the human knee may be one of nature's most spectacular engineering feats, but that doesn't mean the gizmo always works well. It fact, it happens that this joint is one of the body's more sensitive mechanisms, easily injured and not readily repaired.Knee injuries come in two main varieties: cartilage wear and ligament tears. Cartilage keeps the bones sliding across each other smoothly in a joint. It can be worn down by trauma, overuse or misalignment in the knee. Dull pain around or below the kneecap that gets worse going up or down stairs or when you're bearing weight as the knee straightens is a warning sign.
Ligament sprains and tears usually follow a blow to the knee, a poorly landed jump or a strong body twist while the foot is firmly planted. You'll know if you've got this problem from the swelling, pain and loss of mobility. Use RICE (rest, ice, compression and elevation) for ligament injury. It's always a good idea to see a pro ASAP for any kind of knee pain to prevent a possible downward slide to surgery.
Protecting your knees is a matter of alignment,conditioningandgood nutrition and hydration. Bone misalignments and muscle tension in the feet, hips or lower back stress your knees. A chiropractor or osteopath can tell you if you're at risk. Wearing the right shoesfor sport encourages good alignment; high heels are hazardous. Make sure the muscles all around your knees are of roughly equal strength. And get enough waterand essential fatty acids to keep your knees well lubricated.
WHAT THE EXPERTS SAY
"A lot of knee injuries are caused by muscular imbalance. Typically, the hamstrings at the back of the thigh tend to be tight. The quadriceps, the muscles at the front, tend to be weak. People sit too much and don't do a lot of quad extending. Make sure you don't lock your knees back when standing. To strengthen the quadriceps, put your back to a wall, your feet about a foot or a foot and a half away and, making sure your legs stay parallel, slide down the wall to a quarter squat. Make sure your knees don't fall inward or splay out. To strengthen the inner quadriceps,put a play ball or folded-over pillow between your knees and give it a little squeeze."
KATHLEEN SHORTT, physiotherapist, clinic director, Physiotherapy on Bay
"Glucosamine sulphate provides the ground substance for synovial fluid, the liquid in the joint between the bones. For people doing a lot or with a history of knee injury, it's probably worth taking 1,500 milligrams a day. It's really safe. (A new study indicates that) long-term use helps prevent loss of joint space. Traumeel is a topical or internal combination homeopathic remedy for injuries. I've seen it work well when ligaments are involved. I prescribe it internally when the injury is more serious. Try turmeric and bromelain as an anti-inflammatory, but get professional advice since turmeric affects liver function. Sometimes we're more prone to knee injury when there are emotional issues around fear of moving forward."
JEN GREEN, naturopathic doctor, dancer
"People tend to carry on (when injured). Sometimes a little common sense - resting and icing it - can have a dramatic effect. Try to get ice on as soon as possible and continue for 24 to 48 hours. Most injuries happen later in a game - you're tired and go over on an ankle or a knee. If you were in shape, that wouldn't happen. Make sure you stretch properly after exercise. Stretching before hasn't been proven to be that (effective), but stretching after assures that you don't tighten up and become restricted."
DEAN WRIGHT, chiropractor
"The knees are built to support the load they have. Look at how hard you jam into the knee. If you stomp into the ground when you're walking or slouch forward so you're putting more weight on the front of your knees because your chest is collapsed or do violent stretches, those things exasperate injury. Don"t overextend stretches. Going gently so you never go into the red zone of pain will minimize injury."
BOAZ FREEMAN, Alexander Technique teacher
"Any sport where you have to change direction very quickly is tough on the knee joint, as is jogging on a very hard surface. Sometimes when you run on a track with a slight tilt on it, it's important to run the other way to even things out. To prevent knee injuries, strengthen the muscles around the knee. (One exercise for strengthening the typically weaker muscles on the inside of the leg is to) stand up, make sure your legs are hip-distance apart and place something between your legs so you feel you're squeezing them together, then straighten."
MOIRA MERRITHEW, executive director of education, Stott Pilates
"Women are more prone to knee injuries - it may be hormonal - just prior to and during menstruation. The important thing is to approach anything you're doing in a sensible, slow way. Make sure you're using the proper equipment, the proper shoes, the proper surface. Weakness in a leg from a previous injury that hasn't been rehabilitated properly may predispose people to problems."
MICHAEL CLARFIELD, MD, sports medicine physician, director, the Sports Medicine Specialists
By Sibylle Preuschat