>Knee-friendly
exercise
>Ease into it
>Cross train
>Strengthen
>Knees and
nutrition
>Shoes and
equipment
>Sidebar:
Help for Hurting Knees
>Sidebar:
Knee Anatomy
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What You Need to Know About Your Knees |
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By Yasmine Iqbal
Winter 2005 Online
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Don't let a "bum knee" slow you
down. Try these tips to protect and strengthen those hard-working
joints.
We demand a lot from our knees, the
largest joints in our bodies. When we walk, they bear three to five
times our body weight. Climbing a flight of stairs could double that
pressure. Add a daily jog or a few rounds of pickup basketball, and
it's no wonder that by the time we reach middle adulthood, our knees
can start to ache, creak, or show other signs of wear.
Your knees can last a lifetime - if you take care of them. Here's a
crash course on knee knowledge and tips about how to keep them in
good working order.
Knee-friendly exercise
A high-impact, pulse-pounding
workout that's great for your heart and lungs could give your knees
a beating if they're not strong enough to support this activity.
Experts offer the following advice for preparing and protecting your
knees while exercising.
Ease into it
"A good warm-up promotes blood flow
and bathes the knee joints in lubricating fluid, priming them for
activity," says Dr. Thomas DeBerardino, an orthopedic surgeon at
Keller Army Community Hospital in West Point, N.Y. A warm-up should
last at least 10 to 15 minutes and be an easy version of the
activity you're about to do - for example, if you're going for a
run, start with a walk or light jog.
Follow your warm-up with a brief stretch, holding each stretch for
at least 30 seconds. But don't stretch to the point of pain, and
don't bounce.
"Stretching should be a continuous, gradual process," says Dr.
Richard Schaefer, an orthopedic surgeon at Walter Reed Army Medical
Center in Washington, D.C. The Mayo Clinic offers a
slide show about how to stretch your major muscle groups,
including your knee muscles.
Cross train
Too much of the same kind of
exercise - especially high-impact activities such as running - can
damage the knees over time. "Alternate high-impact activities with
low-impact ones, such as bicycling, swimming, or using an elliptical
trainer," Schaefer suggests. Also, avoid the urge to overdo. If
you're starting a jogging program, for instance, start with short
distances and gradually increase your mileage.
Strengthen
The muscles around the knee - the
quadriceps, which run along the front of the thigh and straighten
the knee; the hamstrings, which run along the back of the thigh and
bend the knee; and the calf muscles, which originate at the knee and
raise the heel - are the knee's primary shock absorbers, says Dr.
Hari Bezwada, an orthopedic surgeon at Pennsylvania Hospital in
Philadelphia. "The stronger these muscles are, the less pressure
will go toward the actual knee joint," he says.
Lt. Col. Dan Rendeiro, USA, a physical therapist at Brooke Army
Medical Center, Fort Sam Houston, Texas, suggests incorporating
quadriceps, hamstring, and calf exercises in an overall
strength-training program. Knee 1 (www.kneel.com)
offers detailed descriptions of knee-strengthening exercises (http://www.knee1.com/exercise/index.cfm).
Knees and nutrition
There's some anecdotal evidence
that supplements such as glucosamine and chondroitin sulfate can
alleviate minor knee pain and protect the knee cartilage from wear
and tear. According to DeBerardino, these supplements are said to
increase the thickness of the cartilage surface and promote nutrient
flow to the knee and joint fluid. Rendeiro points out that there's
no evidence these supplements cause long-term changes in the knee,
but they could alleviate pain if they're taken regularly over time.
The American Academy of Orthopaedic Surgeons (www.aaos.org)
has
more information about glucosamine and chondroitin supplements.
A well-balanced diet with enough calcium and vitamin D also promotes
knee health by maintaining bone health, says Bezwada. For more
information about recommended daily amounts of vitamins and
minerals, see the
National Institutes of Health's Office of Dietary Supplements fact
sheets.
Shoes and equipment
Appropriate athletic shoes can help
prevent knee damage by absorbing shock and correcting motion
problems. "Seek a shoe store with knowledgeable salespeople who can
talk to you about your foot type, the activities you plan to do, and
the type of shoe that might be right for you," says DeBerardino.
Another tip: Buy shoes later in the day to ensure a good fit,
because the feet tend to swell as the day passes. WebMD
offers
advice about how to choose athletic shoes.
If you have foot problems, Schaefer suggests consulting your
physician about orthotics, which are custom-designed insoles that
could help with gait problems and prevent overcompensation of the
knee.
In most cases, braces are only useful if you've had a knee injury
and need extra support. "Braces don't prevent injuries - focus
instead on strengthening the muscles around the knee so they serve
as natural stabilizers," says Bezwada. Consider kneepads if you
participate in activities that require a lot of kneeling, if there's
a chance that something could strike your knees, or if there's a
risk of falling on your knees.
Some exercisers, particularly runners, swear by bands such as Cho-Pat
straps (http://www.cho-pat.com/)
that are said to stabilize the knee and reduce inflammation by
applying pressure on the patellar tendon, which connects the kneecap
to the shinbone. However, Rendeiro warns against relying too much on
these devices, pointing out that if you're using them consistently
to suppress pain, you might be masking the symptoms of a serious
problem.
Too often, we ignore our knees until we're in serious pain. Take
time to appreciate and care for these hard-working joints, and
they'll stay strong and limber for years to come.
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Sidebar: Help
for Hurting Knees |
Most minor knee pain and
soreness will respond to RICE - rest, ice, compression,
and elevation - along with over-the-counter pain
relievers. But some symptoms, including sharp pain or
any kind of locking or catching of the knee joint,
warrant an immediate trip to the doctor's office. "In
general, the more localized the pain is, the more
serious it is," says Lt. Col. Dan Rendeiro, USA, a
physical therapist at the Brooke Army Medical Center at
Fort Sam Houston, Texas. Don't wait to seek help, he
warns. Because certain parts of the knee, such as the
cartilage, have no nerve supply, you could have
significant damage and not know it.
Common knee injuries include meniscal tears (in which
the cartilage between the bones of the knee rips) and
tears of the anterior cruciate ligament (ACL), which is
one of the ligaments that connects the femur (thighbone)
to the tibia (shinbone). Today, most knee surgery is
done with minimally invasive arthroscopic techniques, in
which the surgeon uses a tiny camera and miniaturized
instruments to look inside the knee and repair the
damage, bypassing the need for a large incision. Surgery
today is generally much easier to recover from - even
some total knee replacements can be done on an
outpatient basis. The American Academy of Orthopedic
Surgeons has
more information about common knee surgeries.
The philosophy of rehabilitation also has changed. In
the past, physicians elected to keep limbs immobilized
for days or weeks. "Now, rehabilitation starts almost
immediately after surgery," says DeBerardino. "We've
realized that moving the knee keeps the joint fluid
circulating, prevents blood clots, reduces swelling and
stiffness, and promotes faster healing." |
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