How To Deal With Sore Knees
Sore knees can be both structural and mechanical in their nature, explains Rachel McCulloch, consultant rehab physiotherapist at Six Physio Parsons Green. “Structural refers to something inside the knee that isn’t quite right,” she tells SL. “Torn, worn and broken are all words that sum this up. Sometimes, these issues require fixing with surgery, but not always. Mechanical, meanwhile, means that knee pain is being triggered by how you use your knee rather than something being broken. This accounts for a significant amount of knee pain and is often fixable without surgery.” As Rachel explains, if you’re suffering from persistent knee pain, it’s likely to be one of the following complaints…
Osteoarthritis
“The most common cause of dodgy knees in the over-50s is osteoarthritis,” says Rachel. “It’s essentially wear and tear at the joint surfaces, a normal process as we journey through life.” As the joint cartilage thins and wears away, this can cause swelling, which is often accompanied by pain and stiffness. It can also occur rapidly in the wake of a fracture, even one fixed successfully through surgery, and although the symptoms of pain can improve or worsen at different points in the year, they will, generally, worsen with time.
TREATMENT: Arthritic knees will compromise quality of life to a certain extent, and while physiotherapy can help, it’s likely that anti-inflammatory medications and painkillers will also be needed. Other treatments include steroid injections and joint lubricants designed to extend the life of an arthritic joint. A longer-term option is surgery to replace the joint. This can be either ‘partial’, where only the damaged portion of the joint is replaced, or ‘total’, where all joint surfaces are replaced.
Meniscal Tears
“Sandwiched between the joint cartilages of the knee, the meniscus is a C-shaped piece of cartilage that acts as a shock absorber, protecting the joints,” says Tom Corradine, lead physiotherapist at Ten Health & Fitness. “Your menisci help with smooth movement of the joint and help with load absorption. The effectiveness of the meniscus tends to decline with age, making you more susceptible to damage such as tears.” If you have localised pain and swelling around your knee, accompanied by limited movement in the joint, you may be suffering with a meniscal tear.
TREATMENT: A tear in the meniscus won’t heal itself, but treatment can help. A physio may recommend light motion exercises and steroid injections can be used to reduce inflammation and help the tear stabilise. Larger tears that fail to respond to treatment may need keyhole surgery.
Bursitis
If you have overworked your tendons, you may suffer from bursitis. This happens when the bursae – the fluid-filled sacs which act as a cushion between your tendons and skin – become inflamed.
TREATMENT: Bursitis is usually fairly straightforward to treat. You should rest the affected area and avoid any activity that might place further stress on the area. An ice pack can also help, as can anti-inflammatory medication such as ibuprofen. In very rare cases, the bursa may need to be removed surgically.
From how to exercise to the benefits of hot and cold therapy, here the experts share their golden rules for knee health…
Know It’s Not Too Late
“There is plenty you can do later in life to protect your knees – it’s never too late to look after them. Our knees are designed like a hinge – if we use them properly and regularly, they are much happier and healthier than if we avoid using them completely, a little like a creaky door. Try to include some strength training, such as lifting light dumbbells or using resistance bands, in your week, which will give your muscles the ability to support the knee joints. Repetitive, low-resistance work, such as cycling and swimming, will also aid mobility and keep the tissues supple.” – Rachel
Stay Active
“If you are prone to knee pain, it can be tempting to avoid using them, but keeping the knees active is important. Find something you enjoy and aim for 150 minutes of moderate intensity exercise per week, which should include at least two sessions of exercises that build strength. Building strength around the hips, knees and ankles can be extremely effective in easing knee pain. Depending on the severity of your knee pain, your exercise tolerance will vary. As a general rule of thumb, any exercise that causes significant pain or swelling during or following activity should be scaled back. This doesn’t necessarily mean you need to stop altogether – you may just need to ease off or find a lower impact alternative until your knees have settled. For example, if you love playing tennis but find your knees are causing you trouble, it could be you need to take an extra rest day between playing or play for a shorter amount of time.” – Tom
Consider The Impact On Your Knees
“Our knees are weight-bearing joints, and therefore two factors that have a significant impact on the knees are footwear and bodyweight. Shoes that allow your feet to roll around inside and flatten your arches can lead to rotational force at the knee, which can trigger irritation of the knee joint. Instead, look to shoes that offer plenty of support at the arch. Knee problems are also considerably more prevalent in those who are overweight. Research has shown that losing just ten pounds can reduce the pressure on your knees by 40 pounds.” – Rachel
Supports & Braces Can Help
“When it comes to assisting an injury or painful knee, a support can offer some use, particularly when there is some instability. For example, a support is often used to aid ligament and meniscus injuries. The support required should be dictated by the structure that is at fault – a physio can help you here. Similarly, there have been some interesting studies done regarding the use of ice and heat. After an acute injury when there is clear inflammation, use ice for the first 24 to 48 hours. After this time, some people prefer ice and others heat – it’s worth trying both and going with what feels best for you.” – Rachel
Look Out For The Warning Signs
“A certain level of soreness is normal but any sign of inflammation should warrant a review from a medical practitioner. Inflammation can present in a number of ways; more often than not it’s a combination of pain, swelling, redness, heat over the area and changes to sensation. If you are also unable to put weight through your knee comfortably when walking or standing, you should also speak to your GP or a physio. You may find that your knee pain comes and goes with no real explanation, and this can be confusing. As a rule of thumb, if your pain is enough to cause you to grimace, limp, adjust the way you walk or reach for the painkillers, then it’s time to seek help.” – Rachel
Book In With A Physio
“Not all knee conditions require a knee replacement. Even in those that do, physiotherapy has the potential to make a significant difference, making the need to have a knee replacement less imminent or not at all in some situations. Most of the time, people know to have physio after a knee replacement, but there is real benefit to completing a course of physio prior to surgery – better mobility, strength, balance and a much better post-operative recovery if you do end up having surgery.” – Rachel
Knee Replacements Explained…
In terms of treatment, the end of the line for anyone suffering from severe knee pain is a knee replacement. “More than 100,000 knee replacements were performed in the UK last year, with women accounting for 57% of the total number,” Rachel says. “Plus, between 75-90% of knee replacements have been shown to last for 20-25 years.” While the average age for a knee replacement is 70, it’s increasingly likely that younger people will now be offered the procedure. You can have a partial or full knee replacement, depending on the extent of wear in the joint. Surgery typically takes around an hour and is carried out under a spinal anaesthetic. “After surgery, most people are up and walking within 24 hours. The first six weeks may feel a little limiting, but after that you should be well on your way to getting back to normal,” Rachel says. Following knee replacement surgery, the average patient should be able to climb stairs normally, play golf, cycle, garden and walk without aids.
For more information on Six Physio or to book an appointment with Rachel, visit SixPhysio.com. To book an appointment with Tom, visit Ten.co.uk.
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