Nancy Volkers tries to maintain an active lifestyle. The 53-year-old, from Westford, Vermont, plays soccer once a week, hikes and, until a couple of years ago, ran 3 to 4 miles regularly. Then knee pain forced her to stop running.
So she’s adjusted her exercise routine, doing cardio and strength training videos, and adding yoga to the mix. “I figure if I build up the muscles around it, then that will be kinder to it, and it does seem to have helped,” Volkers says. She also wears a knee brace while playing soccer and ices her knee afterward. If the pain persists, she says she will take up her physician’s offer to refer her for physical therapy.
Common symptoms, causes of knee pain
Volkers is not alone.
Most people experience knee pain at some time in their life, says Bruce Stewart, M.D., an orthopedic surgeon with Shoreline Orthopaedics in Holland, Michigan. Common causes include injuries and osteoarthritis (inflammation of the joint) as well as meniscal tears. These are ruptures in part of the knee resulting from a twisting motion.
The symptoms of knee arthritis increase with age starting at 45, says physical therapist Kari Orlandi, director of outpatient operations for the Cleveland Clinic’s Rehabilitation and Sports Therapy, east region. Several variables contribute: being overweight, having a family history of arthritis, injuries and just general wear and tear on the joints associated with aging.
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Some knee pain will go away on its own within a few weeks with a reduction in activity level, Stewart says. “But if it doesn’t get better, then it may be something to get checked out.” Seeing a primary care provider, an orthopedic surgeon, a physiatrist (physical medicine and rehabilitation specialist) or a sports medicine physician is a good first step. Treatments will depend on the cause of the pain, but most knee pain will respond well to physical therapy and a home exercise program, he says.
According to Orlandi, keeping active is the key to preventing pain: “One of the favorite things I say as a clinician is ‘motion is lotion.’ It provides a good exchange of nutrients for the cartilage. It helps to decrease swelling. It gets your muscles working. All of these good things happen when you stay moving.”
As we age, the amount of muscle mass decreases. “There’s nothing that can stop that,” Orlandi says. “It’s just the natural aging process. So exercise is really important to increase the muscle strength so that it’s load sharing with the joints.”
Losing weight if you are overweight also can help. Every extra pound in the body exerts 3 extra pounds of pressure on the knees and other joints, Orlandi says: “Even losing 10 pounds can decrease the amount of stress on your knees by 30 pounds.”
Other ways to minimize joint pain are to stay hydrated or consider an anti-inflammatory diet that emphasizes fruits, vegetables, lean protein, nuts, seeds and healthy fats, says Joseph Ciotola, M.D., an orthopedic surgeon with Mercy Hospital in Baltimore.
Strengthening the muscles around the knee joint can help your body tolerate pain and stress on the joint. One of the best overall exercises is bicycling, because it keeps the quadriceps muscles in the front of the thighs strong, Ciotola says. Weight training and resistance exercises are good, but you must do them with good form, he says. Walking also is helpful, Stewart says, as is swimming or aqua aerobics.
Best exercises for knee pain
A comprehensive exercise program should combine cardiovascular endurance plus flexibility and strength exercises, Orlandi says. There are many good exercises to strengthen the knee joints and surrounding leg, hip and buttocks muscles, she says. Aim for at least two 20-minute sessions a week. Orlandi suggests trying the following.
Start by lying on your side with both hips and knees bent toward your belly. Slowly turn the entire top leg outward so that the hip rotates upward slightly, knee up. Do not let the pelvis or trunk move — the motion is at the hip only. Then slowly return the leg to the starting position. Repeat on the opposite side.
Lie on your back with your knees bent and feet on the floor. Tighten your abdominals and pelvic floor muscles. Press into your feet and lift your hips up a few inches off the floor. Keep your shoulder blades in contact with the supporting surface. Tighten your buttock muscles as you slowly lower your hips. Repeat.
Position yourself on the ground as if you were going to do a push-up. You can modify the move to rest on your forearms (bent) instead of your hands, or plank from your knees instead of having your full body extended and supporting your lower body by your toes. Hold 20 seconds. Relax. Repeat.
Karen Blum is a contributing writer and award-winning health and science reporter in the Baltimore area. Her work has appeared in the Baltimore Sun and numerous magazines for physicians and other allied health professionals.