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Knee Pain: Causes, remedies, prevention

by Cathy Richey

If you're suffering from knee pain, you're not alone. Almost one in three Americans older than age 45 reports some type of knee pain, and it's a common reason that people visit their doctors or the emergency room.

Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Or, certain medical conditions, including arthritis, gout, and infection, may be at the root of your knee pain.

Many relatively minor instances of knee pain respond well to self-care measures. More serious injuries, such as a ruptured ligament or tendon, may require surgical repair.

Although every knee problem can't be prevented, especially if you're active, you can take certain steps to reduce the risk of injury or disease.

The knees are the most easily injured part of the body. The largest and most complicated joint, the knee is used for everything from standing up and sitting to walking and running. It's a weight-bearing joint that straightens, bends, twists, and rotates. All this motion increases your risk of acute or overuse knee injuries.


Acute knee injuries (including torn ligaments and torn cartilage) are often caused by twisting the knee or falling. Sports that involve running and jumping and sudden stopping and turning, such as soccer, basketball, volleyball, tennis, and baseball, as well as contact sports such as football, wrestling, and hockey increase the risk of an acute knee injury.

More common than sudden knee injuries are injuries caused by overuse or overload.

Overuse knee injuries (Including muscle strain, tendonitis and bursitis) may develop gradually over days or weeks. Pain is often mild and intermittent in the beginning, and worsens over time. When muscles and tendons are stressed even slightly beyond their capabilities, microscopic tears occur. Inflammation, which is part of the healing process, is what causes the pain. To avoid overuse injury, these tears must be given a chance to heal before being subjected to the same activity. Treat overuse injuries early to prevent chronic problems.

Knee pain causes

Common causes include lack of exercise. When you haven't exercised for a long time, the joint isn't as strong and is more vulnerable to injury. Certain activities ratchet the risk factors right up there:

  • High-impact aerobics.
  • Hard contact sports.
  • Walking, running, or jumping on hard surfaces or uneven ground.
  • Quick twisting motions, common to many sports such as basketball, baseball, and even bowling.
  • Excessive running up and down stairs. When you walk upstairs you are putting pressure on your knees that is equivalent to four times your body weight, when running up the stairs it can be eight times your body weight.


Knee osteoarthritis is a common cause of knee pain. The risk increases with age. Osteoarthritis is a form of arthritis involving degeneration of the cartilage. Exercise is vital to maintain strength and flexibility of muscles supporting the knee, so as to reduce the stress on the knee joint. People with knee osteoarthritis may also need to take medication like Ibuprofen, which helps pain and inflammation.

Runner's knee (also called patellofemoral pain or anterior knee pain) is a common cause of knee pain in young people (not just in runners). The pain is usually diffuse pain behind the kneecap. Symptoms often worsen after climbing stairs, jumping, running, or prolonged period of sitting. The underlying cause is poor tracking of the kneecap. A regimen of appropriate exercises prescribed by a doctor or physical therapist is the main treatment in correcting runner's knee. Stay away from high-impact activity if you have this condition.

Knee pain prevention

Doctors at Mayo Clinic recommend keeping the muscles that support your knees strong and flexible. Start out slowly. Before you engage in a strenuous high impact activity such as jogging or running, try walking for a week. If walking causes knee pain, you shouldn't be running.

Warm up before working out, and stretch afterwards. Do not stretch before working out; stretching, by its very nature, weakens the muscles and thus destabilizes the joint.

Give your body a chance to recover from exercise. The reason why serious weight lifters work a different muscle group every day is they are trying to allow a minimum of 96 hours between intense training sessions of that muscle group. Front squats, a very knee-friendly exercise if done properly, typically recovers about two weeks for total recovery. Back squats are hard on the back and present danger to the knees, so don't do that exercise.

If you do high impact activities, take every other day off. Avoid running up and down stairs. Doing knee exercises to strengthen and stretch the muscles that support the knee is vital for knee pain and injury prevention. Tight or weak muscles offer less support for your knee because they don't absorb enough of the stress on your knee joints. Source:[].

Because weak muscles are a leading cause of knee injuries, you'll benefit from building up your quadriceps and hamstrings, which support your knees.

Many people do knee extensions, hamstring curls, and leg presses to strengthen these muscles. But those exercises are isolation exercises. They will help you get to a baseline of fitness if you are really weak or very out of shape. Unless you have some physical therapy reason to continue using that equipment under the supervision of a physical therapist, do not use it for more than about 90 days.

Good compound exercises with free weights will permit you to properly train the muscles that support the knee. This means front squats, lunges, and similar exercises that work your core and require you to practice good posture, alignment, and balance. Find a qualified trainer who will show you how to do these exercises correctly. Keeping your knee back behind your toe is vital, and not doing this is a mistake the untrained make. Such a mistake can easily cause significant damage the knee.

Balance and stability training helps the muscles around your knees work together more effectively. You cannot get this (to a useful degree) from isolation exercises or exercise machines. Always graduate to free weights for proper training, as soon as you are able to.

If you can sit on the toilet without assistance, stop doing leg presses and Smith Machine training and do front squats instead. Otherwise, you will have muscle imbalances and defeat the reason you started training in the first place. You can occasionally replace a free weight workout with a machine workout just for some variety, but don't make machine exercises part of your regular routine.

Because tight muscles also can lead to injury, stretching is important. Include flexibility exercises in your workouts. A good trainer will show you how to mildly stretch those abs, quadriceps, and hamstrings between sets of front squats, for example. The front squat hits the abs very hard if you do it correctly (most people do not) and it works the hamstrings and quads as most people figure it would. Stretching between sets is not at all the same as a post workout stretch. The purpose is to simply reduce the tension within the muscle, so you do not stretch to your range of motion limit or hold the stretch very long.

Proper footwear is also important, especially if walking or running on hard surfaces. A well-fitting shoe helps you maintain stability. Choose footwear that's appropriate for your sport. Running shoes aren't designed for pivots and turns, for instance, but tennis and racquetball shoes are. Do not wear the same shoes two days in a row; the cushion needs nearly a full day to recover from use.

Try not to wear shoes at all, as the situation permits. For example, go barefoot around the house. Shoes distort the foot's natural function and create more stress on the knees.

Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.

Most knee pain is treated conservatively, but there are situations in which surgery is required. Athletes are at an elevated risk for sudden injuries that may require surgery, such as torn ligaments in the center of the knee or certain types of fractures. People with advanced knee osteoarthritis may need knee replacement surgery if they are severely limited in day-to-day activities because of their condition. This is optional surgery and is a last resort.

If your knees hurt, or you feel fatigued, don't be a hero. Take a break. You're much more likely to injure yourself when you're tired.

Most knee conditions respond to a combination of non-invasive treatments such as applying heat or cold, temporarily restraining from activities that aggravate pain, and medications that target pain and inflammation. Exercises to strengthen the muscles that support the knee help reduce stress on the knee joint and prevent re-injury.

About the author: Cathy and her Doberman Trooper conduct research into all kinds of topics and produce articles like the one you see here. To contact Cathy, write to Get the facts from Cathy, and let the Cathy Factor give you an edge.


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