By Dr. Trina Rowe, DPT, SCS, CSCS at the Bauerfeind Performance Center
As a physical therapist treating active patients across the age spectrum, one of the main topics my patients talk to me about it how to manage knee pain non-surgically so that they can continue to enjoy the sports they love without having to undergo the trauma of surgery. Fortunately, there are actually many things a person can do to avoid or at least prolong their need for surgery.
6 Ways to Manage Knee Pain for Active Adults
1) Educate Yourself
Figure out why you are feeling pain. Is it arthritis? Did you strain a ligament? Is your cartilage inflamed? Is this a chronic (longstanding) issue or is it an acute (recent) injury that you sustained due to trauma? When in doubt, see your doctor to rule out something serious and get more information about what is happening in and around the joint as that will help you manage your symptoms more effectively.
2) Evaluate Your Activity
The type of exercise you are doing has a huge impact on pain and swelling at your knee joint. For example, during running your knee joints experience forces equal to 3-4 times your body weight. Consider mixing in lower impact activities like swimming or the elliptical machine 1-2 times a week to give your knees a break but still maintain your cardiovascular fitness. Also try running on more forgiving surfaces such as grass or dirt instead of pavement.
Perhaps you play tennis, basketball, soccer or something else? The same principles apply. Evaluate the type of activity you are doing and consider ways of mixing in different types of exercise to give your joints a break. Chances are you’d like to spend all of your exercise time in your sport of choice but if you are experiencing knee pain with activity, its often necessary to modify the volume of your chosen sport so that you can avoid debilitating pain and play for a longer portion of your lifespan.
3) Evaluate your Footwear
Our feet were built to serve as natural shock absorbers via the transverse and longitudinal arches of the foot. If you have excessively high or flat arches, your shock absorption will be significantly impaired and you will feel it in your knees. A good, supportive orthotic will help maintain arch structure and help with shock absorption.
The type of shoe you wear is also important for minimizing impact on your knees. Match your shoes to your sport and make sure you replace them every 4-6 months. The material the shoe is made of begins to degrade over time and it loses some of its supportive and stabilizing qualities. Shoes purchased from big warehouse and outlet stores are typically at least a year old and that means the materials they are made of have already begun to deteriorate. If you have knee pain its well worth the extra money you spend at a running or specialty store to get a quality shoe is still capable of providing the support and durability you are buying it for.
Also steer clear of barefoot or free-style running shoes if you are having knee pain. These types of shoes are only appropriate for a very small percentage of the population and will likely do more harm than good.
4) Ice and elevation
Most knee pain is the result of inflammation and the pain is often accompanied by swelling, especially after activity. Swelling is a healthy joint’s natural enemy so you want to minimize it as quickly as possible. Icing the knee joint causes vasoconstriction that helps minimize swelling and interrupts the inflammatory process. Do yourself a favor and invest in a good gel pack that is large enough to wrap around the knee while maintaining contact with the entire joint.
When pain is accompanied by swelling, make sure you ice with your knee elevated above the level of your heart to help reduce swelling. The easiest way to accomplish this is to lay flat on your bed or couch and prop your whole leg up on several pillows so that your knee is higher than your heart. Keep the ice on for 15-20 min and do quad squeezes throughout that time to further minimize swelling.
5) Seek Professional Guidance
Strengthening of the muscles around the knee joint and at the hip can do wonders to decrease knee joint pain by decreasing joint forces. The same is true for stretching. Consult with a physical therapist to develop an appropriate strength and flexibility program that will allow you to maximize your longevity in your sport.
6) Consider a Supportive Brace
Many “off-the-shelf” braces are actually detrimental to healthy muscle function and as a result your muscles may begin to atrophy with prolonged wear. Instead, look into premium sports medicine braces which combine medical grade compression with specifically placed viscoelastic pads to prove a unique fit that increases propioceptive feedback and actually increases muscle activation, allowing them to be worn indefinitely without adverse side effects.
I always emphasize the importance of strength and stretching exercises to my patients as the best long-term solutions for knee pain but often that is not enough to keep pain levels low enough for continued participation in their sport of choice. In cases such as arthritis or instability, a supportive brace really can be the difference in whether or not a person is able to participate and thus they can really be a godsend to the injured athlete.
Sometimes surgery is unavoidable and is truly the best solution for your problem. However, there are often conservative options you should explore before opting for surgery. Implementation of the points discussed above can help you stay active for longer than you might have otherwise been able to. In any case, if pain persists despite your best efforts, consult your physician for alternative pain management options.
About the Author: Dr. Trina Rowe is Doctor of Physical Therapy (DPT), a Sports Clinical Specialist (SCS) and a Certified Strength and Conditioning Specialist (CSCS). Trina is part of the physical therapy staff at the Bauerfeind Performance Center in Santa Monica, CA. Visit the Bauerfeind Performance Center or contact us at firstname.lastname@example.org to receive expert advice on injury prevention and recovery, active wellness and raising your potential.