Your knees are the hardest-working joint in your body – and the ones that can give you the most trouble if you don’t look after them. Most people see their knees purely as that handy hinge in their legs, or as an indicator for the right length of skirt. Knees get no attention until they start to cry for help by hurting, and that is when you realise that activities that you previously took for granted are now becoming uncomfortable or painful. Listen to your knees and take some action!
Normal walking places a force of 50% of your body weight on the knee joint. Climbing or descending stairs increases this force by a factor of three or more, and exercises such as squats can load the knee with up to seven times body weight. Cycling, hiking, skiing and other active sports can all put extra strain on the joint, so it is perhaps no surprise that knee problems tend to strike more active people earlier in life.
We all get aches and pains, but there are some signals that it may be time to take your knees to the doctor. These include pain that lasts more than a few days, pain that keeps you awake at night and pain that does not seem to be associated with a particular injury.
Some of the things that can wrong with the knee include:
· ‘patella tracking’ problems, where the kneecap no longer runs correctly in the groove at the end of the femur (thighbone)
· Sprains, strains or tears of one or more of the four ligaments that are part of the joint
· Fractures of the patella – usually caused by a bad fall or an impact
· Problems with the knee capsule and membranes that surround the joint
· Longer-term general problems such as arthritis
With all these possible issues, you might wonder how your knees work at all. The good news is that many of these problems can be cured or alleviated if caught early and given the correct treatment. So if you think that you have a knee injury, don’t hesitate to ask for medical advice.
If you would like to reduce the chance of future knee problems, here are some ideas.
The biggest thing that you can do to help your knees is to carry less baggage on them - keep your weight under control. This can be difficult if your knees are already hurting, as this will discourage exercise. This is an excellent reason to manage your weight throughout your life; while ‘star slimmers’ and ‘big losers’ get top billing, it is much better not to get fat in the first place!
Like all joints, the knee itself cannot be strengthened. However strengthening the muscles around it will improve the support to the knee, and can help to keep the patella in the right place. Strong quadriceps (the muscles at the front of the thighs) help to keep the patella in place – but this may need balancing with stronger hamstrings (the muscles at the back of the thighs). So before embarking on a programme of exercises for specific muscles, take advice from a qualified trainer or physiotherapist.
Keep those knees moving! Unless you are advised to do so following an injury, keeping moving is always good, even if it is just a gentle walk. Staying on flat ground is easier for your knees and still allows you to get some exercise.
The lubricating fluid in the knees can be ‘squeezed dry’ by too many steep descents. Keen walkers and hikers might therefore want to use walking poles, which reduce the strain on the knees by transferring body weight to the arms. This is particularly helpful when climbing or descending. One pole is better than none, but two poles are better still as they will keep the body even and in line. Adjust them correctly and watch your technique, you don’t want to transfer the injury to your arms or shoulders.
Even if you are not a ‘serious’ walker, the right shoes are very important for your knees. Women are particularly prone to problems; high heels should be for special occasions, not everyday use, and the same applies to ‘ballet flats’ which do not support the foot at all. Men should also take care to replace worn out shoes, and everyone needs a pair of good trainers or walking shoes for exercise.
Cycling is a low-impact exercise because the knees are not taking weight – but the repetitive motion can lead to overuse injuries. Cyclists must adjust their bike correctly. That means not only the right frame size, but correct adjustment of saddle height and handlebar position. A common mistake is to have the saddle too low. This means that the pedalling motion includes a point where the knee is bent beyond a right angle, and the leg is never straightened. This increases the risk of injury.
Don’t let knee problems stop you doing the activities that you enjoy. Listen to your knees and they will look after you. If in doubt, take them to a doct
by Kath Webb
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