Damage to these tissues also takes its toll on the
sensitive surfaces of the knees' bones. "The tissues in the knees work like the shock
absorbers in a car," says M. Solomonow, Ph.D., director of the bioengineering section
at the Louisiana State Medical Center in New Orleans. "If you make a lot of sudden
stops or subject these components to stresses they weren't designed to handle, they wear
out. In a car you'll hear the sound of metal on metal; in a knee you'll feel the pain of
bone rubbing on bone."
Many overuse pains are lumped under the umbrella
term chondromalacia patellae—a fancy way of saying pain in, around and under the
kneecap.
But not all overuse pains belong in this category.
Suppose you have an active teen in your house complaining of pain just south of the
kneecap. It could be Osgood-Schlatter disease, commonly called growing pains—a
condition arising from excess stress on the tendons of the lower leg bone. Combine lots of
physical activity with the rapid muscle and bone growth of puberty, and you get one
miserable kid with a painful, bony enlargement or bump on the upper part of his lower leg,
just in front of and below the kneecap.
When the knee is subjected to misuse as well as
overuse, it can develop a condition called synovitis. Your mother may have called it water
on the knee, because the achy joint now bears a striking re-semblance to a water balloon.
Synovitis is from a bang or twist that causes certain tissues in the knee to fill with
blood or other fluids.
Another knee condition related to overuse is
sometimes called housemaid's knee. It's really a form of bursitis—irritation
to the front of the knee causes a bursal sac in front of the kneecap to fill up with
fluid. Its most common cause: prolonged kneeling on hard surfaces.
The knee is also a potential site for a painful
condition called osteochondritis dissecans—a necrosis, or death, of a segment of bone
or cartilage. Its cause is unknown. Eventually, the dead cartilage or bone chip can break
off and produce even more pain as well as a locked knee.
In some instances, nasty knee pain can actually
originate elsewhere in the body, such as the toe, foot, spine or hip. Fallen arches or
weak ankles can cause your foot to overpronate (rotate too far inward), putting too much
force on the knee. And if you have poor posture or an improper gait, it can focus pain
directly to your knees.
| Use RICE on injuries. Whether from an acute trauma like a
sprain or simple overuse, injuries respond best to RICE: an acronym for rest, ice,
compression and elevation. "Rest is the key component," says Edward J. Resnick,
M.D., professor of orthopedic surgery at Temple University Hospital in Philadelphia.
"Then after a period of limited activity, doctors like to see a gradual resumption of
activity and exercise." Supplement several days of rest with applications of ice: 15
minutes at a time, several times a day to reduce swelling. Compress the knee by wrapping it snugly, but not too tightly, in an elastic
bandage to limit movement. And elevate the knee with pillows to drain fluids from the
joint. |
| Take an analgesic. Aspirin,ibuprofen and MSM are powerful pain
and inflammation fighters that will help sore, swollen knees. Acetaminophen will help
pain, but won't do anything for swelling. |
| Warm your wobbly knees. Cold is fine for injuries after they
first occur, but most lingering pain responds best to moist warmth, says Dr. Resnick. He
recommends a warm, moist towel, a hot-water bottle, a moist heating pad, a warm bath or a
whirlpool. |
| Drop a few pounds. "If you're overweight, losing weight is
a good way to reduce some of the painful forces acting on your knees with each step,"
says David W. Lhowe, M.D., orthopedic surgeon at Massachusetts General Hospital in Boston
and professor of orthopedic surgery at Harvard Medical School. "Contact forces on
joint surfaces in the knee can range up to eight times body weight. Lose 10 pounds, and
you'll reduce those forces by 80 pounds, which is a lot." |
| Support your arches. A simple over-the-counter arch support in
your shoe can prevent overpronation, says Peter Francis, Ph.D., professor of physical
education at San Diego State University. People who pronate severely may require a
professionally fitted arch device. |
| Cushion your knees. If you must spend periods of time on your
knees, take some of the stress off your kneecaps by wearing cushioned knee pads or knee wraps. And take frequent rest breaks so that the
stress isn't applied constantly. |
| Avoid squatting. Squatting and deep knee bends put enormous
stress on the knee and can cause cartilage tears or possible rupture of the quadriceps
tendon. Repetitive squatting can also produce prolonged episodes of knee pain in certain
individuals, says Dr. Lhowe. |
| Find alternatives to running. Nonpounding activities like
biking, walking and swimming can provide the same benefits as running, but are much kinder
to your knees, says Dr. Francis. If you must run, increase your warm-up time, cut back
your mileage, run on softer surfaces and always wear quality running shoes. |
| Send your knees to the gym. "Poor muscle tone is often the
real culprit underlying most chronic knee problems," says Phillip J. Marone, M.D.,
director of the Jefferson Sports Medicine Center at Thomas Jefferson University Hospital
in Philadelphia. "That's why in 80 percent of all cases, painful knees will respond
to a sensible exercise program focusing on building flexibility and strength, particularly
in the quadriceps and hamstrings [the large muscles at the front and backs of the
thighs]." |
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