Staying active with knee pain

Continuing to stay mobile with knee pain can be quite difficult. We explain a few techniques you can use to reduce pain and stay active.

Will staying active do more damage to my knee joint?

In an otherwise healthy knee, it has not been demonstrated that individuals who are more active across their lifetime develop earlier degenerative osteoarthritis.

Degenerative knee osteoarthritis occurs as individuals age and may occur earlier as a result of genetic predisposition or trauma to the knee. Your general health also plays a role in keeping joints flexible and strong so general advice is to get regular exercise, keep a healthy diet and stop smoking if applicable. 

It is recommended that even for individuals who have an existing knee condition they should keep as active as possible with their knees, except for in specific circumstances. If the knee is very unstable, frequently giving way underneath you, then it is advisable to limit the knee to performing more stable activities to guard against further knee cartilage injuries.

For individuals with symptomatic cartilage tears or osteoarthritis they should try to limit or modify any activities which are causing any significant flares of pain or swelling following these activities. Walking on softer ground or cycling for transport is a good option for many individuals looking to remain active while managing any swelling or pain.

The meniscus in your knee

The knee meniscus is situated on the outer aspect of the lower knee joint surface on top of the tibia. As the upper joint surface contacts and impacts the joint, the meniscus acts as a spring by spreading slightly and dampening the forces on the knee joint. Once a meniscus has been torn this eliminates this spring effect.

Unfortunately, osteoarthritis of the knee also gives rise to increased weight-bearing forces due to increased joint stiffness and the gradual reduction in the specialised, bony joint surfaces known as hyaline cartilage. 

Knee meniscal tears and osteoarthritis of the knee are conditions often characterised by intermittent bouts of inflammation and swelling. It is recommended that individuals pace their activity and don’t do too much on days when their knee is pain free but also continue to perform a moderate amount of activity on other days. This should prevent the knee from flaring as much and also prevent the knee from becoming too stiff.

What the best forms of keeping fit with knee pain?

The best form of exercise depends on the exact nature of the problem but there are a few rules which hold true in most circumstances. Patellofemoral specific knee pain tends to be aggravated with repetitive flexion movements, the worst of which is jogging. Cycling may help patellofemoral problems as this helps to strengthen the gluteal muscles.

General recommendations for gym work is to find two to three cardiovascular machines that do not aggravate the symptoms and use these on a rotational basis or interval between them each session. Resistance work is highly recommended as it keeps the supporting quadriceps muscles strong and protects against knee joint instability which can result with persistent knee pain. 

Unstable knees caused by large cartilage tears and possibly ligament disruption often require a specific gym resistance programme. This may ultimately require surgery if you've been unable to return to sports involving impact and rotational movements with appropriate rehabilitation. 

Fitness regimes are most successful when they are altered every few weeks. Fortunately, changing the types of movements, intensity and number of sets and repetitions may also help offset knee pain while keeping fit.

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