
Methylsulfonyl-methane, more commonly called MSM, is derived from sulfur and may prevent joint and cartilage degeneration, say scientists at the University of California, San Diego. People with osteoarthritis of the knee who took MSM had 25% less pain and 30% better physical function at the end of a 3-month trial at Southwest College of Naturopathic Medicine. Start with 1.5 to 3 grams once daily, suggests Leslie Axelrod, ND. For severe pain, increase the dose to 3 grams twice daily, she says. Studies show that dosages as low as 500 milligrams three times daily helps improve pain and function.
Give Your Knee Some C
Australian scientists discovered that vitamin C, found in produce like bell peppers, kiwifruit, tomatoes, and oranges, reduces knee pain by protecting your knees against arthritis. Researchers studied 293 middle-aged people who were free of knee pain. Ten years later their knee tissue was assessed with an MRI. Those eating high amounts of vitamin C in their diets were less likely to have bone degeneration that leads to knee pain and the development of knee osteoarthritis. Researchers also found that other antioxidants, including lutein and zeaxanthin found in green veggies (such as spinach), can protect against arthritis and age-related wear and tear.
Try The Rub That Soothes
Some menthol lotions produce heat, which can relieve symptoms and make you feel more comfortable, says Fox. By covering the knee in plastic after applying the lotion, you can make the liniment even hotter. Be careful that you don’t burn your skin or cause irritation.
Find A Spicy Cure
Over-the-counter creams that contain capsaicin, an extract from chile peppers, may tone down knee pain. A study found that nearly 40% of arthritis patients reduced their pain by half after using capsaicin cream for a month. These creams, such as Zostrix and Capzasin-P, may be irritating to the skin, so try a small test spot for a few days before applying it to your entire knee, and don’t apply it to broken skin.
Strengthen With Exercise
The only things holding the knee together are the muscles and the ligaments, says Fox. Building up the muscles is critical because they are supporting structures. If the muscles don’t have enough power or endurance, you’re going to be in trouble with your knees. Stronger muscles provide you with a stronger joint, one that’s better able to withstand the considerable strain that even walking or stairclimbing places on the knees. The goal of these exercises is to strengthen your quadriceps, the muscles in front of your legs, and your hamstring muscles, in the back of your thighs. These two muscles must be in balance, says Fox. If just one or the other is developed, it causes stress on the knee joint. The following exercises are not hard to do, and they hurt a lot less than aching knees. Isometric Knee Builder. Sit on the floor with your sore knee straight out in front of you. Place a rolled towel under the small of the knee, then tighten the muscles in your leg without moving the knee. Hold that contraction and work up to keeping the muscles taut for at least 30 seconds, then relax. Repeat this tightening and relaxing up to 25 times. Sitting Leg Lifts. Sit with your back against a wall and place a pillow in the small of your back. (Sitting against a wall ensures that the leg muscles do the lifting. This type of leg lift won’t aggravate back pain.) Once you’re in that position, do the isometric contraction described above for a count of five, then raise your leg a few inches and hold it to a count of five, then lower it and relax for a count of five. Work up to doing three sets of 10 lifts each, always using the five-count for pacing. A word of caution: If an exercise causes increasing discomfort or pain, stop, Fox advises. You have to listen to your body. Don’t work through the pain. MORE: The Best And Worse Exercises For Bad Knees
Try To Modify
Athletes with chronic knee problems have to modify their levels of training or daily activity, says Albohm. “But that doesn’t mean turning into a couch potato.” If you like racquetball and you have a chronic knee condition that racquetball gradually made worse, you’re probably going to have to stop that activity, she says. Options? Try swimming, cycling, or rowing, all activities that are beneficial to health without placing great strain on the knees. The key phrase is “non-weight-bearing” activity. In fact, by helping to strengthen thigh muscles, non-weight-bearing exercises such as cycling and rowing can give you better knees without sacrificing aerobic capacity or caloric burn. Whatever you do, don’t give up a healthy lifestyle because of knee pain. No one should have to stop being active, Albohm says. Simply avoid anything that causes pain in that knee
Change To A Softer Running Surface
A lot of runners have pain caused by tendinitis that results from poor training habits, says Fox. These are not significant mechanical problems, he says, and they can often be minimized by a change in running surface. For starters, run on grass before asphalt and asphalt before concrete. Concrete is the hardest surface of all and should be avoided as much as possible. Don’t make a habit of jogging on sidewalks. Try to find a golf course to run on once the golfers have left. “When you run a mile, your foot strikes the ground between 600 and 800 times,” Fox says.
Try RICE
Following any activity that causes knee pain, Albohm says to immediately rest the area and apply ice, compression, and elevation for 20 to 30 minutes. That advice is commonly called RICE, short for rest, ice, compression, and elevation. “Don’t underestimate the power of ice,” says Albohm. Ice is a tremendous anti-inflammatory and will really help the condition. Keep your icing routine simple, she says. When you return from working out, just prop the leg up, wrap an elastic bandage around it, and apply an ice pack for 20 to 30 minutes. That should always be your first try at relieving pain.
Use Heat With Caution
When there is no swelling present, using a heating pad before an activity may let you exercise with less pain. But, Albohm cautions, if there’s any swelling, don’t use heat. Also, don’t use heat after an activity, she says. We’re assuming the area is becoming irritated by activity, and heat is only going to increase any irritation that’s there.
Update Your Shoes
If your shoes can’t absorb the shock anymore, says Gary M. Gordon, DPM., that shock has to go someplace. So it goes through your foot, up your shin, and into your knee. Sometimes it keeps on going, up to your hip and back as well. “I tell runners that they should change their running shoes every 300 miles,” Gordon says. If they run less than that, they need new shoes once a year. Aerobic dancers and basketball and tennis players who work out twice each week can probably get by with new shoes every 4 to 6 months. But if they exercise four times or more each week, they need new shoes every 2 months. Most people don’t want to hear that. (Try one of the 10 best sneakers of the year.)
Exercise In Water
The buoyancy of water makes it the perfect place to gently exercise a sore knee joint, says fitness consultant Lisa Dobloug. Try your regular knee exercises slowly underwater. Swimming and specific exercises for strengthening the quadriceps and hamstring muscles will keep you in shape without putting stress on your knees, she says. MORE: 19 Pool Exercises You Have To Try
Limber Up In The m
To keep the knee and hamstring muscles supple, start with an a.m. stretch, suggests Dobloug. Lie on your back with one leg bent and your foot flat on the floor. Lift the other leg slowly toward the ceiling, foot flexed, leading with your heel. Then slowly lower your leg. Repeat 12 times with each leg.
Always Stretch And Move Slowly
Many of Dobloug’s clients are older and have special needs when it comes to protecting their knees. Her emphasis is on the quality—not quantity—of exercise and the importance of stretching and moving correctly. It’s very important to warm up, she says. Take about 5 minutes and do very light stretching before you begin to exercise. Maybe go through the motions of whatever exercise you’ll be doing in a very light manner.
When To Call A Doctor About Knee Pain
The abrupt twisting motions that occur in basketball or skiing, or side impact to the knee, perhaps from a car accident or football tackle, can result in a knee injury. Generally the cruciate ligament or the medial or lateral collateral ligament of the knee is damaged. These injuries may or may not involve pain when they occur, but you may hear a buckle sound or “pop.” Tendinitis and ruptured tendons can happen with overuse, or when you attempt to break a fall. These injuries may be followed by swelling, tenderness, radiating pain, and perhaps some discoloration and loss of motion. Your knee should be iced, and then seen by a doctor as soon as possible.
Panel Of Advisors
Marjorie Albohm is a certified athletic trainer and president of the National Athletic Trainers Association in Dallas. She served on the medical staff for the 1980 Winter and 1996 Summer Olympics and the 1987 Pan American Games. Leslie Axelrod, ND, is professor of clinical sciences at Southwest College of Naturopathic Medicine and Health Sciences in Phoenix. Lisa Dobloug is president of Saga Fitness, a personal training and spa consulting company in Washington, D.C. Many of her clients are older people who wish to remain active and who appreciate her sound and appropriate advice about exercising. James M. Fox, MD, specializes in arthroscopic surgery of the knee and sports medicine at Synergy Health Medical Group in Los Angeles. He is author of Save Your Knees, Again and was a member of the medical staff for the 1984 Summer Olympics. Gary M. Gordon, DPM, is chief of podiatry at the University of Pennsylvania Sports Medicine Center and has a practice in Glenside, Pennsylvania. Jane Guiltinan, ND, is a professor of naturopathic medicine at Bastyr University in Kenmore, Washington, and the former president of the American Association of Naturopathic Physicians.
