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Knee problems?

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Our knees are so underappreciated that we don’t realise how much they work for us until they hurt or break down. For many athletes, it’s a very common injury point. Knees take a battering over the course of a lifetime, bearing our full weight when we stand, and take in extra force with every jump, run, kick, slide, or slalom.

While they are a feat of engineering, they are susceptible to short term (acute) injuries and long-term (chronic) problems. Most acute knee problems get better without specific treatment, while others can be alleviated with painkillers, physiotherapy, steroid injections, or even knee replacement.

While new therapies are constantly being investigated (ie. hyaluronic acid knee injection), some of the persisting claims for knee health include dietary supplements like fish oils, glucosamine, and even turmeric.

Here are some common questions about knees:

Is it a problem if my knees pop or crack when I squat?

The ‘popping’ can be caused by air bubbles popping in the joint fluid or ligaments, or tendons snapping back into place after catching bits of bone or cartilage. As long as there’s no pain, swelling, or difficulty in moving your knee, the sounds don’t matter. If your knee hurts, swells or catches in certain positions, you may have a small cartilage tear – they usually get better within 6 weeks.

Are ACL and meniscal tears common?

Meniscus tears are among the most common knee injuries. Athletes, particularly those in contact sports, are at risk for meniscus tears. The meniscus are two wedge-shaped pieces of cartilage on either side of your knee that act as “shock absorbers”. Sudden meniscus tears often happen during sports especially when it involves squatting and twisting of the knee. You might feel a “pop” when you tear a meniscus, and your knee will gradually become more stiff and swollen over 2 to 3 days. If your tear is small and on the outer edge of the meniscus, nonsurgical treatment – from icing to anti-inflammatory gels – may be all you need.

An ACL tear is another common sports injury that makes the knee painful and unstable. It particularly affects skiers, footballers and rugby players who stop or change direction suddenly or get a direct blow to the knee during a tackle. Most cartilage and ligament tears get better on their own within a few weeks, but surgical repair is sometimes needed, especially for an ACL tear.

Is exercise bad for patellofemoral pain syndrome?

Patellofemoral pain syndrome refers to the dull ache and crunching sound at the front of both knees around the kneecap, and often affects young sporty women. Prolonged sitting, bounding up/down stairs, kneeling or doing squats can make it worse – ice packs and anti-inflammatory gel or tables can help in the short term. In the long term, exercises to strengthen the muscles around the knee may help. However, the best course of action is to do low-impact exercises, like cycling or swimming, instead of running.

What’s good for knee osteoarthritis?

There are plenty of ‘treatments’ advertised, but with different prices and results. If you’re thinking of trying a few, look at evidence and price. Does it cause any harm? Is it worth the money? There’s no solid evidence that acupuncture works, but it’s safe and may help some people. It’s the same with a Tens machine or lateral wedge insoles that you put in shoes to take pressure off the knee. In terms of supplements, glucosamine and chondroitin are popular, as is turmeric which contains chemicals that are said to be beneficial in osteoarthritis. They may not work on everyone, but may work for some.

What about a steroid injection?

For those with severe knee pain, swelling or stiffness, steroid injections into the knee joint can provide rapid relief which lasts up to three months or more. However, the evidence is inconclusive; 44% of people given a steroid injection reported an improvement in pain compared with 31% given a placebo injection.

When do I need to go to the doctor?

If you’ve got a red, swollen, painful or stiff knee and don’t know the cause, check with your healthcare specialist. Especially if you have a fever, are unwell, can’t stand on the leg, or have other painful joints. If your knee swells up and is painful after trauma or a fall, you may need to go straight to A&E. Anyone who starts limping suddenly with no clear cause (such as a sprained ankle) should see a doctor to rule out an infected joint.

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