Practice for Strong Knees

You don't have to be a sports jock Practice for Strong Kneesor a former soccer player to end up with a bum knee. Believe it or not, doctors see more regular folk than sports jocks coming in with knee pain, often caused by such seemingly harmless activities as lifting heavy boxes, climbing stairs, or squatting too much in the garden.

What's making these individuals go weak in the knees? Researchers blame everything from muscle imbalances, a lack of calcium that decreases bone density. Women come with built-in disadvantages - the way they are built, with thighbones tending to curve inward from hip to knee, puts added stress on the joints, and plummeting estrogen levels post menopause which affects cartilage regeneration.

You can't do much about your bone structure. But with a few smart moves, you can prevent the most common knee problems - or get the kinks out if they're already giving you trouble. Here's how.

The Problem: Your kneecap aches.

The Cause: Patella injuries arePractice for Strong Knees number one on the list of knee problems for people who exercise regularly. Your kneecap is normally supposed to glide up and down as you extend your leg, explains Edward Wojtys, M.D., professor of orthopedics at the University of Michigan. But the angle at which some people's muscles pull makes it easy for the kneecap to slide off track and rub against surrounding bone, causing pain and swelling around the sides or back of the leg behind the kneecap. You may also hear or feel some cracking.

Who’s at Risk: No matter how old you are, doing too much of a new activity too soon - especially activities like hiking, running up or down hills, or anything else that requires you to jump and land over and over again - can catch your knees off guard and overload them.

What you can do: Don't panic if your kneecaps are already on the sore side. 'The good news about patella pain is that it's very treatable," says Jo Hannafin, M.D., Ph.D., orthopedic director at the Women's Sports Medicine Center at the Hospital for Special Surgery in New York. "The vast majority of individuals respond very well to exercise and strengthening programs to improve the kneecap's alignment."

To help prevent pain, take the time to build up your endurance, and concentrate on strengthening the adductor muscles, the ones near the inside of the knee that keep the kneecap in line. You can work the adductors using the cable cross over machine or by copying a famous Jane Fonda move: Lie on your side, bend your top leg, and place your foot on the floor in front of your bottom leg; slowly raise and lower your bottom leg.

The Problem: Your knee swells up like a balloon

The Cause: Something's got to protect your knee from all the pounding it takes, and that's where the crescent-shaped cartilage called the meniscus comes in. It's the shock absorber that cushions and Practice for Strong Kneesdistributes the force on your knee. When the meniscus breaks down, flaps can form, causing irritation that can eventually lead to pain and swelling. The pain typically starts on the inside of the knee at the point where it bends, but you may also feel it at the same spot on the outside of the knee. Take these signs seriously, since even small tears can eventually lead to arthritis.

Who’s at Risk: For men and women in their 30s or younger, it usually takes a traumatic event - a clash on the soccer field, perhaps, a major wipeout on the ski slopes, or an awkward landing after a lay-up - to tear the meniscus. As individuals hit their 40s and 50s, though, the cartilage starts showing signs of wear and begins to provide less protection from injury, to the point that simply squatting the wrong way could cause it to tear. Being overweight affects the meniscus as well, since extra pounds put a heavier burden on it.

What you can do: To minimize symptoms, Hannafin recommends taking an anti-inflammatory such as aspirin or ibuprofen, applying ice to decrease swelling, and beginning a well-designed leg-strengthening and flexibility program. If you have had pain for several weeks without having suffered an obvious injury to your knee, see your doctor, because some meniscus tears require surgery. (If the pain occurs right after intense activity, though, don't wait longer than two or three days to check in with your physician.) To guard your knees against a meniscus tear, concentrate on stretching and strengthening your hamstrings, quadriceps, hip flexors, and iliotibial band, the band of tissue that runs from your thigh down over your knee to your tibia. If you are heavy, shedding pounds also can help take the pressure off the meniscus.

The Problem: Soreness above or below your knee that worsens over time.

The Cause: Overdoing it on the length or intensity of any exercise session - such as running too far or too fast - could leave you with nagging injuries such as stress fractures in the bones around your knee, inflamed muscles surrounding your knee, or even tendinitis in your knee-cap. In the beginning, soreness follows whatever activity you are doing. Soon the knee begins to hurt during the activity, and eventually you feel pain in the course of normal movement, or even at rest.

Who’s at Risk: Anyone who's recently taken up a heavy duty physical activity or women in their 40s and 50s, when estrogen and bone-density levels start to plummet, making bones and tendons more vulnerable to injuries?

What you can do: To heal an overuse injury, you should let your body rest until your knee is no longer sore. To avoid an injury in the first place, be sure to increase your workouts gradually. If you're a runner, for instance, don't ramp up mileage and intensity all in one shot.

These exercises can keep your knees from aching (or worse) by shoring up the muscles around the joint. Do two sets of 15 reps two to three times a week for best results.

1. Hamstring curls (for hamstrings) Attach one end of an elastic exercisePractice for Strong Knees band to a pole or the leg of a heavy piece of furniture, and tie the other end around your ankle. Stand facing the pole, so the band is pulled tight. Keeping your hips stationary, slowly pull your leg back, bending your knee (you should feel a slight burn in the back of your thigh). Switch legs. Alternatively use the hamstring curl machine in the gym.

2. Straight leg rises (for quadriceps and hip flexors)

Lying on your back with your legs straight, slowly raise one leg off the floor for a count of 15 or 20 seconds, and then very gently lower it back down. Switch legs. To challenge yourself further, add ankle weights for more resistance - start with 3 pounds, and gradually work your way up to 8.

3. Wall squats (for hamstrings, buttocks, and inner quadriceps)

Stand with your back against a wall, with heels just over a foot away from the wall, and a medium-size ball between your knees. Squeeze the ball as you slowly slide down the wall until your knees are as close to a 90-degree angle as is comfortable. Count to 3 and then slide back up.

The Problem: In the midst of an activity that involves sudden shifts in direction, your knee pops, buckles, and swells; you feel intense pain; and your knee gives way if you try to put any weight on it.

The Cause: Chances are you'vePractice for Strong Knees torn your anterior cruciate ligament (ACT). One of the four knee ligaments that connect the thighbone to the shinbone, the ACL keeps the knee stable as it rotates. When it ruptures, it's like a cable snapping.

Who’s at Risk: A torn ACL is most common in high school and college athletes. But all active people need to be aware of the danger, especially those who participate in sports such as soccer, skiing, and volley ball that involve quick changes in direction pivoting, and twisting. ACL injuries can happen to anyone, however; you could tear yours during a fall, in a car accident, or even while playing catch with your kid.

What you can do: This is a serious injury (most individuals who tear their ACLs need surgery), so you should see your doctor right away if it happens to you. To help keep your ACL healthy and intact, "maintain your conditioning," Hannafin advises. "You are more likely to get injured if you're fatigued and you don't exercise on a regular basis." You should also make an effort to strengthen the muscles - the hamstrings and inner quadriceps - that support your knee. Agility and proper form when jumping and landing are important, too. Be sure to keep your knees bent when you land, whether you're pulling down a rebound or hopping off a ladder.

A Leg Up on Pain: Jumping and other high-impact activities are tough on knees, but you can protect them with stretching and regular exercise.