Knee Pain

Knee Pain

Modern warriors from the mighty fullback to the weekend fast walker have made knee pain one of our most frequent health complaints. An estimated 50 million Americans suffer from some sort of knee pain or injury.

Any continuous pressure on the kneecap can cause pain. And that pressure increases when your leg muscles aren't prepared to do whatever you're trying to make them do.

"In my opinion, a lot of knee pain is caused by muscle weakness in the thighs and hamstrings," says Andy Clary, head trainer for the University of Miami football team in Coral Gables, Florida. "We've seen a lot fewer knee problems with our athletes when they've been able to strengthen their lower bodies."

But whether you're a running back or a mall walker, doctors say you can beat knee pain. Here are some routes to relief, along with some tips to prevent knee pain in the future.

Know when to fold them. If you get a sudden twinge in your knee that makes it "lock up," restricting full motion, get off your feet, says Clary. You may be able to move again cautiously after a few minutes. But begin gently: Don't resume heavy or strenuous activity, Clary advises.

Press on some ice. For any knee pain, applying ice will help force your body to flush the knee with blood and oxygen, elements vital for repair. Ice also acts as an anesthetic to soothe the ache, says Patrice Morency, a sports injury management specialist in Portland, Oregon, who works with Olympic hopefuls.

Use an ice pack or ice cubes inside a plastic bag. Just make sure the ice pack is wrapped in a towel, so it doesn't come in direct contact with your skin. Apply ice to the sore knee no longer than 20 minutes every hour, says Morency.

Try an anti-inflammatory. You can calm inflammation and soreness with over-the-counter remedies that contain the anti-inflammatory ingredient ibuprofen, according to Paul Raether, M.D., a marathoner who is a physical medicine specialist at the Kaiser Permanente Medical Center in Portland, Oregon. Nuprin, Advil and Motrin are among the brands of over-the-counter anti-inflammatories. (You can also find low-priced versions marked "ibuprofen" in most pharmacies.)

Taken as directed, ibuprofen is also a painkiller, so it's important not to be lulled into a false sense of security when the pain eases. When you resume your activity, try it when you're not taking an anti-inflammatory, so you can feel the pain if your knee sends out warning signals.

Make a beeline to bromelain. Made from pineapple, bromelain is touted as a natural anti-inflammatory that is thought to speed healing, according to Morency. It is sold in tablet form in some health food stores. "I've used it personally and know that it works," says Morency. According to the directions, you can take up to three tablets a day until the knee pain subsides. Then start to resume your activities with caution. (The only drawback is that bromelain can cause dermatitis in some people, so you should stop taking it if your skin begins to feel itchy.)

Unbrace yourself. Wearing a knee brace may be a short-term solution after a particularly painful bout of knee pain. But try to go without that brace as soon as possible to prevent becoming psychologically attached, suggests Dr. Raether.

Avoid the knee bashers. Some activities, such as running and hiking over hilly terrain, put a greater demand on the kneecap than others. "These force the kneecap strongly against the end of the thigh bone," says Dr. Raether. If you're having knee pain, minimize those activities until you've had time to strengthen your leg muscles, he says.

Check out new workouts. Knee problems often occur when someone starts a workout program without first understanding how to properly perform exercises or an activity. "You need to know the precautions before you launch into a new exercise routine," says Mike Nishihara, director of athletic development for the National Institute for Fitness and Sports in Indianapolis.

Runners and walkers, check your soles. If you're a frequent runner or walker, you need stable shoes if you want to avoid knee injury. Examine the shoes you have been wearing to see whether it's time for a new pair, suggests Dr. Raether. One way to check is to place them on a table at eye level to see whether the shoes stand straight up. (If the soles have worn down unevenly, the shoes will tip out or in.) Also examine around the midsole and sides to spot excessive wear. "Many shoes will begin to severely break down after 300 miles," says Dr. Raether.

Buy shoes with your knees in mind. If you have kneecap-related pain, there's a good chance that you're a pronator--someone whose foot turns toward the inside with every step. When you examine your shoes, notice whether your right shoe is caved to the left or your left shoe is caved to the right, suggests Dr. Raether.

When shoes are worn down this way, it's a sure sign that you are a pronator Ask for a stable shoe when you're buying running or walking shoes.

Muscle up your leg muscles. To strengthen the quadriceps, the thigh muscles that hold your knees in place, start with straight leg raises, says Dr. Raether. Lie on your back with your right knee straight and your right foot angled about 20 degrees toward the outside. (To keep your spine in a neutral position, you can place a rolled-up towel under the small of your back.) Keeping the foot angled, slowly lift your leg a few inches off the floor. Hold your leg in place for a count of three and then lower it. Repeat with the left leg.

This exercise should be repeated about 50 times. "It's one of the best quadriceps strengtheners around," says Dr. Raether.

Work your hamstrings. To rehabilitate an injured knee, it's essential to build up strength in the hamstring muscles on the back side of the thighs. Dr. Raether recommends the following exercise to work the hamstrings.

Strap on some ankle weights and lie on your stomach with your legs outstretched. Bend your knees slowly to lift the ankle weights. Lift both legs to a 90-degree angle (your feet are over your knees), then slowly lower your feet to the floor again. Repeat 12 times.

Note: Begin with very light ankle weights. You can gradually increase the weight as long as it doesn't cause a flare-up of knee pain.

Lose some weight. Every time you run or walk, the force of your feet hitting the ground is felt in your knees. "For someone who's 20 pounds overweight, that's a tremendous blow," says Clary. Less weight on your frame simply means less damage with each step, he says.

Master the stair-climber If you use a stair-climbing machine, reduce stress on your kneecap by taking short steps and maintaining good posture. "By taking shorter steps, you will prevent the knee from going out over the ankle," says Clary. "This reduces the stress on the knee joints."