RETIREMENT & LIFESTYLE PLANNING      Baby boomers need to plan their transition into retirement for  Financial Security     Active Health Management  Emotional Wellbeing  Maximum Self Esteem ISSUE - 22 - Autumn 2005/2006

A pain in the...knee

Physiotherapist Jane Banting explains the pains that can affect the older knee, and how to manage them.

As we move into our 40s and 50s, many of us find ‘the knees have had it' and we are experiencing pain, a sensation of giving way, clicking or swelling. This is not only uncomfortable, it can affect our ability to exercise and keep fit.

What causes knee pain?

Knee pain is commonly musculoskeletal in origin, coming from either the joint between the tibia/fibula (shin) and
the femur (thigh) or the joint between
the patella (kneecap) and the underlying femur.

The main causes of knee pain in the 40 plus age group are:

•  trauma (a fall directly onto the knee), causing pain at the front or on each side of the knee due either to inflammation between the patella and femur or damage to the knee ligaments
•  degenerative changes in the joints due to age-related wear and tear or previous trauma, causing a deep aching in the knee joint
•  repetitive loading in sport (such as cycling, hiking, netball or squash), causing inflammation between the patella and femur.

Risk factors

Factors that predispose us to suffering knee pain are:

•  abnormal biomechanics of the leg or foot that interfere with proper alignment of the knee joint
•  tightness in the lateral muscles of thigh, including the ilio-tibial band and vastus lateralis (part of the quadriceps muscle)
•  weakness in the medial muscles of the thigh, particularly the vastus medialis obliquus (part of the quadriceps muscle)
•  sports training, particularly involving repetitive strain on the knee when squatting, lunging, walking downhill or cycling
•  age-related factors, including :
•  a past history of knee surgery resulting in longstanding weakness of the quadriceps muscles
•  a reduction in muscle power causing quadriceps muscle weakness
•  a reduction in body speed, which can adversely affect sports techniques by altering the timing of activities.

Reducing the risks

To help reduce the risk of suffering knee pain:

•  warm-up thoroughly prior to exercise
•  maintain good fitness with a regular exercise plan that includes
•  weightbearing exercise (e.g. walking, cycling)
•  strengthening exercises (particularly for the quadriceps muscle)
•  flexibility exercises (ilio-tibial band, calf and hamstring stretches).

When to seek help

Seek help from a health practitioner if pain and weakness prevent you from regular walking, or you have the sensation of the knee giving way, which increases your risk of falls.

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More

To brush up on knee anatomy, visit a website like
www.aclsolutions.com/anatomy.php

Exercises

These exercises are important to maintain full extension of the knee joint and improve the strength of the quadriceps muscle. Repeat each 10 times on both knees, twice a day.

Knee over fulcrum

Sit on a flat surface (e.g. your bed or the floor) with your legs stretched out, supporting yourself in sitting as illustrated. Wrap a towel around a glass bottle and position it underneath the knee. Straighten knee, raising heel off ground, hold for 5 seconds.

Lunge in standing

Stand in a walking posture, with one leg in front of the other. Lean forwards onto the front leg, keeping the middle of the kneecap in line with crease between big toe and second toe. Hold for 5 seconds.

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