You are currently viewing Knee-d relief?

Knee-d relief?

Almost every single one of my patients will, sooner or later, tell me that they have some sort of knee pain. Usually, it is the older women who suffer from this problem, though some of my younger patients complain of it as well. It surprises me that so many women just learn to live with constant knee pain without seeking any help for it. Often, it is accepted as part and parcel of ‘aging’ or just a typical female condition due to our fondness for wearing high heels.

However, knee pain should not be ignored. It can lead to very severe pain that can only be resolved with drastic measures like knee surgery. Ignoring knee pain doesn’t make it go away – it only makes it worse, until you can’t even move at all.

Why does the knee hurt?

A common type of knee pain relates to the kneecap, called patellofemoral pain syndrome. The kneecap (patella) itself is actually a bone, which transmits forces to the lower leg via tendons. The ligaments and tendons surrounding the kneecap also protect the knee and prevent knee injuries from occurring. Ligaments are attachments that bind bone to bone or bone to cartilage, while tendons connect muscle to bone.

When you experience kneecap pain, the pain does not originate from the kneecap itself, but rather, from the cartilage under the kneecap. The cartilage is a tough but flexible tissue that covers the ends of our bones in our joints. If our cartilage is healthy, it can protect our bones by preventing them from rubbing against each other. The cartilage in our knees can degenerate due to wear and tear of the joints, causing pain in the kneecap. A great deal of daily walking, especially going up and down stairs, can cause the cartilage to wear out.

Being overweight is also partly the problem, as the knee joint and the cartilage wasn’t designed to bear extremely heavy weight and will wear down faster than in an average person. Sometimes, the pain is also due to malformation of the kneecap, where the bone rides too high or too low and may dislocate. Injuries to the kneecap (a fall or being hit on the kneecap) would, of course, produce pain as well.

Unfortunately, women are more prone to hip and knee problems. This is believed to be due to the fact that women have a wider pelvis than men do, and a wider pelvis has been linked to a larger “Q” (Quadriceps) Angle – the angle at which the femur (upper leg bone) meets the tibia (lower leg bone). The larger Q-angle is thought to place more stress on the knee joint, leading to the degeneration of the cartilage. A high Q-angle may also cause the quadriceps muscle to pull on the kneebone, leading to poor tracking of the kneebone.

Walk slower, die faster

Kneecap problems obviously lead to pain with certain movements, such as pain while kneeling on the kneecap, getting up from a kneeling or squatting position, getting up from a deep chair and while walking up and down stairs. Knee pain inevitably causes a person to walk slower. You may think that there is nothing wrong with walking slower, but research has shown that if you walk more slowly (for any reason) then you will also live a significantly shorter life!

In an article published in the Journal of the American Medical Association in 2011, the researchers found that 87% of men at age 75 who walked fast lived another ten years, whereas those who walked slowest had only a 19% chance of surviving ten years. The results were similar in women. The researchers found that walking speed was just as good a predictor of survival as smoking history, blood pressure, body mass index and hospitalisations. While the cause of this relationship between walking speed and survival is not known, it is clear that we should avoid or resolve knee problems that could slow you down while walking.

Mending the knee

As I mentioned earlier, many women (and their doctors) accept knee pain as an inevitable aspect of growing older and do not attempt to treat it or reduce the pain. However, “living with it” is not the right answer. Knee pain that is not addressed will only cause you to become less active and lead to a whole lot of other health problems, not to mention drastic action will eventually be needed to treat the joint.

There are physical therapy exercises that can greatly help to strengthen the muscles around the knee, so that you can place less stress on the kneecap and prevent any further injuries from occurring. Some of the exercises recommended by physical therapists are Leg Extension for the quadriceps, Seated Leg Curls for the hamstring, stretching exercises (including Proprioceptive Neuromuscular Facilitation, PNF; Active Isolated Stretching, AIS; and Myofascial Release), as well as calf exercises.

You should avoid exercises like the lunge, squat, hack-squat or any others that involve lateral or bi-lateral movement with an exercise ball that places dynamic tension on your knee joint. I would strongly advise women with knee pain to see a sports medicine doctor or an exercise/physical/sports therapist. These are professionals who will help you with exercises that can strengthen your knee over the long term, and also give you some simple tips to help relieve the pain.

For instance, if you have pain in the kneecap, do not squat down (where you bend your knees and balance yourself on your feet) as this puts a lot of stress on the knee cartilage. Instead, if you have to do gardening or pick something off the floor, go down on one knee instead. Kneeling on a hard surface can also be painful, so keep an old cushion lying around if you need to be kneeling for a prolonged time (such as while gardening).

Too many of us take our knees for granted and do not give these joints the proper care that is needed. Even when there is obvious pain, we do not pay it enough attention and try self-treatment or self-medication that could make it worse. Let’s give our knees the pampering they deserve and stop mistreating them.

Star newspape. Mar 04, 2012
By Datuk Dr Nor Ashikin Mokhtar