Knee Pain

The knee joint's main function is to bend and straighten for moving the body. The knee is more than just a simple hinge. It also twists and rotates. In order to perform all of these actions and to support the entire body while doing so, the knee relies on a number of structures, including bones, ligaments, tendons, and cartilage.

• Bones
  • The knee joint involves three bones.
  • The thighbone or femur comprises the top portion of the joint.
  • One of the bones in the lower leg (calf area), the tibia, provides the bottom portion of the joint.
  • The kneecap or patella rides along the front of the femur.
  • The remaining bone in the calf, the fibula is not directly involved in the knee joint but is close to the outer portion of the joint (sometimes this bone is included in the knee joint and therefore the joint will be described as involving four bones).
• Ligaments
  • Ligaments are fibrous bands that connect bones to each other.
  • The knee includes four important ligaments, all four of which connect the femur to the tibia:
    • The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) provide front and back (anterior and posterior) and rotational stability to the knee.
    • The medial collateral ligament (MCL) and lateral collateral ligament (LCL) located along the inner (medial) and outer (lateral) sides of the knee provide medial and lateral stability to the knee.
• Tendons
  • Tendons are fibrous bands similar to ligaments.
  • Instead of connecting bones to other bones as ligaments do, tendons connect muscles to bones.
  • The two important tendons in the knee are (1) the quadriceps tendon connecting the quadriceps muscle, which lies on the front of the thigh, to the patella and (2) the patellar tendon connecting the patella to the tibia (technically this is a ligament because it connects two bones).
  • The quadriceps and patellar tendons as well as the patella itself are sometimes called the extensor mechanism, and together with the quadriceps muscle they facilitate leg extension (straightening).
• Cartilage
  • Cartilaginous structures called menisci (one is a meniscus) line the top of the tibia and lie between the tibia and the two knuckles at the bottom of the femur (the femoral condyles).
  • Menisci provide both space and cushion for the knee joint.
• Bursae
  • Bursae (singular is bursa) are fluid-filled sacs that help to cushion the knee. The knee contains three important groups of bursae.
    • The prepatellar bursa lies in front of the patella.
    • The anserine bursa is located on the inner side of the knee about 2 inches below the joint.
    • The infrapatellar bursa is located underneath the patella.

Any activity that could injure the knee is a risk factor for developing knee pain. Doing strenuous athletic activity without proper warm-up can increase risk for knee pain.

Obesity is a risk factor for osteoarthritis of the knee. Smoking is a risk factor for rheumatoid arthritis.

In treating many types of knee pain, a common goal is to break the inflammatory cycle. The inflammatory cycle starts with an injury. After an injury, inflammation invades the knee, which causes further injury, and further inflammation, and so on. This cycle of inflammation leads to continued or progressive knee pain. The cycle can be broken by fighting the inflammation (through medications or other therapies) and by limiting further injury to tissue.

Some common home-care remedies that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation. This regimen is summarized by the mnemonic PRICE.

• PROTECT the knee from further trauma.
  • This can be done with knee padding.
  • A pad over the kneecap, for example, helps to control the symptoms of some knee injuries (an example is a form of bursitis sometimes called housemaid's knee) by preventing further repetitive injury to the prepatellar bursae.
• REST the knee.
  • Rest reduces the repetitive strain placed on the knee by activity.
  • Rest both gives the knee time to heal and helps to prevent further injury.
• ICE the knee.
  • Icing (cold application) the knee reduces swelling and can be used for both acute and chronic knee injuries.
  • Most authorities recommend icing the knee two to three times a day for 20-30 minutes each time.
  • Use an ice bag or a bag of frozen vegetables placed on the knee.
• COMPRESS the knee with a knee brace or wrap.
  • Compression helps accomplish two goals:
    • First, compression is another way to reduce swelling.
    • Second, in some knee injuries, compression can be used to keep the patella aligned and to keep joint mechanics intact.
• ELEVATE the knee.
  • Elevation also helps reduce swelling.
  • Elevation works with gravity to help fluid that would otherwise accumulate in the knee flow back to the central circulation.
  • Prop your leg up when you are sitting or use a recliner to elevate the legs.
• Over-the-counter pain-control medications: Commonly used pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen
• (Aleve or Naprosyn) and ibuprofen (Advil or Motrin) also play a role in the treatment of knee pain.
  • These drugs directly control pain and, at higher doses, act as anti-inflammatory agents, helping to stop inflammation. Like all medications, however, these drugs have potential side effects.
  • You should not use NSAIDs if you have a problem with bleeding or stomach ulcers, high blood pressure, or some kidney disease.
  • Acetaminophen (Tylenol) can also be used to control knee pain but does not have the anti-inflammatory properties of the NSAIDs. Still, this treatment is useful in many types of knee pain such as arthritis.
  • If you have to take any of these medications for more than seven days, you should have your knee pain evaluated by a health care professional.

When you are deciding whether to call the doctor, a good rule of thumb exists for most long-term knee injuries. If your symptoms have not gone away after trying three to seven days of PRICE therapy and over-the-counter anti-inflammatory pain medications, you should set up an appointment with your doctor or a sports medicine or orthopedic (bone and muscle) specialist to further evaluate the pain. This rule can also be applied to new knee injuries that are not disabling. Any knee injury that makes it impossible for you to walk should be evaluated as soon as possible. Remember, however, that this rule should only serve as a guide. If you are concerned about the pain, you should call the doctor.

• If you cannot walk on your knee and you have had a traumatic injury, you should immediately go to the hospital's emergency department or urgent care center to be evaluated by a doctor because of the possibility of a fracture or significant ligamentous or tendon injury.
  • Many fractures may require immobilization in a specific position or surgery.
  • Putting off seeing a doctor may hinder healing.
• Other signs and symptoms that demand emergency evaluation:
  • Fever (which may indicate infection)
  • Unbearable pain
  • Drainage
  • Large wounds
  • Puncture wounds
  • Swelling, if you are on a blood thinner (warfarin or Coumadin) or have a bleeding disorder (such as hemophilia)
  • Swelling that is associated with redness and the knee feeling warm

• History: Even in today's world of technology, physicians rely on a detailed history and examination more than any single test.
  • The doctor will typically want to know the exact nature of the pain.
    • Where in the knee is your pain?
    • What does the pain feel like?
    • Has it happened before?
    • What makes it better or worse?
    • How long have you had pain in the knee?
  • The doctor will also want to know a bit about you.
    • Do you have any major medical problems?
    • How active is your lifestyle?
    • What are the names of the medications you are taking?
  • The doctor will want to know about any related symptoms.
    • Do you still have normal sensation in your foot and lower leg?
    • Have you been having fevers?
• Physical examination
  • The doctor will likely have you disrobe to completely expose the knee.
  • The doctor will then inspect the knee and press around the knee to see exactly where it is tender.
  • In addition, the doctor may perform a number of maneuvers to stress the ligaments, tendons, and menisci of the knee and evaluate the integrity of each of these. An experienced health care professional will be able to make a preliminary diagnosis based on this examination.
  • These maneuvers can establish potential tendon, ligament, or meniscus injuries.
• X-rays and CT scans
  • Depending on your particular history and examination, the doctor may suggest X-rays of the knee. X-rays show fractures (broken bones) and dislocations of bones in the knee as well as arthritic changes and abnormally large or small joint spaces.
  • Rarely, the doctor may order a CT scan (a three-dimensional X-ray) of the knee to precisely define a fracture or deformity.
  • Both X-rays and CT scans are excellent for diagnosing fractures. They both are also poor, however, at evaluating soft-tissue structures of the knee such as ligaments, tendons, and the menisci.
• MRI
  • Magnetic resonance imaging (MRI) uses large magnets to create a three-dimensional image of the knee.
  • In contrast to CT scans, MRIs do not image bones and fractures well.
  • Also in contrast to CT scans, MRIs are excellent for evaluating ligaments and tendons for injuries.
• Fluid removal
  • The knee and all bursae of the knee are filled with fluid.
  • If your symptoms suggest infection, inflammation, or certain types of arthritis, your physician may use a needle to remove fluid from the knee.
  • The removal of the fluid will sometimes decrease the pain you have been experiencing and make it possible for you to bend your knee.
  • This fluid will then be analyzed to better clarify the diagnosis and detect infection.
  • Crystals, which suggest crystalline arthritis, often can be seen under the microscope.
• Blood tests: The doctor may also elect to perform certain blood tests to evaluate for signs of infection or diseases such as rheumatoid arthritis and diabetes.
• Arthroscopy
  • The orthopedic surgeon may elect to perform arthroscopy if you have chronic knee pain.
  • This is a surgical procedure where the doctor will place a fiberoptic camera within the knee joint itself.
  • By doing so, the surgeon may be able to see small particles in the knee or to look more closely at damaged menisci or cartilage.
  • The doctor may also be able to repair damage by shaving down torn cartilage or removing particles from the knee while the camera shows the inside of your knee.

The nerves that provide sensation to the knee come from the lower back and also provide hip, leg, and ankle sensation. Pain from a deeper injury (called referred pain) can be passed along the nerve to be felt on the surface. Knee pain, therefore, can arise from the knee itself or be referred from conditions of the hip, ankle, or lower back. All of the following sources of knee pain arise from the knee joint itself.

In general, knee pain is either immediate (acute) or long-term (chronic). Acute knee pains can be caused by an acute injury or infection. Chronic knee pains are often from injuries or inflammation (such as arthritis) but can also be caused by infection.

Acute knee pain

• Fractures (broken bones)
  • Description: Fractures of any of the bones of the knee are traumatic injuries typically caused by moderate to high forces (such as car accidents or contact sports).
  • Symptoms and signs: Fractures may be accompanied by swelling or bruising but are almost always extremely painful and tender. The pain is typically so severe that people are unable to walk or even put weight on the knee.
  • Evaluation: Fractures are an emergency and should be checked by a doctor. This evaluation will generally include an X-ray and other relevant studies. A delay in evaluation can result in fracture fragments moving and associated injuries.
  • Treatment: Depending on the particular fracture, the doctor may either recommend immobilization (with a cast or splint) or surgery to repair it.
  • Prognosis: Fractures often heal with no long-term problems. Some fractures, however, are complicated by arthritis or by injuries to arteries or nerves that can be serious.
• Sprained and torn collateral ligaments
  • Description: The medial collateral ligament (MCL) is the most commonly injured ligament in the knee. Like all ligaments, this ligament may be sprained or torn. A sprained ligament may be partially ruptured. A torn ligament is completely ruptured.
  • Symptoms and signs: Severe MCL sprains or tears often produce a tearing or ripping sensation along the inner joint line of the knee. You may also notice knee instability and swelling. A force from the outer (lateral) knee to the inner (medial) knee is typically responsible for this injury in contrast to the more rarely injured LCL, which is typically a result of an inner to outer force. In general, bruises occur at the point of impact. Sprained and torn ligaments occur opposite the point of impact. Both MCL and LCL injuries are common in contact sports but can also result from twisting the knee with a planted foot such as in skiing. Injured medial and lateral collateral ligaments are typically tender at the inner and outer knee respectively.
  • Evaluation: After a history and physical examination, conservative treatment with rest, application of cold packs, and elevation of the involved extremity is often recommended. With persisting symptoms, the doctor may suggest an MRI scan or arthroscopy to further evaluate an injured ligament.
  • Treatment: For a mild sprain, early rehabilitation with compression, ice, elevation, anti-inflammatories, and pain-control medications -- along with an exercise regimen including a stationary bike and leg-strengthening exercises -- may be all you need. Such an exercise regimen should be under the supervision of a doctor or physical therapist, because certain exercises are to be avoided. In contrast to sprains, tears often require surgical repair for best results.
  • Prognosis: The long-term outlook for ligament injury depends on the severity of the injury and the recovery from any surgical repair.
• Sprained and torn cruciate ligaments
  • Description: An anterior cruciate ligament (ACL) injury is a common sports injury generally caused by a hard stop or a violent twisting of the knee. The posterior cruciate ligament (PCL) is stronger than the ACL and much less commonly torn. The PCL requires strong forces, such as those produced when the dashboard strikes the knee in a car accident, to tear. Due to these severe forces, PCL injury is often associated with other ligament and bone injuries.
  • Symptoms and signs: If you tear your ACL, you may hear a pop. You will also notice your knee give way or become unstable and feel pain. This will, almost always, be followed by marked knee swelling over the next couple of hours because the ACL bleeds briskly when torn.
  • Treatment: Surgical repair is recommended for athletes who require return to competition. Conservative treatment and knee braces may prove sufficient for those who do not demand quite so much from their knees.

• Tendon ruptures
  • Description: Both the quadriceps and patellar tendons may rupture partially or completely. Quadriceps tendon rupture typically occurs in recreational athletes older than 40 years (this is the injury President Clinton suffered while jogging), and patellar tendon rupture typically occurs in younger people who have had previous tendonitis or steroid injections to the knee.
  • Symptoms and signs: Rupture of either the quadriceps or patellar tendon causes pain (especially when trying to kick or extend the knee). Those people with complete ruptures are unable to extend the knee. The patella is also often out of place either upward (with patellar tendon rupture) or downward (with quadriceps tendon rupture). The patient can usually notice a difference in appearance when comparing his/her knees.
  • Treatment: Tendon ruptures should be evaluated urgently. Tendon ruptures generally require surgical repair. A partial rupture may be treated with splinting alone.
• Meniscal injuries
  • Description: Injuries to the meniscus are typically traumatic injuries but can also be due to overuse. Often, a piece of the meniscus will tear off and float in the knee joint.
  • Symptoms and signs: Meniscal injuries may cause the knee to lock in a particular position or either click or grind through its range of motion. Meniscal injuries may also cause the knee to give way. Swelling typically accompanies these symptoms although the swelling is much less severe than with an ACL injury.
  • Treatment: Meniscal injuries often require arthroscopic surgical repair. A locking knee or a knee that "gives" should be evaluated for arthroscopic repair.
• Knee dislocation
  • Description: Dislocation of the knee is a true limb-threatening emergency. This is also a rare injury. Dislocation of the knee is caused by a particularly powerful blow to the knee. The lower leg becomes completely displaced with relation to the upper leg. This displacement stretches and frequently tears not only the ligaments of the knee but also arteries and nerves. Untreated arterial injuries leave the lower leg without a blood supply. In this case, amputation may be required. Nerve injuries, on the other hand, may leave the lower leg viable but without strength or sensation.
  • This injury can be due to a motor vehicle accident where the patient's knee or leg hits the dashboard.
  • Symptoms and signs: Knee dislocations are severely painful and produce an obvious deformity of the knee. Many dislocations are reduced or put back into anatomic alignment spontaneously. As this occurs, many will report feeling a dull clunk.
  • Treatment: If the knee dislocation has not been put back into place (reduced), the doctor will immediately reduce the dislocation. Medical treatment, however, does not stop here. Whether a dislocation reduces by itself or is put back into place in the hospital, it requires further evaluation and care. After reduction, people with these injuries are observed in the hospital, where they usually do a number of tests to ensure that no arterial or nerve injury has occurred. If such an injury is found, it must be repaired immediately in the operating room.
• Dislocated kneecap (patella)
  • Description: A common injury caused by direct trauma or forceful straightening of the leg, such as an injury that happens when serving in volleyball or tennis. Patellar dislocation is more common in women, the obese, knock-kneed people, and in those with high-riding kneecaps.
  • Symptoms and signs: If you have this injury, you will notice the patella being out of place and may have difficulty flexing or extending your knee.
  • Treatment: The doctor will pop the patella back into place (reduce the dislocation). Even if the patella goes back into place by itself, however, it needs to be X-rayed for a fracture. After reducing the patella and ensuring the absence of a fracture, the doctors will treat these injuries by splinting the knee for three weeks to allow the soft tissues around the patella to heal followed by strengthening exercises to keep the patella in line.

• Arthritis: Arthritis of the knee is an inflammatory disorder of the knee joint that is often painful. Arthritis has many causes.
  • Osteoarthritis
    • Description: Osteoarthritis is caused by degeneration of cartilage in the knee. In its extreme form, the menisci (cartilage) will be completely eroded, and the femur will rub on the tibia, bone on bone.
    • Symptoms and signs: Osteoarthritis (OA) causes a chronically painful knee that is often more painful with activity. It can be stiff with prolonged sitting and may become enlarged from new bone formation at the edge of the degenerated cartilage.
    • Treatment: Treatment is aimed at pain control with over-the-counter pain relievers. Anti-inflammatory medications, either over the counter, or by your doctor's prescription, are also quite helpful. Knee bracing can be beneficial for more mobile patients. Injections of hyaluronic acid (viscosupplementation; Synvisc-One) can be helpful in relieving chronic pain from OA. More severe OA can be treated with narcotic pain medicines or a knee joint replacement with a synthetic joint.
  • Rheumatoid arthritis
    • Description: Rheumatoid arthritis (RA) is a disease of the whole body that affects many joints, often including the knee. People who have this disease often have family members who suffer from it as well.
    • Symptoms and signs: In addition to knee pain, rheumatoid arthritis may produce morning stiffness and pain in other joints. The knee can be warm to the touch and swollen.
    • Treatment: Treatment includes pain medications, anti-inflammatory medications, and prescription drugs. (These drugs either try to slow the progression of the disease or try to suppress the immune system or decrease inflammation.) Newer medications, called biologics, are proteins that specifically target the substances that stimulate rheumatoid inflammation. Your health care professional will need to evaluate which one of these medications is best suited for you.
    • Prognosis: It is essential that patients with rheumatoid arthritis be evaluated and treated aggressively early for best outcomes. This generally will include a thorough evaluation by a rheumatologist.
  • Crystalline arthritis (gout and pseudogout)
    • Description: These severely painful forms of arthritis are caused by crystals that form in the knee and other joints. These crystals can form as a result of defects in the absorption or metabolism of various natural substances such as uric acid (which produces gout) and calcium pyrophosphate (pseudogout).
    • Symptoms and signs: Gout and pseudogout cause a rapid-onset, markedly inflamed knee joint. The knee can be exquisitely painful, swollen, and warm with loss of range of motion.
    • Treatment: Treatment is aimed at controlling inflammation with anti-inflammatory medications and at aiding the metabolism of the various chemicals that may lead to crystal formation. Alcohol should be avoided and gout-specific dietary changes can be successful in avoiding flare-ups.
• Bursitis
  • Description: As a result of trauma, infection, or crystalline deposits, the various bursae of the knee may become inflamed.
  • Symptoms and signs: Acute or chronic trauma causes a painful and often swollen knee from the inflammation of the bursae. A particularly common bursitis is prepatellar bursitis. This type of bursitis occurs in people who work on their knees. It is often referred to as housemaid's knee or carpet layer's knee. Another type of bursitis is anserine bursitis. The anserine bursa is located about 2 inches below the knee along the medial side of the knee. Though it occurs more commonly in the overweight and in women, it also affects athletes and others. Anserine bursitis often causes pain in the region of the bursa and is often worse with bending the knee or at night with sleep.
  • Treatment: Treatment will usually include home care with PRICE therapy and NSAIDs. Severe forms, however, can be treated with periodic steroid injections to the bursae.
  • Prognosis: With optimal treatment and management, patients generally do very well.
• Infection (or infectious arthritis)
  • Description: Many organisms can infect the knee. Gonorrhea, a common sexually transmitted disease, can infect the knee, as can common organisms residing on normal skin, especially when the immune system is suppressed by underlying diseases or certain medications.
  • Symptoms and signs: Infection of the knee causes painful knee swelling. In addition, people who develop such an infection typically complain of fevers and chills. Less severe infections may not have associated fevers.
  • Treatment: New swelling and pain in the knee must be evaluated for infection based on your doctor's opinion. Treatment usually includes intensive antibiotic therapy and may include aspiration of the joint or surgical drainage of the infection.
  • Prognosis: The outlook depends on how early the appropriate antibiotic therapy is begun. Infection in a knee joint can lead to permanent cartilage damage.

• Patellofemoral syndrome and chondromalacia patella
  • Description: These two conditions represent a spectrum of disease caused by patellar mistracking.
  • Symptoms and signs: The condition typically occurs in young women and also in athletes of both sexes and elderly people. In patellofemoral syndrome, the patella rubs against the inner or outer femur rather than tracking straight down the middle. As a result, the patellofemoral joint on either the inner or outer side may become inflamed, causing pain that is worse with activity or prolonged sitting. As the condition progresses, softening and decay of the articular cartilage on the underside of the patella occurs, and the syndrome is referred to as chondromalacia patella.
  • Treatment: Home care with PRICE therapy, NSAIDs, and exercises (such as straight leg raises) that balance the muscles around the patella work for most people. Others may benefit from commercial arch supports (for the arch of the foot) or orthotic supports that correct foot mechanics and may reduce abnormal forces on the knee. Severe cases of patellofemoral syndrome or chondromalacia may be treated surgically through a variety of procedures.
• Jumper's knee
  • Description: Tendonitis (inflammation of the tendon) of the quadriceps tendon at the upper point of the patella, where it inserts, or tendonitis of the patellar tendon either at the lower point of the patella, or at the place where it inserts on the tibia (called the tibial tuberosity, about 2 inches below the knee on the front side), is termed jumper's knee. Jumper's knee is so named because it is typically seen in basketball players, volleyball players, and people doing other jumping sports.
  • Symptoms and signs: Jumper's knee causes localized pain that is worse with activity. It usually hurts more as you jump up than when you land because jumping puts more stress on tendons of the knee.
  • Treatment: Home therapy with the PRICE regimen together with anti-inflammatory drugs is the basis of treatment. Particularly important are rest, ice, and NSAID drugs, which will help stop the pain and break the cycle of inflammation. After controlling the pain, you should slowly start an exercise regimen to strengthen the quadriceps and hamstring muscles and resume your sport of choice a few weeks down the line.
• Osgood-Schlatter disease
  • Description: Osgood-Schlatter disease occurs most commonly in adolescents participating in sports where repetitive extension of the knee causes inflammation and injury of the tibial tubercle (of the bone itself). It can occur in nonathletes as well and is usually linked to growth spurts during puberty.
  • Symptoms and signs: Children suffering from this syndrome report pain at the tibial tubercle (the tibial tubercle is the protuberant knob on the front of the tibia, a couple of inches below the knee, where the patellar tendon attaches). This pain is typically worse when extending the leg. The tibial tubercle is tender to touch and over time begins to protrude more because the chronic inflammation stimulates the bone to grow.
  • Treatment: Osgood-Schlatter disease is a self-limited condition that usually resolves as the bone stops growing with the end of adolescence (at about 17 years of age in males and 15 years of age in females). Treatment includes PRICE and NSAID therapy. In severe cases, splinting the knee for a few weeks may help reduce the pain and halt the inflammation cycle.
• Iliotibial band syndrome
  • Description: A fibrous ligament, called the iliotibial band, extends from the outside of the pelvic bone to the outside of the tibia. When this band is tight, it may rub against the bottom outer portion of the femur (the lateral femoral epicondyle).
  • Symptoms and signs: Distance runners typically suffer from this condition. These runners complain of outside knee pain usually at the lateral femoral epicondyle. Early on, the pain will typically come on 10-15 minutes into a run and improve with rest.
  • Treatment: The most important aspect of treating iliotibial band syndrome is to stretch the iliotibial band. One way to do this is to place the right leg behind the left while standing with your left side about 2-3 feet from a wall. Then, lean toward your left for 20-30 seconds using the wall to help you support yourself. In addition to stretching the iliotibial band, PRICE therapy and NSAIDs may be of some help.

The major complication of knee pain is inadequate mobility and ability to walk. Long-term knee pain that is caused by diseases of the knee joint can lead to permanent damage to the knee and loss of function.

Knee pain has a host of causes. Many types of pain are difficult to prevent, but you can do some general things to reduce the likelihood of sustaining a knee injury.

• Stay slim
  • Staying slim reduces the forces placed on the knee during both athletics and everyday walking and, according to some medical research, may reduce osteoarthritis.
  • Keeping your weight down may also reduce the number of ligament and tendon injuries for similar reasons.
• Keep limber, keep fit
  • Many knee problems are due to tight or imbalanced musculature. Stretching and strengthening, therefore, also help to prevent knee pain.
  • Stretching keeps your knee from being too tight and aids in preventing both patellofemoral syndrome and iliotibial band syndrome.
  • Strengthening exercises particularly of the quadriceps (straight leg raises and leg extensions are two excellent exercises, but please see a book on exercise and training for more) can help prevent knee injury.
• Exercise wisely
  • If you have chronic knee pain, consider swimming or water exercises.
  • In water, the force of buoyancy supports some of our weight so our knees do not have to.
  • If you don't have access to a pool or do not enjoy water activities, at least try to limit hard pounding and twisting activities such as basketball, tennis, or jogging.
  • You may find that your aching knees will act up if you play basketball or tennis every day but will not if you limit your pounding sports to twice a week.
  • Whatever you do, respect and listen to your body. If it hurts, change what you are doing.
  • If you are fatigued, consider stopping; many injuries occur when people are tired.
• Protect the knee
  • Wearing proper protection for the activity at hand can help avoid knee injuries.
  • When playing volleyball or when laying carpet, protecting your knees may include knee pads.
  • When driving, knee protection may include wearing a seat belt to avoid the knee-versus-dashboard injuries as well as injuries to other parts of your body.