Keep Your Knees Healthy

Whether you're a seasoned athlete, a weekend warrior, or totally laid-back when it comes to exercise, knowing how to protect your knees from damage can mean the difference between an active lifestyle and long-term, strained mobility. According to the American Academy of Orthopaedic Surgeons, nearly 15 million Americans experience knee pain every year.

“Our knees take such a beating through everyday life,” says Sutter Health orthopedist Charles Stuart, M.D. “It’s crucial to take care of them so they can continue to keep us moving.”

A Complex Joint

The knee is a hinge joint joining the femur, tibia and kneecap and held together by four major ligaments – the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), the posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL). Connective tissue called menisci protect the joint by acting as pads between the bones.

"It's hard to find the right balance between mobility and stability; the knee needs to move back and forth, twist a little, and pivot too,” Dr. Stuart says. The knee's ligaments can tear, its tendons can swell up,osteoarthritis can take hold, and even everyday wear and tear can ruin a perfectly good set of knees.

Somewhere between the late 30s and age 50, a large percentage of active people (particularly those who’ve participated in high impact sports) will begin to notice knee pain. Women, in particular, suffer from some knee problems more commonly than men. They have a much higher prevalence of kneecap alignment issues, likely due to the angle between the hips, the femur and the patella. “These issues can start as early as the teen years and lead to arthritis,” Dr. Stuart says. “When women get to be in their 40s, we see a lot of them with chronic patella problems that make it difficult to climb stairs and squat.”

Avoid Knee Problems

There’s a lot you can do to prevent knee injuries and avoid knee pain, Dr. Stuart says. Here are his tips.

Don’t ignore pain — When the knees begin to hurt or swell on a regular basis, listen to your body and take a break. “Don’t think you can push through the pain. Take time off and try a low-impact sport like cycling or swimming,” Dr. Stuart says. Too many people wait until knee pain has gotten out of control. “At that point, many patients think surgery is the only option, but the truth is that the majority of overuse problems don’t require surgery and can often be addressed through activity modification, shoe inserts and weight loss.”

Lose weight — The American Academy of Orthopedics Journal reported in a study that weight loss had the single biggest impact on reducing knee pain. The knee bears three times a person’s body weight going up stairs and nearly five times the weight going down stairs. Even a five-pound weight loss can make a huge difference in overall knee health.

Strengthen the support muscles — Weak muscles and lack of flexibility are primary causes of knee injuries. When the muscles around the kneecap, hip and pelvis are strong, the knee stays stable and balanced.

Dr. Stuart stresses the importance of strengthening the quadriceps and hamstring muscles to support the knee, as well as the body's core muscles, including the obliques, lower back muscles, and upper thigh.

Avoid overtraining — Maintaining a base level of well-rounded fitness is key to injury prevention. “You can’t just be a runner or just a cyclist,” he says. “You have to look at whole body conditioning.”

If you do high-impact sports like running five or more times a week, consider swapping a few workouts with low-impact activities like cycling or swimming to give your knees a break. If you perform endurance sports, increase your distance slowly to avoid injuries.

Protect your ACL — One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year according to the American Academy of Orthopaedic Surgery.

Sports like soccer, basketball, football and volleyball that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing.

Women in particular have a two- to eight-times higher risk for ACL tears compared to men.

However, neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques, has been effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies.

Dr. Stuart recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.