Well functioning knees can help ease our path through life. For those who have suffered or are suffering knee issues, less well-functioning knees are an obstacle and benefit from careful management to help smooth that path. Knees come in a variety of shapes and sizes and like all body parts, their:
all can or will be altered by our lifestyle, life events and how we treat them, once our genes have determined the knees that we get to begin with.
Yes, with somewhere between 15-25% of middle-aged and elderly people suffering from knee pain at any one time. In 2012 over 70,000 knees were replaced with artificial ones and 2017 figures show that there are over 2.35million replaced joints in the all-time UK registry, though with the vast majority of people being aged over 75 at the time of their replacement many of these joints will by now be underground.
Your knee is a modified hinge joint between your upper leg (femur) and lower leg (tibia & fibula)
Think of a door hinge that hasn’t been screwed in properly – our knees will bend and straighten (door open and close) and will also perform a little rotation (door rocking on loose screws) which helps ensure that twisting and turning movements at your knee cause no issues.
The fourth bone involved in the knee joint is the knee-cap (patella) a floating bone which plays a large part in straightening your leg at the knee and also helps to stabilise your knee.
The main four cited risk factors for knee pain are:
Knee pain falls largely into three categories:
These will often – though by no means always – present as pain/ache/stiffness at the front of the knee (anterior knee pain) and sometimes pain on the outside of your knee caused by asking too much of your knees too soon. Rest, gentle stretching, heat/ice will all probably help initially and careful consideration by you and/or advice from a physio on how and when to start upping your activity again is pretty important, helping to ensure that you return to your activity without flare-ups.
These are more likely to result in strains to soft tissues – tendons and ligaments – and can obviously also affect joint surfaces if the injury is severe enough. Pain can appear at any area of the knee. Sharp pain, feelings of an unstable knee or a knee that gives way will benefit from some investigation to help establish what the problem is and how it can be fixed.
Osteoarthritis (OA) – degeneration of joint surfaces is a frequent offender here, commonly affecting the knees, hips and spine in the older population. OA can present as swelling, warmth and/or pain and/or reduced function i.e. a knee that has reduced ability to bend, squat, weight-bear etc. Rheumatoid arthritis (RA) is another joint condition, causing inflammation in the joint and leading to pain, joint deformity and immobility and more commonly affects fingers, wrists, feet and ankles. Symptoms of both will often be managed conservatively with exercise and lifestyle changes, with surgery being a last resort if these methods are no longer effective.
No, definitely not. Generally in the clients I see it is not the joint that is the issue but the soft tissues – muscles, tendons, ligaments – that surround the joint that are complaining. Soft tissue problems, relating to overuse and faulty mechanics are more likely to be the problem.
There is a genetic link which can slightly increase your likelihood of having degenerative knee problems if conditions such as rheumatoid or osteoarthritis are ‘in the family’ BUT this is by no means a given. Genes are randomly-behaving things and you can hugely affect the health of your joints by the care and attention that you do or do not pay your joints over the course of your lifetime.
If the popping/cracking noise, technically termed ‘crepitus’, is not painful then probably not. Scientists now think that the pop sound is caused by a sudden and very small vacuum space (cavity) that is created within the joint on sudden movements. The jury is still out on whether or not noisy knees will lead to problems down the line but I’ve see plenty of old, noisy and pain-free knees that are in better condition than similarly aged quieter knees.
I’m glad you asked! The long-term view as is best known contains the following:
Do some. Start small if you’re new to it and build up nice and gradually – a little and often, always choosing the level that suits you and your knees. If you’re changing the type of exercise you do then the same rules apply. Cardiovascular stuff – walking, cycling, swimming, running – are all good and knees will almost always welcome an element of strength training (see below) again tailored to suit you, your age, your level of fitness and many other factors.
This is a recognised contributing factor (fact) in knee pain. If you know that you should weigh less then consider your weight loss options – there are some amazing and effective diet plans, apps and programmes available these days to help. And remember that broadly speaking and medical conditions aside:
I think we all know that being a healthy weight is better for our joints – if you don’t then I can email you some information to back that statement up. See if you can’t bump ‘knowing’ to ‘doing’ and work out the weight loss method that works for you – with some self-administered shots of perseverance and responsibility, it can be done.
Pitch these at your level; I’ve started with the easiest options and progressed to the more challenging:
Tense your thigh muscle and, maintaining upright posture, straighten leg at knee – make it as straight as you possibly can (with only minor discomfort if you have grumbly knees) hold for 10 secs then relax & repeat….
Stand on a step or on the floor, rise up onto the balls of your feet, pause then slowly lower heels as far as you can, pause again and return to starting position and repeat….
Place your hands on your thighs and draw a circle with your knees, bending them more to take them forwards, then shifting them to the right, then backwards, then left and repeat… in both directions….
Balance is great for the muscles that support and stabilise your knees and this can easily be a time-filler at several points in your day while you’re waiting for something. Pick a leg, stand on it and see how you manage. If easy then get creative and make it more challenging…
Bend at your hips and knees, taking your upper body forward but keeping your back straight and your bum sticking out, to lower your bottom backwards, making sure your knees stay hip-width apart and don’t pass your toes. Go as low as you comfortably can – it doesn’t matter if this is 6 inches or bum on your heels – work with what is best for YOUR knees and then squeeze your bottom to get you back to the starting position and repeat….
Your gluteal (bottom) muscles provide a descending pillar of stability for your knees so improving their strength and function – see previous article here – can also make a huge difference to your knees.
If your knee(s) is causing you problems then initially PRICEM (Protect, Rest, Ice, Compression, Elevation, Medication) can help, along with some frequent, gentle and fairly pain-free movement – bedrest and immobility are not recommended.